Awareness Failure

When bad sciences gets worse.

question mark on chalk board

It’s been a while since I had a good look at some junk science. I kind of missed doing it. So, what better way to get back to it then with this steaming pile of festering dingo kidneys?

This study sought to assess: 1) pervasiveness of vaping or electronic cigarette (e-cigarette) use, 2) General understanding of information on vaping or e-cigarette use, 3) Prevalence and respondent awareness of smoking/vaping prevention programs, and 4) Awareness of the harmful effects of e-cigarettes.

Kanyadan et al 2019

Oh boy.

To be fair, those are reasonable goals to assess. So, let’s look at the method.

This was a cross-sectional survey of 101 young adults (ages 18-24) in the United States designed to assess the prevalence and knowledge of vaping. Ten questions tested this knowledge and prevalence, some directly (for example, “Which of the following have you used? Select all that apply”) and some indirectly (Which of the following pictures corresponds with that of an e-cigarette?). After the results were obtained, the crosstabs showed the percentage of respondents who identified a particular answer for each question.

Kanyadan et al 2019

Wait. A cross-sectional survey with an “n” of 101? Good grief. Also, why only ten questions? I mean, the Smoking Toolkit Survey has hundreds of questions with branches and details. What possible data can be obtained on a complex topic from only ten questions?

That’s just some snippets from the abstract. This is not going to end well for the authors.

Tobacco contains an addictive substance called nicotine. Nicotine is a stimulant that has multiple harmful effects, such as yellowing of nails, sexual impotence, cough, abdominal pain, and lung cancer. Traditional tobacco products, such as cigarettes and cigars, contain over 500 harmful and carcinogenic substances [1]. This may be one reason that many have turned to e-cigarettes (also known as Electronic Nicotine Delivery Systems, or ENDS) under the erroneous belief that e-cigarettes are safer than tobacco.

Kanyadan et al 2019

Good grief! The supposed harmful effects of nicotine listed apparently originated from this paper which mentions nothing of the sort. So far, this paper is worse than anything put out by Glantz. That’s saying something.

However, e-cigarettes are only shown to be more harmful, as e-cigarettes contain the same nicotine that is found in cigarettes, plus they contain vapor that can produce inflammatory chemicals and impair alveolar macrophages in the lungs, which function to remove organisms and objects that harm the lungs [2]

Kanyadan et al 2019

Oh good. Another complete falsity. Guess what is cited for this? The FDA ‘Real Cost’ campaign. Should I continue? Probably.

In the survey, young adults (18-24) were targeted in order to determine the general notion on how much less harmful e-cigarettes were believed to be. Young adults were additionally targeted because the 2018 National Youth Tobacco Survey showed that vaping had increased by 78% among high-schoolers and 48% among middle-schoolers, showing that current programs are somewhat ineffective in preventing youth from using e-cigarettes [4]

Kanyadan et al 2019

Except the data shows nothing of the sort. Now, of course, citation 4 is “The Real Cost of Vaping” sponsored by FDA which, in part, tells worthy students to quiz their classmates on vaping and to document their results while gathering data about the “dangers” from trusted sources. Oh yes, you guessed it. Those ‘trusted sources’ include the FDA, the American Lung Association, the American Heart Association and the National Academy of Sciences.

No mention of further citable sources.

A cross-sectional survey of young adults aged 18-24 years in the United States was conducted using the Google Consumer Survey methodology to assess how many respondents were aware of the appearance, properties, and effects of e-cigarettes and vaping.

Kanyadan et al 2019

Give. Me. Strength.

The background questions targeted the prevalence of smoking, awareness of properties of e-cigarettes, and awareness of their effects. The program knowledge questions targeted the respondents’ knowledge of programs to help them and others quit smoking and vaping, and whether their educational institution ran one of these programs.

Kanyadan et al 2019

I see where this is going now. This is all about nicotine abstinence and getting people to use the various programs that offer that kind of service. Gotcha.

Supposedly responses to the question “Which of the following effects of nicotine are you aware of?”

In just one chart, I can summarise just how misled youth in the US really are.

  • Nicotine is not a carcinogen
  • Nicotine does not cause yellowing of nails (that’s the TAR you muppets)
  • Nicotine is not responsible for impotence (that’s the carbon monoxide)
  • Nicotine may cause vomiting and nausea when consumed in extremely high quantities – that’s the body forcibly ejecting it. In the levels consumed by smokers & vapers, it doesn’t. It’s called self-titration.

It’s only a little comforting that just over a quarter of the n=101 correctly answered that question with “None of the above”. But it gets worse.

“Do you think e-cigarettes and tobacco have similar cancer causing agents”

The misinformation campaign waged across the US is having its intended effect I see.

“Which brand of e-cigarette are you familiar with?”

Funny how JUUL is the most recognised. Could that be something to do with the fact that the likes of Campaign for Tobacco Free Kids and Truth Initiative won’t shut the fuck up about it? JUUL couldn’t ask for better brand recognition. (If only they weren’t such floppy appeasers; and I’m being diplomatic there).

“Do you think vaping is safer than using cigarettes”

The next generation of US youth are doomed.

The cross-sectional survey showed that if both of the respondent’s parents smoked, the less likely they were to be aware of any of the harmful effects of nicotine (40% of people of whom both parents smoked or vaped responded “none of the above” for the knowledge of effects question).

Kanyadan et al 2019

Those 40% that answered “none of the above” to the supposed harms from nicotine are 100% correct. All that shows is those kids bothered to do research that you, as the lead author, and thus the research designer, didn’t do.

This “paper” isn’t scientific. It is full of bias and will only serve to distort any future real science. Even the fucking conclusion is wrong:

This cross-sectional survey of young adults aged 18-24 echoes the existing literature in depicting a widespread use of e-cigarettes, with little awareness of the many associated perils. The results of the cross-sectional survey also point to a large number of people under the impression that e-cigarettes are safer than traditional cigarettes. Despite existing educational campaigns and resources to quit nicotine, the prevalence remains strong, and makes a case for a call to action to prevent an epidemic of nicotine addiction.

Kanyadan et al 2019

Let’s rewrite that shall we?

This cross-sectional survey of young adults aged 18-24 corresponds with existing literature in demonstrating widespread use and awareness of e-cigarettes. This survey also demonstrates that those who use e-cigarettes have performed research of their own and have further made their own choices based on their risk-reward scales. The results of the cross-sectional survey also point to a large number of people correctly having the impression that e-cigarettes are safer than traditional cigarettes.

Think that covers it.

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