NHMRC - National Health & Medical Research Council Ecig Influencers
- Pippa Starr
- Jan 24, 2022
- 4 min read
Updated: Apr 24
Jan 24 2022 - NHMRC Vaping Postion Is A Disgrace
"THE NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL, Australia’s peak medical body has released its latest guidelines on vaping. However, the guidelines are alarmist, seriously flawed, do not reflect the latest evidence on vaping and will harm public health." Full Article>>
2022 - CEO Statement On Electronic Cigarettes
⚠️ Warning - The Statement Contains:
Critical Limitations
1. Risk Inflation via Data Absence
The report conflates data absence with potential risk by framing the lack of inhalation toxicity data as cause for concern. This supports a precautionary principle stance without balanced risk-benefit evaluation.
It assumes that substances permitted in food or medicine might pose inhalation risks without verifying real-world exposure levels, dosage, or cumulative risk in vapers.
2. Lack of Quantitative Risk Assessment
No attempt is made to evaluate exposure thresholds, bioavailability, or dose-response curves. The presence of a hazard is not equivalent to actual harm.
The report doesn't differentiate between trace amounts versus harmful doses under real-life vaping conditions.
3. Scoping Review Without Risk of Bias Assessment
The review fails to assess the quality or reliability of the 89 included studies. No filter for methodological rigour undermines the credibility of aggregate findings.
Only 12 studies examined individual chemical constituents—yet sweeping generalizations are made about all ingredients.
4. No Comparative Context (Smoking vs. Vaping)
There is no comparison with the toxicant load from cigarette smoke, which weakens any claim about potential health risks.
This omission is critical given vaping’s harm reduction premise. Without it, the report cannot inform regulatory prioritization in a meaningful way.
5. Misuse of Food/Medicine Safety Frameworks
The report suggests that chemicals safe in food or medicine might be unsafe when inhaled, which is true in principle—but this needs to be quantified, not speculated upon.
It fails to assess thermal degradation products in context (e.g., aldehydes at realistic power settings vs. dry puff conditions).
🧪 Scientific Caution vs. Policy Alarmism
The document adopts a precautionary tone throughout. While this may be justifiable in a research roadmap, it becomes problematic when interpreted as justification for prohibitionist policies—especially since:
Most studies reviewed are in vitro or animal-based, not reflective of actual vaping behavior.
Real-world data showing reduced biomarkers of harm in vapers (compared to smokers) is absent from consideration.
✅ Recommendations for a More Balanced Approach
Incorporate Exposure-Based Risk ModelsE.g., margin of exposure (MOE) or probabilistic risk assessments, as used in toxicology and pharmacology.
Compare Against Cigarette ToxicologyPlace findings in context with known harms from smoking to assess relative, not absolute, risk.
Prioritize Research Funding for Human DataFocus on longitudinal, observational human studies and biomarker analyses.
Avoid Regulatory Overreach Based on Data GapsDo not regulate or restrict based on unproven speculation—support innovation in safer formulations instead.
🧾 Conclusion
This NHMRC report provides a broad and cautious overview of potential risks associated with non-nicotine e-liquid ingredients, but it is fundamentally hamstrung by missing inhalation toxicity data, lack of exposure quantification, and absence of comparative context. It underdelivers on actionable science while overselling speculative harm, which risks misleading policymakers and the public.
November 2021 - Flawed review of evidence on the health outcomes of e-cigarette exposure
Key Issues Identified in the Report
1. Overemphasis on Uncertainty Without Clear Risk Stratification
The report presents evidence of potential harms from vaping in an absolute context without consistently comparing these risks to the well-established, vastly greater harms of smoking combustible tobacco. This undermines the principle of Tobacco Harm Reduction, which is central to public health strategies in countries like the UK and New Zealand.
In contrast, authoritative reviews from:
The UK NHS state clearly: "Vaping is substantially less harmful than smoking".
The Royal College of Physicians recommends promoting e-cigarettes widely as a substitute for smoking.
Cancer Research UK consistently supports that vaping carries "a fraction of the risk of smoking" and contains far fewer toxic substances.
2. Methodological Bias and Selective Evidence Presentation
While the report references a wide body of literature, it has been criticized for selective interpretation of data. As highlighted in Colin Mendelsohn’s response to the NHMRC's broader e-cigarette review, the report "exaggerates risks, ignores context, and selectively includes studies that support a negative view of vaping".
Additionally, the supplementary nature of the document means it builds upon a core report that has itself faced substantial expert critique, including concerns of methodological weaknesses and lack of engagement with harm reduction experts.
3. Lack of Public Health Perspective on Smoking Cessation
There is minimal discussion of vaping’s efficacy as a smoking cessation tool, a key omission given its status as the most commonly used and effective quit method in countries with supportive policies. For example:
The NHS describes vaping as one of the most effective methods to quit smoking.
The NCSCT calls vaping "no more hazardous than licensed medicines when used for up to two years".
4. No Consideration of Real-World Outcomes
The report doesn't address population-level evidence showing reductions in smoking prevalence in countries where vaping is widely available. Nor does it mention the public health cost of denying smokers access to safer alternatives.
Critical Appraisal
While this NHMRC supplementary report provides a collection of potential risks from e-cigarette exposure, it falls short in balancing risk against benefit, particularly for current smokers. Its lack of engagement with harm reduction principles, failure to contextualize risks, and omission of cessation benefits make it a misleading guide for policy-making, especially in light of broader international evidence.
