Authors
Published
February 26, 2025
Background
On the 26th of February 2025, Clive Bates wrote to an academic at Manchester Metropolitan University, Dr Maxime Boidin, about generating irresponsible publicity based on false interpretations of unpublished data. This letter relates to vaping and nicotine products, you can learn more about the harms of these products and smokable tobacco here.
The letter is reproduced below.
Letter
Dear Dr Boidin,
Re: Irresponsible publicity related to an unpublished vaping study
I write to request that you stop the irresponsible promotion of your incomplete vaping study and follow a credible scientific process for releasing its findings. The study has received considerable publicity. For example, the following:
Vaping horror as first ever study reveals deadly side effects – heart disease, organ failure, dementia (Mirror, 23 Feb)
Vaping horror as first ever study reveals deadly side effects (Manchester Evening News, 23 Feb)
Vaping ‘more dangerous than smoking’, bombshell first-of-its-kind study reveals – it raises risk of THREE deadly diseases (Mail, 24 Feb)
I am a long-standing public health advocate and analyst, and have been engaged in the tobacco science and policy field since 1997. I was previously the Director of Action on Smoking and Health (UK) and a senior civil servant. Now I run my own consultancy. I am disturbed by what you are doing with this study.
Here are some things for you to consider:
You have not published the study, and from the reporting, it seems you have not even completed it. There is no published paper, pre-print, protocol, trial registration, or even conference abstract. There is no information on the participants, how they were selected and their smoking history. Nor have you disclosed competing interests or funding information. Yet, you are making alarming statements to the media about the findings of a study no one else has seen. It is unethical and unacceptable to conduct science in this way.
You are making statements to the media that are claiming an equivalence in risk between smoking and vaping or even suggesting that vaping may be worse. “What we have found is the dangers for someone who keeps vaping are no different from smokers.” There is no basis for you to make this claim and a large body of evidence that shows that this claim is false. Extraordinary claims demand extraordinary evidence, but you have not provided any evidence, let alone enough evidence, to support this claim.
From the newspaper descriptions of your methods, one can speculate that you have been measuring the acute cardiovascular effects of nicotine use and nicotine withdrawal. Nicotine is a well-known stimulant with a well-known effect of arterial stiffening. You have drawn conclusions from measurements in fairly unusual experimental conditions (acute nicotine withdrawal and temporary fasting). This effect is common to many forms of stimulation, and it is not directly linked to long-term cardiovascular outcomes. This same story (the “discovery” of acute arterial stiffening in e-cigarette users) has been written before (e.g E-cigarettes are as bad for you as SMOKING, a new study has claimed (in The Mirror). You can read my review of such a study and the related media coverage here: When you thought public health could go no lower – it just did (2016). I do not know precisely what you have done, but that’s the point: you are evading scrutiny.
Sadly, you are not the first to find this, and you are not the first to hype the findings into generalised statements about the relative health risks of smoking and vaping. However, such potent claims cannot be made on the basis of acute responses to nicotine use. They demand consideration of long-term cardiovascular risks based on meaningful biomarkers, but your study cannot do this. It would also require estimates of cancer and respiratory disease risks, but your study does not attempt to address either. You have no basis for making claims about conditions like dementia or organ failure from measurements of Flow Mediated Dilation (FMD). I assume you have seen this recent paper:
Storck, M., Kröger, K., & Rammos, C. (2025). Caffeine and nicotine acutely inhibits flow-mediated vasodilation, but not both are necessarily harmful in the long term. VASA. Zeitschrift Fur Gefasskrankheiten. https://doi.org/10.1024/0301-1526/a001167
“acute FMD effects cannot always be equated with long-term damaging effects”
A further criticism has been made by the American expert, Professor Michael Siegel of Tufts University, Researchers of Severely Flawed Study Conclude that Vaping is Just as Harmful as Smoking and Causes Heart Disease and Dementia (25 Feb). Siegel highlights the problem of the residual effects of years of smoking exposure in current vapers. “Thus, this study did not show that vaping is no better than smoking. Instead, what it showed was that the respiratory function and exercise capacity of ex-smokers takes a while to return to normal.” He concludes: “If this study is eventually published — and no reputable journal would do so — it will be too late to reverse these headlines.”
You might object to the points raised above, and they are based on indirect understanding of your work through accounts in tabloid newspapers. That is why there is a process for scientific publishing and post-publication scrutiny: authors can address criticisms or accept the limitations of their work, and make appropriately qualified comments about their findings. Journals can decide whether the work merits publication and assess the significance or otherwise of the findings.
Your specialism is in sports science, a respectable discipline. However, you have little experience in the smoking and vaping field. You have not explained why meticulous, credible assessments that find that vaping poses only a small fraction of the risks of smoking are somehow mistaken. These include assessments by the government’s Office of Health Improvement and Disparities (Nicotine Vaping in England, 2022) and the Royal College of Physicians (E-cigarettes and harm reduction: an evidence review, 2024), all involving surveys of the published literature, including the acute effects of nicotine.
It is, of course, possible for plucky outsiders to overturn a scientific consensus among complacent practising scientists in the relevant field. And we should celebrate such iconoclasts when they triumph. However, to claim the mantle of Galileo, you must first publish the science and subject your analysis to scrutiny, not just make wild claims in newspapers. To make heroic projections of vaping mortality risks relative to smoking, you should assess the full spectrum of harms caused by smoking and not just use a small sample of vapers and a few measurements, which are, at best, poor markers for longer-term cardiovascular outcomes only.
Many scientists and academics are facing pressures to secure funding and demonstrate impact, but few would resort to this. I see from your Twitter/X feed that you are proud of The Mirror coverage. You should not be. While it may help with fundraising and offer personal and institutional prestige, it is profoundly irresponsible for scientists to communicate in this way. If people are led to believe that there is no difference in risks between smoking and vaping, they will be less likely to switch from high-risk to low-risk nicotine use, more likely to relapse, and less likely to divert from smoking initiation. While you may feel some satisfaction from the publicity for your unpublished, unscrutinised work, you may be carelessly leading people towards disease and death. Six million adults still smoke in the UK, what do you think the effect of your highly publicised claims will be on them?
It is tempting to blame the media, and we should. But it is no secret that the media has increasingly debased itself in its lust for clicks and engagement and that scientists can easily manipulate credulous journalists with alarming clickbait. High-quality, sceptical scientific journalism is becoming increasingly rare. That should not be a signal for opportunists to jump at the opportunity but for scientists to raise their own standards of communication and integrity.
I would like to end more positively, but I cannot. What you have done here ranks with the worst kind of misinformation of the tobacco industry of the 1970s and will likely have the same effect – more smoking, disease, and death. I do not expect you or the university will do anything to address this lamentable situation. However, I am copying this letter to Michael Thompson, Head of Governance and the Secretariat Team, in the hope it will cause some reflection on the governance of reckless publicity-seeking by its staff.
Yours sincerely
Clive Bates