How to Generate Bogus Conclusions (E-Cig Study Edition)

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58. No, that's not right. They made no study of whether it helps people quit.

Check this out: “You’ll hear lots of stories from people that say that e-cigarettes help them quit, but what we found was when we actually studied that systematically, we didn’t see a significant effect on cessation”

They did not study whether e-cigs help people quit at all, systematically or otherwise. They studied whether having used e-cigs in he past helped people quit smoking in he future.

In this study, a person who had never tried e-cigs would be in the smoker/no ecig experience subset. So then three months later they try ecigs and quit. It appears that in this study that would count as an e-cig fail because they quit using e-cigs, rather than quitting after using e-cigs and cigarettes simultaneously.

On the other hand, some guy had been smoking and vaping up a storm. Loves e-cigs. Decides to quit cold turkey, with no e-cigs. That would be an e-cig success story.


For this all to mean what it claims to mean requires that people who have used an e-cig in the last month are identical to the general smoking population, and that statements about quitting are interchangeable between the two groups.

The e-cig experienced subset is self-selected. This is a population of, in this case, smokers who have for some reason used an e-cig in the last month.

Does anyone think that group is comparable to all cigarette users?

Most smokers,by a lot, say they would *like* to quit.

Some people who would like to quit try an e-cig to see if they will magically quit. Since quitting takes an effort, they do not magically quit. No surprise.

We have no identified a population who would *like* to quit, but have taken a step in that direction and failed. And surprise! That group is less successful over the following year.

Let me try it this way... I suggest that a study of people who smoke while using nicotine gum (or any other method of quitting) will show a lower quit rate than the general population of smokers.

People who smoke while using nicotine gum are hardcore addicts in trouble who can't quit no matter what.

Would anyone compare them, apples to apples, to ordinary smokers who don't also chew nicotine gum while smoking, and thus conclude that nicotine gum doesn't work?

Almost everyone who has ever used methadone is a serious junkie, not a casual user. Out of the population of people who have ever used heroin but do not use heroin today, I can guarantee you that the group that has used methadone has a higher, not lower rate of heroin use.

But that is because nobody who can quit on their own uses methadone. Nobody who isn't all that addicted to begin with uses methadone.

It is not a sensible way to look at whether X helps people quit Y.

And, as I am sure you know, the populations of users of any addictive substance, from heroin to alcohol to caffeine, etc., are very different. Some people's brains are wired to crave and need shit like you wouldn't believe while others can take it or leave it.

That goes for nicotine as much or more than for cocaine.

And the hardest cases are precisely the people who quit and fail and quit and fail. They have a lot more experience with quiting, with alternatives, with therapies.

If this stuff is not done apples to apples it is an auto-fail.