"Vapes DON'T help people quit smoking normal cigarettes," the headlines blared this week, based on the results of another awful study. Let's examine the critical details most reporters overlooked.
Anti-smoking groups had a serious problem on their hands. About a decade ago, studies began to show that vaping helped smokers abandon their deadly cigarette habit, and the evidence has only grown more convincing since then. Many tobacco researchers handled this dilemma the way any good scientist should: they concocted increasingly complicated study designs to avoid the obvious conclusion: vaping works.
Consider this paper just published in Tobacco Control, which purported to show that smokers who tried an e-cigarette either went back to exclusive smoking or started smoking cigarettes and vaping, a phenomenon known as “dual use.” The press went bananas crafting puerile headlines. “Vapes DON'T help people quit smoking normal cigarettes, study finds,” the Daily Mail announced with unnecessary capitalization. There were several other copycat news items, all featuring the same dishonest quote from one of the study authors:
“This study suggests that at the population level, vaping may not help people kick the smoking habit,” lead researcher Nandita Krishnan said in a press release. “People who concurrently use e-cigarettes and cigarettes experience increased health risks, and both products deliver nicotine, which is addictive. We should be trying to help them quit both smoking and vaping.”
This study is dreck for reasons we'll examine shortly. But even if we take the results at face value, the paper could be used as further evidence that vaping helps many smokers quit. Let's take a closer look to see why.
Vaping reduced smoking in the study
Press reports have emphasized a single statistic from the study: 41.6 percent of participants quit vaping early in the research but were "stable" smokers when it ended six years later. Fair enough, but how did the other 58.4 percent of people do? “Good question, Aguado,” as Ace Ventura might say. Let's look at those numbers:
14.8% were early vape quitters and gradual cigarette quitters
14.6% were stable vape users and stable cigarette users
11.2% were stable vape users and gradual cigarette quitters
10.3% were early vape quitters and early cigarette quitters
7.4% were stable vape users and early cigarette quitters.
Look carefully and you'll see a common thread running through all these groups. Every one of them significantly reduced their cigarette intake or quit smoking entirely! The researchers noted the last group, arguing it was “the most important from a harm reduction perspective, as it is marked by quickly switching to exclusive [vaping].”
That much is true. However, look at the others. Just over 11 percent of people took up vaping and gradually quit smoking; more than 10 percent quit vaping and smoking; almost 15 percent became long-term dual users. In other words, nearly 60 percent of the participants saw some benefit from vaping. How's that for an alternative headline?
Dual use is a good thing
Now, what about Ms. Krishnan's claim that dual users experience “increased health risks”? It's blatantly false. As she acknowledged in the paper, “current evidence suggests that [vaping] products are less harmful than combustible cigarettes in the short and medium term.” So, if a smoker replaces some of his smoking with vaping, a far less harmful habit, that person has clearly decreased his health risk. As one recent review put it,
Switching from smoking to vaping or dual use appears to reduce levels of biomarkers of potential harm significantly.
In other words, dual use is a feature, not a bug. We definitely want smokers to quit altogether. But if they can't make such a radical change, partially reducing the number of cigarettes they smoke is an excellent first step.
Now, put everything we just discussed aside. As I mentioned up top, this new paper leaves a lot to be desired. The researchers were working from self-reported (meaning “unreliable”) data from just 545 people. They didn't know which vaping devices or how much nicotine the participants used, nor did they know with any precision how much they smoked. Participants were included in the analysis if they had ever smoked a cigarette, smoked more than 100 cigarettes, or currently smoked “every day or some days.”
Those numbers are as trustworthy as a politician on the campaign trail. Anyone who accepts them is just a bit too gullible.