When Doctors Are the Source of Public Health Misinformation

Medical professionals are often unaware of the relevant research on the relative risks of tobacco products, and that can matter for public health.

Most Americans understand that smoking is harmful. It remains a leading cause of preventable death in the United States. A growing number of Americans do not understand that vaping and non-combustible tobacco products are far less risky. In a recent article, Jacob James Rich and I explored why this might be.

One source of public misunderstanding could be that doctors are often unaware of the extensive research concluding that vaping, while not risk-free, is substantially less risky than smoking (such that were all smokers to switch to vaping, tens of thousands--if not millions--of premature deaths could be averted). While reports by the National Academy of Sciences and Public Health UK (among others) have concluded that vaping exposes users to significantly lower contaminant levels and is likely to be substantially less harmful than smoking, one recent study found that 60 percent of doctors believe all forms of tobacco are equally harmful.

While some medical professionals are simply unaware of what can be said about the relative risks of smoking versus vaping, others seem intent on spreading disinformation. For instance, here's a TikTok by a cardiovascular surgeon claiming that vaping "is significantly worse than cigarette smoking." This is an outrageous and unfounded claim. Worse, insofar as this message is internalized by current smokers, it could discourage them from switching to less harmful sources of nicotine.

[Note: Even if this claim is based upon experience with EVALI victims, suggesting that EVALI is a consequence of vaping generally, when EVALI has been linked to black-market THC vaping fluids containing vitamin E acetate, is still quite irresponsible. There is no documented case of EVALI that has been linked to conventional vaping products.]

It is one thing to discourage vaping, as it is not risk-free (and there is limited evidence about its long term effects). It is quite another to suggest that vaping is equal or worse than smoking. The latter is misinformation--and the sort of misinformation that could cost lives.