Dr. Glantz is simply wrong. There is abundant evidence which demonstrates that while vaping does cause some degree of respiratory irritation (and probably triggers a bit of inflammation), it is far safer than smoking and has far less of an effect on lung function.

The problem is that the smokers who used e-cigarettes were likely more heavily addicted and more resistant to quitting. The reason they tried e-cigarettes was probably related to their failure to quit smoking using other types of therapy, such as NRT or other drugs. E-cigarettes, after all, are not generally the first smoking cessation approach that a smoker will try.

Third, the Surgeon General's report comes across as a project of massive hypocrisy, as the report itself complains about how tobacco-funded scientists failed to disclose their conflicts of interest. The report emphasizes that in the 50 years since the release of the report, disclosure of financial conflicts has become the "norm." It bemoans the fact that in the past, tobacco-funded scientists did not disclose their conflicts of interest, which left readers unaware of these important financial relationships.

In fact, in a by Flouris et al., the investigators found that real cigarettes, but not the fake ones, had a significant detrimental effect on pulmonary function, measured by spirometry. This study documents that while active smoking has immediate, clinically meaningful effects in reducing lung function, electronic cigarettes do not.

"The government has an obligation to carefully scrutinize any new consumer product that is presented as an alternative to smoking. But government agencies and public health officials have no business discouraging or disparaging e-cigarettes in the absence of any data that they are causing harm. This is especially the case when these products have so much potential to curb cigarette smoking, the public health scourge that still claims half a million lives a year."

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