What’s the harm?

E-cigarettes (or “vapes”) are battery-powered devices that create vapour by heating up liquid contained in a cartridge. These cartridges usually contain nicotine, though some can be nicotine-free. In addition to nicotine, e-cigarette cartridges contain over 100 compounds, some of which can be harmful for health or even carcinogenic. However, e-cigarettes do not contain the cancer-causing substances or properties of traditional cigarettes. For this reason, e-cigarettes can be used as a smoking cessation tool for individuals who are unable to quit by other methods or want to maintain a similar habit.

Despite their potential as a harm reduction tool, public health messaging tends to characterize e-cigarettes as being just as harmful as traditional cigarettes. This has led to the widespread and misleading impression that there is no difference between the two. Nearly 80% of Canadians believe that e-cigarettes cause cancer and, in the 2023 Tobacco and Nicotine Survey, two-thirds of all respondents either thought e-cigarettes were just as harmful as smoking or didn’t know how harmful they were.

On social media, this narrative has taken hold, fuelling a flood of misinformation that makes it difficult to argue for a harm-reduction approach. As a result, many smokers who might benefit from switching to e-cigarettes are left feeling confused or discouraged from trying them at all. One study found that even brief exposure to social media posts claiming e-cigarettes are just as harmful or worse than smoking reduced smokers’ willingness to use them as a quitting aid. More pointedly, for every 1% increase in the misperception that e-cigarettes are just as harmful as smoking among current smokers, prevalence of e-cigarette use decreases by approximately 0.5%.

This is not to say that there are no harms to using e-cigarettes! There is plenty of evidence that e-cigarettes use can lead to decreased lung function, particularly for people with chronic conditions like asthma, and they are perhaps more addictive than traditional cigarettes.

There is also reason to be skeptical of e-cigarette companies when they make claims about their products. These companies often use the same famous tactics that were used by Big Tobacco – including creating advertising that appeals to children and teenagers – and they are often owned by tobacco companies. But, as the evidence stands, e-cigarettes are much less harmful than traditional cigarettes and can be used as a strategy to quit smoking and reduce the risk of lung cancer.

Not long ago, cervical cancer was one of the most common cancers among women and especially impacted younger women. Virtually all cases of cervical cancer are caused by infection with the human papillomavirus (HPV). HPV is a common sexually transmitted infection that usually clears on its own but some strains are persistent and can turn cancerous. Today, thanks to the HPV vaccine and regular screening, it is the only cancer that is 100% preventable. The World Health Organization has even set a strategy to eliminate cervical cancer as a public health problem. But misinformation about the HPV vaccine has created a gap between what is possible to achieve and what is actually happening.

False claims about the HPV vaccine have persisted since it was first approved despite overwhelming scientific evidence supporting its safety and effectiveness. Here’s just a few of those HPV vaccine myths:

1. “HPV vaccines are too new to know whether they are safe”: HPV vaccines have been provided in Canada since 2006 so we have almost two decades of real-world data on their safety and efficacy. Vaccines also go through rigorous testing prior to being given to the public and continue to be monitored after approval and distribution.
2. “Children don’t need to receive the HPV vaccine because they aren’t sexually active”: Vaccination prior to exposure improves immune response and reduces the amount of doses needed for protection.
3. “Only girls and women need to get the HPV vaccine”: Even though we are focusing on cervical cancer in this section, HPV can cause cancers in people without a cervix as well, such as penile, anal, and oropharyngeal cancers. Everyone, regardless of gender, can also get vaccinated to avoid being infected with HPV and passing it along to their sexual partners.

These myths (and many more) have spread wildly online, and in some cases are amplified by political and public figures. The result is widespread vaccine hesitancy that has derailed progress toward cervical cancer elimination in many countries.

Japan offers a striking example of how quickly misinformation about vaccines can reverse public health gains. HPV vaccination was introduced in Japan in 2013 but, after a widely publicized media scare about side effects, quickly withdrew recommendations for the vaccine. In a nine-year span where vaccinations were suspended, coverage for eligible populations plummeted from 70% to <1% and has not since recovered. Years later, despite reinstating its recommendation, Japan is still working to rebuild trust and protect a generation of young people from preventable cancer.

The evidence is clear: HPV vaccines are safe, effective, and critical tools to preventing cervical and other HPV-related cancers. Yet vaccine hesitancy driven by misinformation continues to jeopardize public health progress. Confronting HPV vaccine-related misinformation about more than just correcting false beliefs. It’s also about achieving the goal of eliminating cervical cancer as a public health concern.

Misinformation about cancer doesn’t stop at prevention. Some people believe that chemotherapy and radiation do more harm than good, or that it’s just a way to make money while governments hide the “real cure” for cancer. These beliefs are often rooted in experiencing a loved one go through difficult cancer treatments and a general fear of cancer treatment. Unfortunately, these fears may lead to patients delaying or rejecting proven treatments in favour of alternatives that sound more natural, less toxic, and, often, more hopeful.

A cancer diagnosis can be life-altering and, in these moments, it’s very human to look for hope and answers where we can find them. An understandable first step after a diagnosis would be to turn to a search engine for more information. Unfortunately, internet algorithms may use these searches to shape the information you receive. Social media platforms have allowed, and sometimes actively promoted, alternative cancer clinics through targeted ad campaigns. People may not be initially searching for these kinds of clinics, but can quickly find themselves pulled into a world of promises, testimonials, and false claims of a cure. In that space, the line between support and exploitation becomes very thin.

Clinics offering “natural” or “alternative” cancer cures often operate outside the bounds of medical oversight or scientific consensus. The typical cost for treatment at one of these clinics can be tens or hundreds of thousands of dollars, even though they lack any proven benefit. These clinics frequently feature glowing testimonials or dramatic before-and-after stores – one of them even has a reality series – but they rarely disclose patient outcomes. In far too many cases, the testimonials are known to come from patients who have since died from their cancer. Many clinics accept patients with late-stage or terminal diagnoses, an unethical practice that offers false hope to people who may have little time left. The result is a deeply exploitative system, where desperation becomes a business model, and the most vulnerable patients are often the most heavily targeted. Online reviews of these clinics sometimes provide insight into how families feel about their loved ones spending time at these clinics. They reveal the emotional, financial, and physical toll of pursuing unproven treatments, and show the lengths the clinics will go to hide these stories.

People who face a cancer diagnosis deserve compassion, support, and trustworthy information from people who want them to be well. Misinformation about cancer treatment takes advantage of our need for hope and the consequences are often irreversible. Some complementary therapies can play a role in supporting quality of life during cancer treatment and they should be discussed with an oncologist so they can be incorporated into a treatment plan. Stopping the spread of information isn’t just about correcting false claims. It’s about protecting people when they are at their most vulnerable.