“E-cigarettes are not subject to many laws,” begins lead author Brian Primack, before veering off into “youth-oriented flavourings” territory. He was declaring vaping to be dangerous back in 2015 with some exceptionally dubious logic: “A young person who is used to the taste of candy and sugar soda is more likely to be interested in a sugary wine cooler than a shot of bourbon. Similarly, a young person who is naïve to nicotine and tobacco would probably be more likely to begin by experimenting with a mango flavoured electronic cigarette, as opposed to a traditional non-flavoured cigarette.”
Primack and the other team members have been has been slamming vaping for years. James Sargent previously worked on papers with Soneji Samir that claimed there is a gateway for children, that dual use is dangerous, and worked with Primack on numerous disingenuous other pieces of research. This is another chapter in them scrambling around to find evidence to support their solid position opposing harm reduction.
“In conclusion, based on currently available evidence on the e-cigarette associated transition probabilities of cigarette smoking cessation and initiation, our study suggests that e-cigarettes pose more harm than they confer benefit at the population level,” writes the team.
The trouble with studies like this is that the wild claims invariably lead to instant media coverage. Fortune Magazine’s online portal lays out their arguments in an unquestioning manner, and adds some glaring factual errors in for good measure.
“Current research already points toward e-cigarettes being a public health risk because of the chemicals they use, making the new research even more problematic for the industry,” writes Janine Wolf, taking her lead from Samir Soneji and who has since removed her name from the piece. The industry, in her opinion, is Reynolds American – who declined to comment on the ridiculous puff piece.
Then she accuses Consumer Advocates for Smoke-Free Alternatives Association (CASAA) of being “an e-cigarette industry lobby group”. This can only be a slur or an outright lie as CASAA is a consumer advocacy group.
While CASAA’s spokesperson is quoted as describing the study ‘s conclusions as “surprising”, others have not been so kind.
“Junk science of the week award to this flawed and alarmist article on ecigs and vaping,” writes Jim McManus, Director of Public Health for Hertfordshire. “What has happened to the quality of peer review in these journals?”
Professor Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London, said: “This new ‘finding’ is based on the bizarre assumption that for every one smoker who uses e-cigs to quit, 80 non-smokers will try e-cigs and take up smoking. It flies in the face of available evidence but it is also mathematically impossible. In the UK alone, 1.5 million smokers have quit smoking with the help of e-cigarettes. The ‘modelling’ in this paper assumes that we also have 120 million young people who became smokers.”
“In reality there is no evidence, from any country, that vaping lures young non-smokers to smoking (let alone in huge numbers). In the USA, the country where the authors live and whose smoking statistics they should know, smoking in young people has been declining at an unprecedented rate.”
Dr Lion Shahab, Senior Lecturer Epidemiology & Public Health at UCL, adds: “Modelling of outcomes is crucially dependent on the initial assumptions being made. The authors make some very speculative assumptions here, particularly on the ‘gateway’ effect in teenagers – they assume that vaping leads to smoking. The trouble is, all their data on this comes from studies that don’t prove anything of the sort, and ignore the possibility that e-cigarettes could actually be driving kids away from tobacco.”
“In my opinion, the authors’ choice of studies used to justify the impact of e-cig use on quitting rates is rather biased. In at least one case they have used a paper whose methodology has previously been heavily criticised.”
“If you’re going to make assumptions, a much more reasonable approach would be to assume e-cigarettes are at least as effective as things like patches or gum – that is what the very best evidence from proper randomised controlled trials shows. Unfortunately the authors of this study modelled using wrong assumptions – and, unsurprisingly, they’ve ended up with the wrong conclusions.”
For a detailed explanation of why the research is flawed, Adam Jacobs applies his statistical overview to it on the Statsguy blog.