Claims by a Government-funded agency that e-cigarettes are 95 per cent less harmful than smoking were based on a meeting of just 12 people, some with links to the tobacco industry, researchers have said.
Experts writing in the British Medical Journal (BMJ) joined The Lancet in criticising the evidence used by Public Health England (PHE) in its report on e-cigarettes.
PHE published the “landmark” report last month, describing it as a “comprehensive review of the evidence”.
But several researchers have questioned the robustness of the data and pointed to links between some experts and the tobacco industry.
An editorial in The Lancet medical journal last month attacked the “extraordinarily flimsy foundation” on which PHE based its major conclusion.
Writing in the BMJ, two further researchers have questioned whether the claims were “built on rock or sand”.
Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, and Simon Capewell, professor of clinical epidemiology at the University of Liverpool, said: “A fundamental principle of public health is that policies should be based on evidence of effectiveness.”
The pair said a review of evidence included in the PHE report featured only two randomised controlled trials and concluded the evidence was of “low or very low quality”.
A separate review, “which the PHE report surprisingly fails to cite”, found flaws in more than 70 studies on e-cigarettes and conflicts of interest from researchers, Prof McKee and Prof Capewell said.
They said the public would expect PHE’s claims that “the current best estimate is that e-cigarettes are around 95% less harmful than smoking” would be based on a detailed review of evidence and modelling.
“In fact, it comes from a single meeting of 12 people convened to develop a multi-criteria decision analysis (MCDA) model to synthesise their opinions on the harms associated with different nicotine-containing products; the results of the meeting were summarised in a research paper.”
Prof McKee and Prof Capewell said one sponsor of the meeting was a company called EuroSwiss Health, whose chief executive was reported to have previously received funding from British American Tobacco for an independent study.
He also endorsed British American Tobacco’s public health credentials in a sustainability report, they said.
One of the 12 people at the meeting declared funding from an e-cigarette manufacturer but not the funding he is reported to have received previously from tobacco company Philip Morris International, they added.
“The rationale for selecting the members of the panel is not provided, but they include several known e-cigarette champions, some of whom also declare industry funding in the paper.
“Some others present at the meeting are not known for their expertise in tobacco control.
“The meeting was also attended by the tobacco lead at PHE.”
The research paper produced by the group “tellingly concedes” there is a lack of “hard evidence for the harms of most products on most of the criteria”, Prof McKee and Prof Capewell wrote.
“However, none of these links or limitations are discussed in the PHE report.”