A new study co-authored by Lauren Dutra and Stanton Glantz (yes, THAT Stanton Glantz) and titled “Electronic Cigarettes and Conventional Cigarette Use Among US Adolescents”, suggests e-cigarettes does not discourage, and may encourage, tobacco cigarettes smoking among US teenagers. Actually, the study itself does not imply that at all, but that didn’t stop its authors from drawing a preposterous conclusion.
Electronic cigarettes “aggravate the tobacco epidemic among youth”, according to the recent study published online yesterday in the JAMA Pediatrics journal. Basically, the paper reports the results of a cross-sectional (remember that word, it’s important) sample of teenagers questioned in 2011 and 2012 in the National Tobacco Survey. The adolescents were asked to report both their e-cigarette and tobacco cigarette use (any use and current use), and the two researchers found that electronic cigarette use is associated with smoking status, which apparently led them to the conclusion that “e-cigarette use is aggravating rather than ameliorating the tobacco epidemic among youths”.
Wait, that can’t be right, can it? Just because e-cigarette use is associated with smoking doesn’t mean vaping actually encourages smoking, right? As Dr. Michael Siegel points out on his blog, Tobacco Analysis, “the authors of this study make one of the most cardinal errors in all of epidemiology. They ignore the principle that “correlation does not equal causation.”” Because this is only a cross-sectional study, a causal relationship between e-cigarette use and tobacco cigarette smoking simply cannot be established. In other words, we don’t know which one of the two came first. Does the e-cigarette use precede, and cause, the smoking? Or does the smoking precede, and cause, the e-cigarette use?
In fact, Lauren Dutra and Stanton Glanz themselves point out that “this is a cross-sectional study, which only allows us to identify associations, not causal relationships”. They mention this not once, but twice in their paper, adding that “the cross-sectional nature of our study does not allow us to identify whether most youths are initiating smoking with conventional cigarettes and then moving on to (usually dual use of) e-cigarettes or vice versa…”.
But while they acknowledge the nature of their study and its limitations, the authors draw a very concerning conclusion – “e-cigarette use is aggravating rather than ameliorating the tobacco epidemic among youths.” How is that possible? Dutra told Health Day that “The study doesn’t show a causal relationship. I can’t say e-cigarette use causes kids to smoke based on this finding. We need some more longitudinal data on this. But it does look like these devices are contributing to it,” and finished her statement with a baffling line – “But that’s more my opinion.”
So we’re at a point where scientists are basing their conclusions on personal opinions? After all, this same study could be interpreted in favor of e-cigarette use as well. Electronic cigarettes are meant to be associated with tobacco cigarettes, as they are advertised as an alternative to smoking and used by some as a smoking cessation aid. One could argue that the questioned teens were using the e-cigs to quit smoking, as the study itself mentions that youths who used e-cigarettes were more likely to plan to quit smoking. But because the cross-sectional research did not track this kind of data, any such claim is impossible to confirm.
Dr. Siegel, who called the study “junk science”, was not the only one to question its controversial conclusion. The New York Times covered the subject and asked other reputed scientists to give their opinions on the paper. David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the Legacy Foundation, said “I am quite certain that a survey would find that people who have used nicotine gum are much more likely to be smokers and to have trouble quitting, but that does not mean that gum is a gateway to smoking or makes it harder to quit.”
Thomas J. Glynn, a researcher at the American Cancer Society also admitted that “The data in this study do not allow many of the broad conclusions that it draws”.
You would think that all these logical conclusions would make large media outlets think twice before publishing it as a legitimate scientific work, but that’s not the case. Glantz and Dutra’s study has already appeared on large news sites around the world, sowing more fear in the hearts of the general public, some of whom might have actually given e-cigarettes a chance. At the same time, the same news sites and networks choose to either completely ignore, or worse, misinterpret scientific research in favor of electronic cigarettes…
Stanton Glantz has been critic of electronic cigarettes from the very beginning, and seems determined to destroy them before they become too popular. Dr. Michael Siegel believes there is only one possible explanation for his latest bogus study: “Dr. Glantz is no longer playing by the rules of science. He is now a man on a mission: to destroy the e-cigarette industry and to remove e-cigarettes as an option for smokers trying to quit. He has apparently drawn the pre-determined conclusion that e-cigarettes are aggravating the tobacco epidemic among youth, and he will stop at nothing to draw this conclusion and disseminate it to the public.”