Latest / The Morning Edition / An Australian study linked vaping to cancer for the first time. Why all the backlash?

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An Australian study linked vaping to cancer for the first time. Why all the backlash? · The Morning Edition

• 0:03
  S1: Many of us probably have a hunch that vaping is
• 0:06
  S1: bad for our health. Questions about just how bad have
• 0:09
  S1: been around for years. So why then, has there been
• 0:13
  S1: a backlash by health researchers against a new study that
• 0:16
  S1: has now declared that the evidence is in and e-cigarettes
• 0:20
  S1: are likely to cause oral and lung cancer? I'm Samantha
• 0:24
  S1: Selinger Morris, and you're listening to Morning Edition from the
• 0:27
  S1: age and The Sydney Morning Herald today, science reporter Angus
• 0:31
  S1: Dalton on the main warnings contained in this Australian study.
• 0:35
  S1: It's April the 6th. Welcome back Angus.
• 0:39
  S2: Thank you. Sam.
• 0:40
  S1: Well, Angus, we've known for a while that vaping isn't
• 0:43
  S1: good for us. Right. But we've now got a first
• 0:45
  S1: of its kind scientific review into vaping use. It's just
• 0:49
  S1: been published. So what does the study tell us now
• 0:51
  S1: that we didn't know before?
• 0:53
  S2: Yeah. So this study is really interesting. I mean, first off,
• 0:56
  S2: you might hear the news that scientists have said that
• 0:59
  S2: vaping causes cancer. And I've had a lot of comments
• 1:02
  S2: like water is wet. Fork found in kitchen. You know
• 1:06
  S2: what I mean? Like duh. Sucking on this blueberry flavored
• 1:10
  S2: battery is probably bad for you, right? But what we're
• 1:14
  S2: dealing with here is the fact that vapes are relatively new.
• 1:17
  S2: You know, they only started to be sold in, I think,
• 1:20
  S2: 2003 at first, but widely. I think most people would
• 1:24
  S2: sort of agree that they've really taken off over the
• 1:27
  S2: last five years. And even if you go back like
• 1:31
  S2: 15 years ago, they were around in Australia, but certainly
• 1:34
  S2: not at the levels that we're seeing at the moment. Um,
• 1:37
  S2: and what this study has done, it doesn't actually bring
• 1:40
  S2: any new knowledge per se to the table. But what
• 1:43
  S2: these public health experts have done is trawl through the
• 1:47
  S2: existing research, of which there's a lot. And it looks
• 1:51
  S2: like testing the effect of vape aerosol on animals such
• 1:55
  S2: as lab rats. We're looking at what chemicals in vapes
• 2:00
  S2: can do to lung and mouth tissue in a dish
• 2:04
  S2: and seeing what happens on a cellular level. We're looking
• 2:07
  S2: at analyses of, you know, things that are present in
• 2:10
  S2: vapes and taken all together. Kind of what the headline
• 2:14
  S2: was the other day is that it is the first
• 2:16
  S2: time that a guest scientists have published an article and
• 2:20
  S2: said vaping probably causes cancer, specifically lung and oral cancer.
• 2:27
  S2: So this study, it's kind of a review of the reviews, right?
• 2:30
  S2: It's reviewing the existing evidence and and kind of making
• 2:33
  S2: a new claim. Um, it doesn't prove a link. We
• 2:36
  S2: won't have a definitive link between vaping and cancer for
• 2:39
  S2: a very long time. And honestly, even the statement that
• 2:42
  S2: these scientists have made about the link between vaping and
• 2:45
  S2: cancer has already attracted some pretty fierce criticisms. So there's
• 2:48
  S2: lots to get into.
• 2:49
  S1: Yeah, no, we're definitely going to get into that. But
• 2:51
  S1: is the main takeaway from this particular review that, you know,
• 2:55
  S1: many people have been thinking that vaping, okay, it might
• 2:58
  S1: not be great for your health, but it's a less
• 3:00
  S1: dangerous alternative to smoking, you know, less dangerous than sort
• 3:04
  S1: of maybe even illicit drugs. But does this sort of
• 3:07
  S1: basically saying, yeah, not so fast. That's folly.
• 3:10
  S2: That's what the authors have argued. They've said that their
• 3:13
  S2: results or their review sort of contradicts this idea that
• 3:17
  S2: vaping is generally safer than smoking. When vapes first came
• 3:22
  S2: onto the scene, you know, say a decade ago, they
• 3:26
  S2: were very much promoted as a safe alternative to smoking.
• 3:29
  S2: We know that in Australia you can go and get
• 3:32
  S2: a vape legally through a pharmacy as a smoking cessation device.
• 3:36
  S2: I'll say at the outset that for people who are
• 3:38
  S2: trying to quit smoking and and vaping through a pharmacy
• 3:41
  S2: to get off smoking, they should absolutely keep doing that. Um,
• 3:45
  S2: I guess the unanswered question is, you know, we have
• 3:49
  S2: so much, you know, hundreds, literally more than a hundred
• 3:52
  S2: years of research on cigarettes and how bad they are
• 3:55
  S2: for you. We know they are absolutely shocking for your health.
• 3:58
  S2: Two out of every three people who continue smoking cigarettes
• 4:01
  S2: will die from smoking cigarettes. So we cannot say yet
• 4:06
  S2: that vaping is worse than that. There's a lot of
• 4:09
  S2: evidence that generally vapes have a lot less of these
• 4:13
  S2: carcinogens in smoking and that sort of thing. What I
• 4:16
  S2: think maybe the authors are trying to do here is
• 4:17
  S2: kind of correct the record and correct. Maybe this idea
• 4:20
  S2: that has been backed by the tobacco industry, by the way,
• 4:23
  S2: that vaping is a lot safer than smoking. They just
• 4:26
  S2: want to dislodge or challenge that idea, which is very
• 4:28
  S2: much moved from in about 2017, the language was very
• 4:33
  S2: much we still don't really know. Like we're a bit
• 4:36
  S2: concerned about the chemicals we're finding in vapes and the
• 4:39
  S2: knock on effect to human health, particularly because so many
• 4:42
  S2: young people use these products. Oh, we're not really sure
• 4:45
  S2: what the researchers say they've identified is a real hardening
• 4:49
  S2: of that language, from questioning to more and more and
• 4:53
  S2: more concrete concern that the signals that they're seeing in
• 4:57
  S2: their animal studies and other experiments are showing that vapes
• 5:03
  S2: probably are linked to cancer.
• 5:05
  S1: Okay. And can you tell us a little bit about
• 5:07
  S1: the effects that vaping has on the body and just
• 5:10
  S1: how harmful it is. And does the study tell us
• 5:13
  S1: anything that we didn't previously know on this count, or
• 5:15
  S1: are there perhaps just harms that it does to us
• 5:18
  S1: that have sort of fallen through the cracks, that perhaps
• 5:20
  S1: they just want to highlight to us like, hey, hey.
• 5:22
  S2: Yeah. So what they're really highlighting is that chemicals that
• 5:26
  S2: we know pass into the body from vapes include carcinogenic
• 5:31
  S2: derivatives from nicotine, which do trigger and encourage tumors. There's
• 5:36
  S2: also toxic chemicals and in particular metals such as nickel
• 5:40
  S2: that we know get into the body from, especially in
• 5:45
  S2: vapes where the coil sort of heats up and releases
• 5:48
  S2: metals into the body. Obviously, they are toxic. There's other
• 5:52
  S2: other substances like volatile organic compounds and also cytotoxic flavoring
• 5:57
  S2: agents that vary really wildly between the different flavor profiles.
• 6:01
  S2: So particularly with these unregulated disposable vapes that are still
• 6:05
  S2: being sold illegally in Australia, you just really never know
• 6:08
  S2: what you're consuming. Um, Consuming. But, you know, certainly there's
• 6:11
  S2: been other really nasty chemicals such as formaldehyde and antifreeze
• 6:14
  S2: found in these vapes. So one of the lead authors
• 6:18
  S2: said that the studies that he reviewed had shown that
• 6:21
  S2: these chemicals inflict things like oxidative stress, inflammation and genomic
• 6:26
  S2: damage within tissues, which are known for runners to cancer,
• 6:30
  S2: and that experiments into vape aerosols have unequivocally showed DNA
• 6:34
  S2: damage and long term changes in oral and lung tissues
• 6:37
  S2: that are probably indicative of cancer development. So yeah, there's
• 6:41
  S2: nothing new there. But he is sort of like referring
• 6:44
  S2: to to all of these bringing together all of these
• 6:46
  S2: different experiments, which seem to point very strongly towards a
• 6:50
  S2: cancer link.
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  S1: Holy moly. Okay. And so, and let's talk about one
• 6:53
  S1: of the most alarming quotes that really stood out in
• 6:55
  S1: your piece. This was from Professor Bernard Stewart. He's the
• 6:59
  S1: review's lead author at the University of New South Wales.
• 7:02
  S1: And he said that sort of pitting vaping against smoking
• 7:06
  S1: was like trying to study the safety of knives by
• 7:08
  S1: comparing them to machine guns. So how was vaping ever
• 7:13
  S1: originally marketed as a safer alternative to smoking, right?
• 7:17
  S2: Yeah. Well, that's sort of what he said. I mean,
• 7:19
  S2: I asked him basically if that study design, which we see,
• 7:22
  S2: which is like, you know, the vast majority of these
• 7:24
  S2: studies study the health effects of vaping and compare them
• 7:27
  S2: to people who smoke. And he is frustrated by that
• 7:31
  S2: because he thinks it means that is kind of, I guess,
• 7:36
  S2: hid behind this claim for so long because, you know,
• 7:39
  S2: in a lot of these studies, you do compare vaping
• 7:41
  S2: and smokers and the smokers do have worse outcomes, you know,
• 7:44
  S2: so but that doesn't mean that the vapes themselves are safe.
• 7:46
  S2: And that's where the machine guns and the knife metaphor
• 7:49
  S2: comes in, right? Like if you're doing a study into
• 7:51
  S2: whether it's safe for a child to run around with
• 7:54
  S2: a knife in the garden, you don't give it a
• 7:56
  S2: machine gun and do the same experiment and see which
• 7:58
  S2: one has the better outcome. You know what I mean?
• 8:00
  S2: So let's not. So we certainly need far more studies
• 8:03
  S2: and far more evidence into vaping as a health risk
• 8:07
  S2: in its own right, that's for sure.
• 8:13
  S1: After the break.
• 8:14
  S2: The case is that there is a growing number of
• 8:17
  S2: young people who have only vaped, who have only picked
• 8:20
  S2: up vapes and have never smoked. So it's very directly
• 8:23
  S2: relevant to that population that just because it might be
• 8:28
  S2: less bad than smoking, it does not mean that it's
• 8:30
  S2: a safe thing to do.
• 8:36
  S1: Okay, so I think you might have said before, but
• 8:38
  S1: the importation of vapes has been illegal since the beginning
• 8:41
  S1: of 2024. So why did another professor that you spoke
• 8:45
  S1: to say it was going to be a, quote, nightmare
• 8:47
  S1: to research vaping more broadly and its associated health risks?
• 8:52
  S2: Yeah. So this was a guy called Distinguished Professor Brian Oliver.
• 8:56
  S2: He's a nicotine researcher at the University of Technology Sydney,
• 8:59
  S2: who has studied the effect of vape smoke on rodents.
• 9:03
  S2: So I thought he'd be a good person to speak to.
• 9:04
  S2: He wasn't involved in this study. And he basically said that,
• 9:08
  S2: you know, this is a very early call and it
• 9:11
  S2: is controversial. And a lot of scientists, particularly overseas, have
• 9:15
  S2: very much criticized it as saying that what these scientists
• 9:19
  S2: are saying is not backed up by the evidence yet, basically,
• 9:25
  S2: and that we're going to need that longer term, epidemiological,
• 9:31
  S2: definitive studies to be able to actually say really, really
• 9:35
  S2: confidently that there is a link between vaping and cancer.
• 9:38
  S2: The issue is that it's going to be in his
• 9:41
  S2: quote marks, as you said, Sam, a nightmare to get
• 9:44
  S2: there because not only do we have to wait for decades,
• 9:46
  S2: but also vaping, at least in Australian context, is really unregulated.
• 9:51
  S2: Like I'm not talking about the people going to a
• 9:53
  S2: pharmacy and getting a vape legally as a smoking cessation device.
• 9:56
  S2: That's sort of a different issue. But anyone could tell
• 10:00
  S2: you that the vast majority of people vaping are using
• 10:04
  S2: these illegal disposable vapes, like the gold Alibaba's that you
• 10:08
  S2: see all of the other colourful ones. There's 100 different designs,
• 10:12
  S2: there's literally thousands of different flavors, from blueberry bliss to
• 10:17
  S2: English marmalade to, you know. One day my housemate brought
• 10:20
  S2: home like a like a milk bubble tea boba tea
• 10:23
  S2: flavored vape. It was revolting. Um, and all of these
• 10:27
  S2: different vapes have completely different chemical makeup. So to be
• 10:30
  S2: able to have a standardised study where you're looking at
• 10:33
  S2: a group of people who are frequently vaping and comparing
• 10:37
  S2: that to, say, another group of people who have never
• 10:39
  S2: touched a vape in their life, that's going to be
• 10:41
  S2: really difficult because in that group of people who have
• 10:44
  S2: been vaping, they are just exposing themselves to such different
• 10:46
  S2: devices on a week to week basis, which might have
• 10:49
  S2: completely different heavy metals going into their body, completely different carcinogens,
• 10:54
  S2: completely different flavors. And the other thing is, is that
• 10:57
  S2: I spoke to an Australian vape researcher last year who
• 11:00
  S2: said that even in the short time period that she's
• 11:03
  S2: been studying these vapes, say over the last 3 or
• 11:05
  S2: 4 years, the chemical makeup of them, even in the
• 11:08
  S2: same kind of design or type of model, has changed massively.
• 11:12
  S2: For example, the nicotine content in some of them has
• 11:15
  S2: been ramped up by about 40% in about a year.
• 11:19
  S2: And because nicotine really scorches the the throat when you
• 11:23
  S2: hit it through a vape. To pack in more nicotine,
• 11:27
  S2: the manufacturers will put in more. More and more nasty chemicals,
• 11:31
  S2: basically to try and disguise that burning nicotine feeling. So
• 11:35
  S2: not only is there more nicotine, there's more potentially more
• 11:38
  S2: of these chemicals that we do not want in our body.
• 11:40
  S2: So that variability is just one of the massive issues
• 11:44
  S2: we have in terms of getting definitive evidence between vapes
• 11:49
  S2: and bad health effects.
• 11:51
  S1: Okay. And you just raised there that there's been a
• 11:53
  S1: bit of a backlash against this study. And before we
• 11:56
  S1: started recording, you mentioned that a lot of this backlash
• 11:58
  S1: has come from the UK. So is that what their
• 12:01
  S1: backlash is? Essentially, the evidence just doesn't support this claim
• 12:04
  S1: or is it something else?
• 12:06
  S2: Yeah. I mean, that's essentially what a lot of researchers
• 12:09
  S2: in this space are doing. I mean, the the authors
• 12:11
  S2: of the Unsw led study knew it was going to
• 12:13
  S2: be controversial, but essentially a lot of their peers in
• 12:17
  S2: the UK in particular, have come out saying that the
• 12:20
  S2: claim is misleading. Essentially, just because we don't have that
• 12:25
  S2: high level human evidence yet. There was some criticism in
• 12:29
  S2: terms of how they had compiled the studies, and I
• 12:33
  S2: guess the lack of analysis that they'd maybe done on
• 12:35
  S2: the study, they sort of just brought them together and
• 12:37
  S2: then made this conclusion. Um, but at least in some
• 12:41
  S2: of these UK scientists view, they hadn't done any analysis.
• 12:44
  S2: They didn't, for example, and they were very upfront about this.
• 12:46
  S2: They didn't actually identify how much vaping was likely to
• 12:51
  S2: increase your risk of lung and oral cancer. They were
• 12:54
  S2: just interested in saying, can we say with a reasonable
• 12:58
  S2: amount of confidence that vaping is likely to cause lung
• 13:02
  S2: and oral cancer? They've obviously said yes, but other scientists
• 13:05
  S2: have criticised them, saying that, you know, the fact that
• 13:07
  S2: they can't necessarily put a figure on this just shows
• 13:11
  S2: that it is a little bit of a shallow analysis.
• 13:14
  S2: There was one professor from the University College London, Professor
• 13:18
  S2: Leon Shehab. He said. While it is clear that e-cigarettes
• 13:21
  S2: expose users to harmful chemicals which may lead to later disease,
• 13:24
  S2: I would urge against sensationalization of evidence. No one would
• 13:28
  S2: argue that e-cigarettes are entirely risk free. They should be
• 13:31
  S2: used as a harm reduction product to help those who
• 13:33
  S2: smoke to quit and reduce their risk of developing smoking
• 13:36
  S2: related diseases. They should not be used by someone who
• 13:38
  S2: has never smoked. However, this review does not offer a
• 13:41
  S2: smoking gun that e-cigarettes cause oral or lung cancer, nor
• 13:46
  S2: does it make an attempt at quantifying this risk, which
• 13:49
  S2: is unsurprising because the evidence is simply not there to
• 13:51
  S2: allow for such an estimation. There are a couple of
• 13:54
  S2: things to say there. One is that Australia and the
• 13:56
  S2: UK have very different, I guess, public health approaches to vaping.
• 14:00
  S2: The UK is a lot more in favour of this
• 14:02
  S2: harm reduction model, where they really encourage smokers to get
• 14:05
  S2: off vaping. So a lot of people would see this
• 14:07
  S2: study and be very concerned that people accessing vapes to
• 14:10
  S2: get off smoking are going to stop doing that, which
• 14:12
  S2: they absolutely shouldn't because as far as we know, and
• 14:15
  S2: I'll say it again, smoking is probably worse than vaping.
• 14:19
  S1: Um, so is that why? Because I'm so interested in.
• 14:21
  S1: And you made that point that, you know, definitely if
• 14:24
  S1: you're using vaping to get off smoking, don't stop that
• 14:28
  S1: because we know smoking's definitely worse. Is that it? So
• 14:31
  S1: the fear is that if people stop vaping, which they've
• 14:33
  S1: been using to stop smoking, if they stop vaping, they'll
• 14:36
  S1: go back to smoking, which we know is worse.
• 14:38
  S2: Totally, totally. That's the thing. But the case is that
• 14:41
  S2: there is a growing number of young people who have
• 14:46
  S2: only vaped, who have only picked up vapes and have
• 14:48
  S2: never smoked. So it's very directly relevant to that population. Um, that,
• 14:53
  S2: you know, just because it might be less bad than smoking,
• 14:58
  S2: it does not mean that it's a safe thing to do.
• 15:00
  S1: Right. Okay. And just to wrap up, Angus, you've spoken
• 15:04
  S1: to a public health expert in Sydney who really kind
• 15:07
  S1: of reflects this, right? She's saying that, yeah. Long term
• 15:10
  S1: smokers using vapes through a pharmacy to quit cigarettes should
• 15:14
  S1: continue doing so. So it's sort of like she's kind
• 15:16
  S1: of going against the Sydney study, I guess a bit.
• 15:19
  S2: A little bit. I mean, she she thought the study
• 15:20
  S2: was really interesting. This is Professor Becky Freeman from the
• 15:23
  S2: University of Sydney School of Public Health. Um, but yeah,
• 15:26
  S2: she did very much want to walk this line between
• 15:28
  S2: saying that yes, we should heed these early warnings, um,
• 15:32
  S2: in terms of vapes and cancer risk, but at the
• 15:35
  S2: same time, we do not want to scare people off. Uh,
• 15:38
  S2: going back to smoking, if they're using vaping as a
• 15:40
  S2: smoking cessation thing. And the one other thing that I'll
• 15:43
  S2: say just very quickly is that this study really gets
• 15:45
  S2: to this issue, that there is a latency period of
• 15:49
  S2: about 10 to 30 years, sometimes between exposure to a
• 15:52
  S2: carcinogen and that cancer manifesting. So we may not get
• 15:55
  S2: this definitive answer for decades and decades and decades. And
• 15:59
  S2: there's this example where it actually took 100 years between
• 16:02
  S2: the first study to be published, finding a link between
• 16:05
  S2: cigarettes and ill health, and for the scientific community at
• 16:09
  S2: large to accept that smoking causes cancer. 100 years for smoking, right?
• 16:13
  S2: We don't want to wait that long. It probably wouldn't
• 16:15
  S2: take that long again this time, but it would take
• 16:17
  S2: at least a couple more decades. So I think we're
• 16:20
  S2: just starting to enter a new era of scientific debate,
• 16:23
  S2: where some scientists will be really, really keen to start
• 16:26
  S2: making these really definitive claims for the purpose of public health,
• 16:29
  S2: whereas others are really going to try and urge caution,
• 16:32
  S2: and there'll be a lot more to emerge in this space.
• 16:35
  S1: Wow. Well, it's so important that we are talking about
• 16:37
  S1: it now, because we're not going to be around in
• 16:39
  S1: 100 years. Angus.
• 16:40
  S2: No. We're not. Hopefully. I mean.
• 16:42
  S1: Yeah.
• 16:42
  S2: Maybe.
• 16:43
  S1: Yeah.
• 16:44
  S2: Now that I've stopped vaping, I could be.
• 16:46
  S3: Exactly. Well, we're so lucky.
• 16:49
  S1: Reporting in this space. Thanks, Angus.
• 16:51
  S2: Thanks for having me, Sam.
• 17:00
  S1: Today's episode was produced by Josh towers. Our executive producer
• 17:04
  S1: is Tami Mills, and our podcasts are overseen by Lisa
• 17:08
  S1: Muxworthy and Tom McKendrick. If you like our show, follow
• 17:12
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