Monday, March 24, 2014

New Study on Electronic Cigarettes by UCSF Researchers is Not Only Bogus Science, But is Also Dishonest

Researchers from the Center for Tobacco Control Research and Education at UCSF have published a research letter in JAMA Internal Medicine which purports to show that electronic cigarettes are ineffective for smoking cessation.

(See: Grana RA, Popova L, Ling PM. A longitudinal analysis of electronic cigarettes use and smoking cessation. JAMA Internal Medicine. Published online March 24, 2014. doi:10.1001/jamainternmed.2014.187.)

The study involves a survey of 949 adult smokers who were interviewed at baseline in 2011 and followed up one year later. Of these smokers, at baseline, 88 had tried electronic cigarettes in the past month (that is, they had used electronic cigarettes at least once).

The study reports that at one year follow-up, the rate of smoking cessation among the baseline non-e-cigarette users was 13.8%, compared to 10.2% for the 88 electronic cigarette users, a difference that was not statistically significant. On this basis, the study concludes that electronic cigarettes are not effective for smoking cessation.

The authors write: "Consistent with the only other longitudinal population-level study with 1-year follow-up that we are aware of, we found that e-cigarette use by smokers was not followed by greater rates of quitting or by reduction in cigarette consumption 1 year later."

They conclude that "our data add to the current evidence that e-cigarettes may not increase rates of smoking cessation."

The Rest of the Story

I'm sad to say that this is complete garbage.

It is truly an example of bogus, or junk science.

Why? Because the study does not examine the rate of successful smoking cessation among electronic cigarette users who want to quit smoking or cut down substantially on the amount that they smoke and who are using e-cigarettes in an attempt to accomplish this.

Instead, the study examines the percentage of quitting among all smokers who have ever tried electronic cigarettes - for any reason - in the past month.

A large proportion of the 88 smokers who had tried an e-cigarette may have simply been trying these products to see what they are like. It is plausible, in fact probable, that many of these 88 smokers were not actually interested in quitting or trying to quit with electronic cigarettes. These products have become very popular and have gained widespread media attention and it is entirely possible that many of these smokers simply wanted to see what the big fuss is all about.

It is easy to see how this fatal flaw in the research destroys the validity of the authors' conclusion.

But that isn't the end of the story. If this were simply a bogus conclusion, then we could simply evaluate the article as being junk science, dismiss it as bogus, and leave it there. But unfortunately, it doesn't end there.

Why? Because it is quite apparent from the study itself that the authors knew that the overwhelming majority of the 88 electronic cigarettes "users" in their study had little or no interest in quitting and were not using these products as part of a quit attempt.

How do we know this? Because the authors tell us!

In the Table, the authors report that of the 88 e-cigarette "users," only 8.0% reported that they were trying to quit at that time (that is, within the next 30 days). And only 39.8% of the e-cigarette users had any intention of quitting in the next six months. This means that we actually know for a fact that the majority of e-cigarette users in this study were not using these products as part of a quit attempt.

What this indicates is that this is not simply junk science. Rather, it is a deliberate attempt on the part of the investigators to misuse data. They are using these data to draw a conclusion about whether electronic cigarettes are effective in helping smokers quit, yet they are knowingly drawing upon data from smokers who are using e-cigarettes for other reasons, who may have simply tried an electronic cigarette once, and who most definitely were not using these products as part of a current quit attempt.

In other words, 92% of the e-cigarette users in the study were not trying to quit. We know for a fact that 92% of the e-cigarette users were not making a quit attempt. And yet the study authors interpret the data as if these smokers were trying to quit using e-cigarettes, but failed!

This is dishonesty in research.

Unfortunately, it does not appear that these investigators are truly interested in whether e-cigarettes help many smokers quit or not. Instead, I believe that these researchers have a pre-determined conclusion that e-cigarettes are ineffective and that they are trying to manufacture results that support their pre-determined conclusion.

It would be a tragedy if policy makers use the conclusions of this "study" to draw conclusions about the effectiveness of electronic cigarettes for smoking cessation purposes.

2 comments:

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