Flawed Science for Flawed Policy

I would say that this is a break from the norm, but I’d be lying. You see, as vapers, ex-smokers and current smokers (and even never smokers to some extent) we all know that the tobacco control science is little more than bits of paper trying to justify disproportionate restrictions, taxes and even bans on the things we enjoy doing.

I get it, some folk really don’t like us for our choices and they really don’t want us outside of their sphere of influential control. That’s really the reason for much of this pseudo-science. Those in power, seek power entirely for their own sake. They are not interested in the good of others, they are solely interested in power, pure power.

So it behooves me to read yet another piece of “science” where the authors have absolutely zero understanding of the subject matter at all.

Background

Longitudinal research is needed to identify predictors of continued electronic cigarette (e-cigarette) use among youth. We expected that certain reasons for first trying e-cigarettes would predict continued use over time (eg, good flavors, friends use), whereas other reasons would not predict continued use (eg, curiosity).

In plainspeak, these researchers are trying to find out why folks choose to use vapour products and from that reason predict how the products are going to be used in the future.

Methods

Longitudinal surveys from middle and high school students from fall 2013 (wave 1) and spring 2014 (wave 2) were used to examine reasons for trying e-cigarettes as predictors of continued e-cigarette use over time. Ever e-cigarette users (n = 340) at wave 1 were categorized into those using or not using e-cigarettes at wave 2. Among those who continued using e-cigarettes, reasons for trying e-cigarettes were examined as predictors of use frequency, measured as the number of days using e-cigarettes in the past 30 days at wave 2. Covariates included age, sex, race, and smoking of traditional cigarettes.

We asked kids some questions in 2013 and 2014 about e-cigarettes and only 340 responded to us. We then categorised them into two groups – those who were using them at both points in time, and those that weren’t. Oh, we also added things like basic demographics, just for kicks.

Results

Several reasons for first trying e-cigarettes predicted continued use, including low-cost, the ability to use e-cigarettes anywhere, and to quit smoking regular cigarettes. Trying e-cigarettes because of low-cost also predicted more days of e-cigarette use at wave 2. Being younger or a current smoker of traditional cigarettes also predicted continued use and more frequent use over time.

We found several reasons why these yoofs were using e-cigarettes and were quite astonished at the reasons we were given, so we predicted that they would either continue to use them or go on to smoke cigarettes.

Conclusions

Regulatory strategies such as increasing cost or prohibiting e-cigarette use in certain places may be important for preventing continued use in youth. In addition, interventions targeting current cigarette smokers and younger students may also be needed.

We think that by making these products more expensive, these yoofs will stop using them. We would also recommend strongly suggest demand prohibition. These yoofs can’t be allowed to have fun, they need to be under the watchful eye of Big Brother.

Quite. Well, that’s what they think anyway. Let’s see what the data actually tells us eh?

The total number of participants in this study, after making sure that identification codes (self-generated as per the norm for these things) sufficiently match, was 2100 – out of the 2915 that completed the survey at both stages. Out of that number, only 340 were classified as “ever e-cigarette users” based solely on a “yes” to the question “have you ever tried an e-cigarette” – this gave them a “whopping” 16.2% of the total participants that had “ever used” an e-cigarette.

Things then get a little fluffy when the authors list the “reasons” why these teens use them:

• Curiosity
• It is cool (really?)
• Good flavours
• Does not smell bad (eh, subjective)
• Can hide it from adult (kids are really good at that, but adults are better at spotting it, after all adults know all the tricks)
• Low cost
• My friends/parents/family use it
• Can use it anywhere
• To quit smoking
• It is healthier than traditional cigarettes

Here’s what they discovered:

Over half of the 340 – which by the way is only 194 participants – were curious about vapour products. Well they’re kids. Kids are curious about a lot of things. Especially things that adults and Big Brother frown on.

Let’s look at that list again, complete with totals this time:

• Curiosity – n=194
• It is cool – n=31
• Good flavours – n=142
• Does not smell bad – n=70
• Can hide it from adult – n=43
• Low cost – n=34
• My friends use them – n=110
• My parents/family use them – n=28
• Can use it anywhere – n=71
• To quit smoking – n=20
• It is healthier than traditional cigarettes – n=87

Now of course, the participants would have chosen more than one reason, so a break down such as that really doesn’t mean much. Now if it was broken down by primary reason then that data might be more useful, though I doubt it. Kids tell adults what adults want to hear.

E-cigarette frequency at wave 2 was assessed with an open-response question: “How many days out of the last 30 did you use e-cigarettes”? Youth were coded as continuing (ie, >1 day of use in the past 30 days) or not continuing (ie, 0 days of use) e-cigarette use at wave 2.

From answering that question at stage two as more than one day of “use” (even one puff remember), the researchers then used that data coupled with their “reasons” for use to say that kids were more likely to “continue use” based on their uptake reason. Amusingly, those troublesome yoofs who said they still used at stage two (by the way, that was only a “mere” 140 participants), whereas those that didn’t provide “frequency of use” data (30 kids) were _still categorised _as “continuing” to use.

What a way to skew results in favour of a policy objective!

But there’s a twist, as there always is.

This figure apparently shows “predictors” of continued use – i.e. Low cost is likely to be associated with continued use. Well isn’t that a shock? Teens use them because they’re curious, or they want to use them to stop smoking or some other reason, yet the overriding reason they continue to use them is because they don’t cost as much as smokes. Who knew?

So once again, research from the US – and I use the term research loosely here – is being performed, not on the basis of actual fact-finding, but on the basis of supporting (putting it politely) bonkers regulation.

Tell me, is that really about health?

(image credit Olivier Le Moal/shutterstock)