Monthly Archives: March 2015

Ideology beating science at it’s own game – how on earth that could be possible

Reblogged from Professor Michael Siegel

E-Cigarette Opponent Uses Cross-Sectional Study to Conclude that E-Cigs are a Gateway to Smoking

On his blog Sunday, Stan Glantz cited a new UK study as supporting the conclusion that e-cigarettes are a gateway to smoking among youth.

The study was a cross-sectional survey of nonsmoking 10-11 year-old children in Wales. They reported on their e-cigarette use and on their intentions to smoke in the future. The study found that users of e-cigarettes were significantly more likely to have intentions to smoke.

Specifically: “Having used an e-cigarette was associated with intentions to smoke (OR=3.21; 95% CI 1.66 to 6.23). While few children reported that they would smoke in 2 years’ time, children who had used an e-cigarette were less likely to report that they definitely would not smoke tobacco in 2 years’ time and were more likely to say that they might.”

From these findings, Glantz concludes: “While a cross-sectional study, susceptibility to smoking is a well-validated measure of future smoking, so the results support the gateway effect.”

The Rest of the Story

Because this is a cross-sectional study, it is unable to determine the direction of causality. Which came first? The e-cigarette use or the intention to smoke?

While Glantz reports the result as e-cigarette users being more likely to have intentions to smoke, the results could just as easily presented as youth with intentions to smoke being more likely to try e-cigarettes.

Clearly, except for Stan, one cannot discern from this study whether youth who try e-cigarettes then develop an intention to smoke or whether youth with a predisposition to smoking are more likely to experiment with e-cigarettes.

That Stan draws a conclusion anyway suggests that he has come to a pre-determined conclusion and is twisting the data to support this conclusion.

However, it is entirely possible that what these results indicate is that e-cigarettes appeal much more to kids who are highly predisposed to try tobacco cigarettes. In fact, it is possible that by diverting these youth to e-cigarettes and their flavorings, e-cigarette experimentation may actually prevent youth from smoking. After all, once they try the sweet flavors of e-cigarettes, it would be extremely difficult to imagine them then transitioning to a Marlboro cigarette.

The rest of the story is that many e-cigarette opponents have drawn a pre-determined conclusion that e-cigarettes are evil and are therefore so biased that they are skewing the interpretation of scientific studies to support their pre-determined conclusions, even when the science does not support these conclusions.

This is another way of saying that ideology has taken over for science in the anti-smoking movement.

E-cig möjligheten i Sverige kidnappad av Läkemedelsverket, Sweden’s Medical Products Agency prohibits E-cig through kidnapping them as Medical Products

Gratefully reblogged from Clive Bates of Counterfactual
March 6th, 2015

Public health experts talking sense about e-cigarettes and vaping

Public Health England recently published some excellent video commentaries on vaping and e-cigarettes by genuinely thoughtful and engaged public health experts – I have collected them here.  These are intended for an English audience, but they deserve a much wider airing because they show what public health could be like if it actually approached the subject with an open and enquiring mind, regard for evidence and an attitude of humility and empathy.

Professor Ann McNeill, Kings College London
Distinguishing between vaping and smoking
Professor John Britton, University of Nottingham
Protecting bystanders
Deborah Arnott, Action on Smoking and Health
Protecting children and young people
Professor Robert West, University College London
Supporting smokers to stop
Ian Gray, Chartered Institute of Environmental Health
Impact on compliance with smokefree laws & policies

Peter Astley, Warrington Borough Council
Impact on compliance with smokefree laws and policies

Public Health England also published some video commentaries to contrast with those above.  I think they usefully illustrate the quality of argument and evidence that stands behind the ‘concerns’ of some in public health.  So I am reproducing them here for completeness and to be judged on their merits.  It’s not all negative: there are some good and welcome points from two of these sceptics.

Cecilia Farren, GASP (a consultancy)
Distinguishing between vaping and smoking

Andrea Crossfield, Tobacco Free Futures:
Protecting bystanders

Professor Gerard Hastings, University of Stirling:
Protecting children and young people

Snus Snus Snus E-cig E-cig E-cig ENDS ENDS USA reshuffles the FDA Tobacco Board because of conflicts of interest

Thursday, March 5, 2015

Conflicts of Interest Exposed, FDA Reorganizes Tobacco Advisory Panel

Reblogged with thanks and credits to Professor Brad Rodu

A range of obvious conflicts of interest has led to the replacement of several FDA Tobacco Products Scientific Advisory Committee (TPSAC) members.

Federal judge Richard Leon ruled last July that “The presence of conflicted members on [TPSAC] irrevocably tainted its very composition and its work product” and “the Committee’s findings and recommendations…are, at a minimum, suspect, and, at worst, untrustworthy.” (here).

Today, Mitch Zeller, director of the FDA Center for Tobacco Products, announced (here) that, “As a result of the expanded [conflict of interest] criteria outlined in Judge Leon’s ruling, each voting TPSAC member was rescreened and four members – Chairman Jonathan Samet, Claudia Barone, Joanna Cohen, and Suchitra Krishnan-Sarin – have resigned or their terms on TPSAC have been terminated.”  Pebbles Fagan, Gary A. Giovino and Thomas E. Novotny are new committee members; the chair remains vacant.

Judge Leon ruled that Samet was conflicted because he “received grant support from [pharma giant] GlaxoSmithKline at least six times, including in 2010.  He also led the Institute for Global Tobacco Control, funded by GSK and Pfizer.  Dr. Samet also testified for lawyers suing tobacco-product manufacturers…he was designated to testify in two pending tobacco cases.”  I have noted that Claudia Barone also had a conflict of interest because of a Pfizer grant in 2013 that preceded her 2014 TPSAC appointment (here).

I have reported that Dr. Samet and Krishnan-Sarin also had conflicts due to their having received substantial grants from the anti-tobacco NIH ($8 million in 2014 for Dr. Samet, $5.8 million for Krishnan-Sarin).  Current TPSAC members with major NIH funding include Kurt Ribisl ($9.2 million in 2014), Thomas Eissenberg ($3.9 million), Richard O’Connor ($0.5 million) and Warren Bickel ($0.4 million)(here).

Experts can be influenced by substantial financial support from organizations committed to a tobacco-free society, a euphemism for the obliteration of the tobacco industry (an objective that is at odds with the principle of regulation).  To avoid even the appearance of impropriety, those who are funded by the American Cancer Society, the American Heart Association, the American Lung Association, the National Institutes of Health, the Centers for Disease Control and Prevention, or the Robert Wood Johnson Foundation should be ineligible for TPSAC membership.