"2014 worst published study award" - The nominees are

Looks like Clive Bates managed to find another canditate for the "2014 worst published study award": www.clivebates.com/?p=2426. Quite an amusing post by Clive pointing out how utterly useless this "research" really is.

There you go - problem solved

The topic at hand now is "3rd hand exposure" to nicotine, and you can read the whole study here: http://goo.gl/o0BkK9. The authors of the study found out that nicotine is actually left on walls, windows and so on in a chamber, and from that they conclude that people will be exposed to it "3rd hand". But, as Clive points out, there is a quite important difference between deposition of nicotine and exposure to nicotine. This is Clive's response to our dear Dr. Glantz's praising of the study on his blog:

The main risk appears to be to people who lick windows – or ‘window-lickers’ as they are known on the Internet.  However, even these people, who have other problems and priorities, would have to lick the deposition from 38 square meters* of glass in this chamber to be exposed to 1mg of nicotine (47/6*1000/205).

I don't really think there is anything else to say about this. Go read Clive's post if you haven't yet. Oh, and I've put up a poll on the right hand side so you can vote on which of the 3 studies I've written about lately that you think should get the "2014 worst published study award". Who will win this prestigious award? The nominees are:

• "3rd hand exposure" by Goniewicz and Lee
• "Scary warning labelz" by Popova and Ling 
• "Creative Cancer research" by Borderud, Li, Burkhalter, Sheffer and Ostrof

"2014 worst published study award" - a new contender

On Wednesday I wrote about a study that I thought would win the "2014 worst published study award" quite easily. But reading Clive Bates' blog today I'm glad I didn't put any money on that: http://www.clivebates.com/?p=2418. I'm not going to go through what's wrong with this study, as Clive does an excellent job at that. So please read his article.

I must say that it surprises me a bit that someone actually manages to get such an article published. First of all the the numbers they present shouldn't really surprise anyone with just the tiniest bit of common sense. Of course a label telling you that something is risky would, unless you have any other information to go by, make you think that something is more risky than before you saw the label. I mean... doh! And then there is the conclusion:

In conclusion, this study provides the first evidence against allowing “reduced harm” or “lower risk” labels on alternative tobacco products. While further data should be collected to validate our results, our findings provide initial evidence that endorsements such as the one proposed by RJ Reynolds may have similar effects to the prohibited “FDA Approved” label. Warning labels may be an effective way to decrease interest in e-cigarettes among non-users of tobacco. Regulatory agencies should consider implementing graphic warning labels for smokeless tobacco and investigate use of warning labels for e-cigarettes.

This pretty much shows why this so called study is done: They're trying to figure out how to label e-cigarettes to make them the least attractive. So actually their data (for once) supports their conclusion 100%. Because if you hate e-cigarettes, and you don't care how much you'd have to lie to get rid of them, and you don't care one tiny bit that you're actually preventing people from getting rid of their smoking habit, then yeah... telling people they'll get cancer from e-cigarettes is probably a good way to start. However, the fact that someone needed to do a study to figure this out proves that they are unable to use any kind of common sense and hence their statements should be considered totally useless and ignored in every possible way.

There are bad studies, really bad studies - and then this

On Monday this week a study claiming e-cigarettes are not helpful for smoking cessation among patients with cancer, was published online ahead of printing in the journal "Cancer". You can view the abstract of this study here (or the whole study if you have access): http://goo.gl/qCyHPs. This of course triggered a lot of headlines:
- Study: E-cigarettes do not help people trying to give up (Telegraph.co.uk)
- E-cigarettes 'not helping cancer patients to quit smoking' (Medical News Today)
- E-cigarettes 'make cancer patients more nicotine dependent' (Daily Mail)

Thankfully there has also been more balanced headlines, that also includes some criticism of the study, like this one from Reuters for example:
- Study of smoking cancer patients fuels e-cigarette debate 
 
Dr. Siegel has (once again) done a great job analyzing what's wrong with this study: http://goo.gl/58sXkL. And of course there is something very, very wrong with it. The conclusion that e-cigarettes don't help smoking cancer patients quit just makes no sense at all. We know that e-cigarettes help a lot of normal smokers quit (http://goo.gl/17Ocyn), why the hell shouldn't it help cancer patients? I suggest you read Dr. Siegel's analysis. It explains pretty well what exactly they did wrong, or more likely what they failed to cover up. I don't have access to the full study, so I'll have to trust the comments of (more competent) others that I assume have read the study:

Dr. Robert West, director of tobacco research at University College London:
"the study was not able to assess whether or not for cancer patients who smoke using an e-cigarette to try and quit is beneficial "because the sample could consist of e-cigarette users who had already failed in a quit attempt, so all those who would have succeeded already would be ruled out."

Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary, University of London:
"The authors followed up smokers who tried e-cigarettes but did not stop smoking, and excluded smokers who tried e-cigarettes and stopped smoking. Like smokers who fail with any method, these were highly dependent smokers who found quitting difficult. The authors concluded that e-cigarette (use) was not helpful, but that would be true for any treatment however effective if only treatment failures were evaluated."

So in other words, they haven't counted the ones that successfully quit by using e-cigarettes, when trying to figure out whether e-cigarettes work or not. One user commenting on Dr. Siegels blog has this to say about it: The methodology used reminds me of High School chemistry labs. Everyone knew what the results were supposed to be and you fudged the numbers doing the experiments so it came out "correct". I couldn't agree more. How is it even possible to get such a study published? I'd like to quote a fellow blogger, James from the Ashtray blog:

There are bad studies, really bad studies - and then this

Vaping areas - a good idea?

A vaping area could be a great place to meet
other vapers, or recruit new ones.

This weekend I spotted someone posting an article about the U.S. Military opening a vape deck on USS George Washington (http://goo.gl/16EZHe). I was pretty excited about this "news" and set out to write a blog post about it. In fact, I almost finished the whole post before I suddenly noticed the date.... 23rd of July. Damn that's old news, but still really good news though. Anyway, seeing that a lot of people have blogged about this already, I'm sure I'm the only one in the whole world of vaping that missed it, so I'm not going to bother you with that post now.

However, reading the article I especially took notice of something Aviation Maintenance Administration-man 3rd Class Zachary Dixon (damn, that is some title) said:

“I think having an E-cigarette smoke pit is a great idea and I believe it is a step forward, not just for the George Washington, but for the U.S. Navy as a whole,” said Dixon. “People like myself now have the option to avoid being exposed to cigarette smoke, and still enjoy our E-cigarettes in a similar environment.”

Thinking of it I don't see this argument too often: making vapers go to the smoking areas, or outside with the smokers, to vape, will in fact expose them to cigarette smoke. Of course I've seen it mentioned before, but I do feel it's not emphasized enough.

The most obvious negative effect of this is the exposure to secondhand smoke. The reason smokers have to go outside or to a designated area is to protect non-smokers from this. Well, a lot of vapers are also non-smokers now so why shouldn't they be protected?

Another negative effect, that in my opinion is just as bad, is that I do believe this will cause quite a lot of people relapsing and start smoking again. I think new vapers, or people that are on the verge of making the switch will be very vulnerable to this. A lot of people start out with poor performing cig-alikes. If they were allowed to vape inside, without exposure to cigarette smoke, this might just have been the one advantage that keeps them from switching back, and might encourage them to search for better performing equipment. If forced to vape with the smokers, the way back to cigarettes at this stage is not very long. I know this was the case with myself, as I started out with a crap set from Deal Extreme, and I have to admit that when I went outside with the smokers at work the cigarettes were very tempting. And yes, I had a cigarette once in a while... and it was great. At home, I didn't cause I used the crap set inside, and this inspired me to search for something better. Now I'm pretty much immune to this effect, since I've been vaping for so long and I've got equipment that makes vaping so much better than smoking. Cigarettes now taste so awful that I'd never go back.

Then there is the fact that vaping in non-smoking areas could encourage more smokers to try it out. Now this one is a bit tricky though. Making vapers "hang out" with the smokers could also get some more smokers interested. But then again, there is one less advantage for the vaper to boast of. To be totally honest I'm not sure whether forcing vapers to use the smoking areas or allowing vaping in non-smoking areas will trigger the most smokers to try it out, but I do think allowing vaping in non-smoking areas will increase the success rate of those who try.

I don't see any good reason that vaping needs to be banned in any non-smoking area. Of course there are some places I don't vape. In general I'd say I try to avoid vaping openly where there is a lot of kids. It's all about vaping responsibly, and using common sense. But I also think having special vaping areas, for example on ships or in airports, preferably combined a vape bar, is a good idea. You could do this without banning vaping in other areas, and I think it would still attract a lot of vapers. Such areas, especially if it offers smokers the opportunity to try it out, could be great for gathering vapers, sharing experiences and convincing smokers to switch. And it is certainly a lot better than forcing vapers to go vape with the smokers.




photo credit: lindsay-fox via photopin cc

Public Health vs. Vapers

This week has been quite a busy one for me. Feels like I haven't been standing still for a minute, with quite a lot to do at work and even more to do when I get home. But even though there haven't been much time for writing, I've managed to squeeze in some reading, and some of the stuff I've read has been fantastic. So, today, I'm just going to recommend 3 of the best pieces I've read this week on the relationship between Public Health and Vapers. Enjoy! And have a nice weekend :)

• http://www.redheadfullofsteam.com/its-different-when-they-do-it/
• http://theindefatigablefrog.blogspot.no/2014/09/the-indefatigable-frog-or-why-this-wont.html?spref=fb
• http://www.clivebates.com/?p=2391