New research disproves the NEJM Formaldehyde Study

The New England Journal of Medicine (NEJM) formaldehyde study made headlines around the world. The study said the risk of getting cancer was higher for vapers than smokers, which undoubtedly discouraged many smokers from switching.

Since the formaldehyde study was published, it’s become clear that it was based on a misunderstanding of how vapers vape. The NEJM formaldehyde study looked for formaldehyde hemiacetals in vapour of e-cigarettes puffed at two voltage settings. At 3.3V there were none detected, where at 5V there were dangerously high levels. The researchers went on to conclude that the cancer risk from vaping was 5 – 15 percent higher than smoking. This was concluded from a high voltage test only.

A couple of big issues with the study were pointed out by other researchers and vapers alike. The biggest being:

  • The CE4 coil was used. This is an outdated top-coil clearomizer, which no vapers use anymore – it was already obsolete by the time the study was done. Combine this with a ridiculously high voltage setting, it will result in “dry puffs”. Every vaper knows this.
  • Machines were used, but no actual humans or more importantly vapers.

Media all over the globe picked up on and published the results of the study, which impacted on the public in general. One can only imagine that many smokers in dire need to adopt healthier lifestyles and quit smoking, were discouraged to do so. The result of this may be that a lot of people returned to smoking or decided not to switch to vaping in the first place. It’s a proven fact that vaping helps people quit smoking. The damage might well be done as the study was viewed almost 300 000 and cited 138 times in scientific literature.

The new study

In lieu of the study, Dr Farsalinos and his team did their own replication study. Important to note is that they used vapers to participate in their study instead of machines, and two different wick setups were tested. Vapers tested each autonomizer at 6.5, 7.5, 9 and 10 W and reported when dry puffs were experienced. Findings stated that the single wick setup, like in the NEJM study led to dry puffs at 9 or 10 W, but dual setup never did.

Authors of the study cited high aldehyde levels in the vapour at these high settings, and this was no surprise. The levels of formaldehyde and similar chemicals in the vapour severely increased in dry conditions – anything from 30 to 250 times. In actual usable conditions, formaldehyde levels were considerably lower, in fact 34 times lower than the results in the NEJM study.

Dr Farsalinos and his colleagues are using their results to bolster the efforts to get the NEJM study retracted or corrected. Although the same equipment was used than in the original study, an additional stage was added too. 26 experienced vapers took 5-7 puffs from the device according to a puffing schedule, without knowing what setting the devices were on. Settings were progressively increased until vapers experienced dry puffs. This was generally experienced at 4.2 – 4.4V. It’s interesting to note that none of the vapers were willing to vape at 5V, which was the setting in the original study.

It was concluded that vapers won’t go over the 4V setting. At this setting, the formaldehyde levels were 36 times lower than the levels at 5V, and 19 times lower reported in the original study.

Click here to read the full article on the study.