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