Several researchers have questioned robustness of data and pointed to links between some of those involved and the tobacco industry

Claims by a government-funded agency that e-cigarettes are 95% less harmful than smoking arose from a meeting of 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 main 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.”

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.”

McKee and 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 BAT’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 was reported to have received previously from the 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”, McKee and Capewell wrote. “However, none of these links or limitations are discussed in the PHE report.”

McKee and Capewell said PHE’s claims that “there is no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers” were premature.

Prof Kevin Fenton, director of health and wellbeing at PHE, said the claims in the BMJ had been responded to before. He said: “E-cigarettes are significantly less harmful than smoking. One in two lifelong smokers dies from their addiction. All of the evidence suggests that the health risks posed by e-cigarettes are small by comparison, but we must continue to study the long-term effects.

“PHE has a clear duty to inform the public about what the evidence shows and what it does not show, especially when there was so much public confusion about the relative dangers compared to tobacco.

“Nearly 80,000 people a year die of a smoking-related illness and smoking costs the NHS £2bn a year. By spelling out clearly the current evidence – that while e-cigarettes are not risk-free, they carry only a fraction of the harm caused by smoking – we are fulfilling our national remit.”

Source : theguardian