New Farsalinos vape study debunks old NEJM ‘formaldehyde myth’

New Farsalinos vape study debunks old NEJM ‘formaldehyde myth’

When the New England Journal of Medicine (NEJM) published a 2015 report claiming that e-cig vapor is laced with deadly levels of formaldehyde, vape enthusiasts immediately took notice.  The report essentially claimed that vaping was even more carcinogenic that smoking, which is simply not true.  When vaping advocate and world-class cancer specialist Dr. Konstantinos Farsalinos reviewed the NEJM study, he discovered several key problems.

Several details were missing from the publication regarding the manner in which the scientific research was conducted.  The co-authors stated that they initially tested the e-cigarette at 3.3 V, but no significant levels of formaldehyde were detected (only about 0.001 mg per every 10 puffs). They then turned up the power to 5 V, and the detected levels rose by 3.8 mg per 10 puffs.  As a result, the researchers published a report claiming that e-cig vapor is 5 to 15 times higher in formaldehyde than conventional cigarettes.   

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What was missing from the study’s details?  According to Farsalinos, the co-authors failed to mention the type of atomizer and the resistance of the coil used in the testing procedures.  Only after a reporter emailed the NEJM team was it discovered that the coil being used was a CE4 – a top-coil cartomizer with a terrible reputation and which was already obsolete.

Meanwhile, the coil resistance was set to 2.1 ohm when vaping at the uber-high 5 V. which only means that the atomizer was being powered by a whopping 12 W.   Furthermore, the smoking machine used in the test produced 3 to 4 second puffs at 30-second intervals over a period of 5 minutes.  When Farsalinos publicly criticized the NEJM study, the co-authors refused to back down, calling his assertions “highly tenuous.”

“(Dr. Farsalinos is) entitled to speculate that use of the higher power setting in our work constituted ‘overheating’, and led necessarily to vapour characteristics for all humans (and e-cigarette fluids used) of ‘acrid’, ‘harsh’, and non-inhalable. However, that view seems highly tenuous, especially because of the very high concentrations of flavor chemicals we have found in many e-cigarette fluids. In fact, the tobacco industry has used flavorants to overcome smoke that is ‘acrid’ and ‘harsh’ for many years.”

While the NEJM study was widely criticized by both the vaping and scientific communities, the damage had been done. News that e-cigs are formaldehyde-producing deathtraps spread like wildfire across the Internet, and the vaping industry took another massive hit to its collective reputation.  That is, until the release of the new Farsalinos study of August 31, 2017 entitled, E-cigarettes emit very high formaldehyde levels only in conditions that are aversive to users: A replication study under verified realistic use conditions. 

The replication study by Dr. Farsalinos

Dr. Farsalinos and his team began by duplicating the exact testing procedures of the 2015 NEJM study.  They used the same CE4 atomizer, the same iTaste VV device, and the same 6 mg/ml e-liquid from Halo.  The smoking machine also puffed away at the same 4-second rate for the same 5-minute periods at at the same 30-second intervals. 

However, in the new study, Farsalinos asked 26 veteran vapers to take 5 to 7 puffs of the device according to the same schedule.  Without the participants’ knowledge, the scientists then gradually modified the settings until the vapers complained of dry hits.  What the researchers discovered is truly eye-opening.

  • 88% of participants reported dry hits at or below 4.2 V.
  • Three vapers made it all the way to 4.4 V.
  • No one, not a single participant, would vape at the massive 5.0 V.
  • The study also notes that when e-cigs are used “in realistic conditions, formaldehyde in e-cigarettes is lower than cigarette smoke.”

Several scientists have already publicly admonished the original NEJM study from 2015.  In fact, the UK’s Clive Bates has already provided a PubMed comment calling for an immediate retraction just four days ago, thanks to the new research provided by Dr. Farsalinos and his team.  Until the original study is officially retracted, anti-vaping lobbyists may still be tempted to cite the bogus research as “evidence” that vaping is just as harmful as combustible cigarettes.    

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The opinions expressed in this article are those of the author's and do not necessarily represent the viewpoints, policy or company position of Vapes.com, the rest of our staff, and/or any/all contributors to this site.

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