The Evidence is Incontrovertible

Stan is an idiot.

There. I’ve said it diplomatically. For once. Never again.

Starting with e-cigs triples odds of starting cigarettes among college students; the evidence just keeps piling up

The latest of his blog titles screams at you that starting the use of an e-cig will most definitely lead the crazy youth of today to take up smoking. Y’see, Stan is a firm believer in the whole gateway theory. That theory goes that should a young, impressionable youth (up to the age of 30) be taken in by the kiddie orientated marketing of e-cigarettes by “Big Tobacco” then sooner or later that impressionable youth is going to progress to cigarettes. It is inevitable. Resistance is futile.

Thing is, and I love saying this, Professor Stanton A. Glantz is wrong. The data has, and continues to consistently show that uptake of cigarettes by e-cig users (formerly never users) remains at an all time low of… wait for it… 0.1%.

His latest gushing over another “study” – read, longitudinal survey at two points in time 12 months apart – tries, and fails to point to the fact that never smokers, or baseline e-cig users are XX more times likely to smoke.

It’s bullshit, just as we knew it would be.

See, the survey only looked at one university so cannot in anyway shape or form be extrapolated to population level. Furthermore, the questionnaire only included e-cigs since 2014, and we know just how far behind the curve the US are when it comes to asking questions about e-cigs.

E-cigarette questions were first added to the survey in 2014 and re-administered again in 2015; accordingly, responses provided in 2014 served as “time 1” while responses provided in 2015 served as “time 2” for all the present analyses. 5779 participants responded in 2014 (time 1) while 4748 participants provided responses in 2015 (time 2).

To be clear, they asked the very first e-cig question in 2014 where 5779 students responded. They asked the same questions again the following year, and only 4748 responded. 23% drop out. Good going so far. But wait.

This study includes all participants who responded to the survey at both time points (total N = 3757)

So 991 responses at the second point didn’t answer at T1. Did they recruit other participants? It wouldn’t surprise me, it’s not the first time they have done stuff like that.

So what do they find out I wonder? Well, it all starts with the questions (as always):

Participants were asked how many e-cigarettes they had used in their lifetime (“None”, “1–9”, “10–99”, “100–200”, or “200 or more”) and during the last 30 days on how many days they used e-cigarettes (“I didn’t use e-cigarettes in the past month”, “Once or twice”, “A few days”, “A couple of days a week”, “Three times a week”, and “Daily or almost daily”). Items addressing other tobacco products (i.e., cigarettes, smokeless tobacco, little cigars/cigarillos, and hookah) were formatted similarly. Participants were also asked whether they had ever used marijuana (“yes” or “no”)

Standard fare for the US. But the researchers don’t stop there.

For all logistic regression analyses, ever use and past 30 day use items were changed from the original formatting to a dichotomous “yes” or “no” outcome. Thus, participants were considered to have ever used cigarettes/e-cigarettes if they had used these products on even one occasion and were considered current users if they had used these products at least once in the past 30 days.

So, “ever-use” measured by even a single puff, and current use if the product was used at least once in the past 30 days. The thing with the US measure is that the past 30 day use thing doesn’t just capture irregular users, it also captures experimentation. The way the questions and answers are worded it is impossible to distinguish if a respondent is merely experimenting or just uses the product occasionally.

What were the stats I hear you ask?

  • 2163 initially identified as never users of either cigarettes or e-cigarettes
  • 153 initially reported as having “tried” e-cigarettes
  • 651 initially reported as having “tried” cigarettes
  • 690 were reported as dual-users

Now, as they are looking specifically for progression from e-cigarettes to cigarettes they found a whopping 24.2% had tried cigarettes by T2. That’s a massive 37 respondents. Or to put it into context, 0.01% of the total respondents.

But what about this so-called “marketing at youth theory”?

Well at baseline there were 2163 never-users. At T2 a total of 5.7% had tried an e-cigarette. That’s 123 participants that, at T1 didn’t use either but at T2 had tried an e-cigarette. Context: 3% In contrast to those never users that “tried” cigarettes – 153 or 4% of the total.

On the flip side, the researchers report that 29.3% of those that reported trying cigarettes (651) had taken up e-cigarettes. 190 individuals had moved away from tobacco to e-cigarettes.

We’re not talking big numbers here. We’re also not talking about something that can be extrapolated to nationwide levels. This is environment specific.

Furthermore, 0.8% of the “never-users” became exclusive cigarette smokers (17), 1.5% reported exclusive use of e-cigarettes (32) and 0.4% reported dual-use (8) at T2.

But there’s more.

Those classified as e-cigarette users at T1 (153) 7.2% reported current cigarette use at T2 (11) and of those who initially used cigarettes at T1 (651) 7.1% reported current e-cigarette use at T2 (46).

So, the list (context):

  • Never users at T1 to EC use at T2: 37
  • Never users at T1 to Cig use at T2: 153
  • EC use at T1 to Cig use at T2: 11
  • Cig use at T1 to EC use at T2: 190

These are hardly numbers to worry about given the context.

However, current e-cigarette use at time 1 did not make initial never smokers more likely to transition to current cigarette smokers at time 2.

Not forgetting:

Indeed only six initial nonsmokers transitioned from a time 1 current e-cigarette user into a current cigarette smoker at time 2

Out of the total number of participants only six T1 e-cigarette “users” moved to being a current cigarette smoker at T2. Of course, remember that if you’ve ever touched an e-cig in the US (even just one or half a puff) you’re an e-cig user so I suspect that the actual migration (or “gateway”) is a lot lower than that.

Good ol’ Stan eh?

(image credit Catmando/

  • Robert Innes

    Well done!

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  • Nate

    To put it another way, half a dozen people at a certain American college, who had vaped at least once in the past 30 days a year ago, have smoked more than one cigarette in the last month.

    The thing that enrages me is not so much that people like Stan exist (though I don’t like that he’s a public employee in the state where I pay taxes), but that they are continually published and covered, by publications and outlets that can see perfectly well his science doesn’t pass the laugh test. It is a really, really stark example of the unconscionable extent to which tobacco control orthodoxy, and the idiot cartoon characters who traffic in it, have become ingrained like a state religion upon the entire civilized world.

    • Couldn’t have put that better myself Nate 🙂