New atrocity perpetrated by ANTZ

[DrMA]

Another review peddling the poisonings nonsense (among other lies) made press the other day.

https://www.ncbi.nlm.nih.gov/m/pubmed/25136064/

The review basically says: the data support that ecigs look like they're safer and more effective than NRT, but we're gonna spew some unsupported alarmist garbage about poisonings instead...

I can't wait for Hajek's Cochrane review to bury all these shameless lies. I hope it makes a point of calling out these ANTZ for the 1.24 billion counts of desk murder that they're trying to perpetrate.

 

[dragonpuff]

"DATA SYNTHESIS: A total of 6 clinical studies were included in the review. In small studies, e-cigarettes significantly decreased desire to smoke, number of cigarettes smoked per day, and exhaled carbon monoxide levels. Symptoms of nicotine withdrawal and adverse effects were variable. The most common adverse effects were nausea, headache, cough, and mouth/throat irritation. Compared with nicotine patches, e-cigarettes were associated with fewer adverse effects and higher adherence. Most studies showed a significant decrease in cigarette use acutely; however, long-term cessation was not sustained at 6 months.

CONCLUSIONS: There is limited evidence for the effectiveness of e-cigarettes in smoking cessation..."

Wait, what??? Are you saying you happened to review the wrong evidence to support your belief, or... ?

This sounds to me like "Well we were planning to review all of these studies to show that e-cigs do not help people quit smoking. However, upon review, we found that they actually do help people quit smoking. Therefore, instead of actually changing our minds on the subject, we decided that we must pull more reasons out of our {expletive deleted} to bolster our original argument that 'e-vapor cigs', or whatever the kids who obviously use them are calling them these days, must be ineffective and dangerous."

 

[Nate760]

Quick dose of perspective: even if e-cigs failed to produce smoking cessation in 90% of cases, they would still be more effective than any smoking cessation product currently on the market. This is one of those little inconvenient details that tend to get lost when the ANTZ are the ones doing the analyses.

 

[DrMA]

Quick dose of perspective: even if e-cigs failed to produce smoking cessation in 90% of cases, they would still be more effective than any smoking cessation product currently on the market. This is one of those little inconvenient details that tend to get lost when the ANTZ are the ones doing the analyses.

That's right. We'd better use the same rhetorical tricks as ANTZ to talk about this.

Fact: NRT fails more than 90% of the time when used as directed
ANTZ: NRT doubles the success of quitting compared to cold turkey.
Vapers: NRT is useless, expensive, and disgusting. Quit smoking "support" services do not make it any better, but are irritating, demeaning, and an affront to your intrinsic value as a human being.

Fact: PVs help more than 44% of vapers achieve >50% reduction or complete cessation at 8 months (see here)
ANTZ: There is limited evidence for the effectiveness of e-cigarettes in smoking cessation
Vapers: vaping increases the odds of quitting smoking 7X over cold turkey and 3-4X over NRT. It is also yummy and fun

 

[Nate760]

That's right. We'd better use the same rhetorical tricks as ANTZ to talk about this.

Fact: NRT fails more than 90% of the time when used as directed
ANTZ: NRT doubles the success of quitting compared to cold turkey.
Vapers: NRT is useless, expensive, and disgusting. Quit smoking "support" services do not make it any better, but are irritating, demeaning, and an affront to your intrinsic value as a human being.

Fact: PVs help more than 44% of vapers achieve >50% reduction or complete cessation at 8 months (see here)
ANTZ: There is limited evidence for the effectiveness of e-cigarettes in smoking cessation
Vapers: vaping increases the odds of quitting smoking 7X over cold turkey and 3-4X over NRT. It is also yummy and fun

ANTZ: Won't SOMEONE think about the children???

 

[bigdancehawk]

"Concerns" are "alarming." Translation: In the absence of evidence to support their views, ANTZ profess concern. I suspect that "concern" and "concerned" are the most frequently used terms in these articles.

". . . significantly decreased . . . exhaled carbon monoxide levels . . ." DUH

"long-term cessation was not sustained at 6 months." Oreally? It seems they overlooked some studies:
"[We] monitored possible modifications in smoking habits of 40 regular smokers (unwilling to quit) experimenting the 'Categoria' e-Cigarette [what's that?]. . . .Sustained 50% reduction in the number of cig/day at week-24 was shown in 13/40(32.5%) participants; their median of 25 cigs/day decreasing to 6 cigs/day (p < 0.001). Sustained 80% reduction was shown in 5/40(12.5%) participants; their median of 30 cigs/day decreasing to 3 cigs/day (p = 0.043). Sustained smoking abstinence at week-24 was observed in 9/40(22.5%) participants, with 6/9 still using the e-Cigarette by the end of the study. Combined sustained 50% reduction and smoking abstinence was shown in 22/40 (55%) participants, with an overall 88% fall in cigs/day." Efficacy of Electronic Cigarettes for S... - PubMed Mobile - NCBI
And here's another one showing long-term cessation: Effectiveness and tolerability of elect... - PubMed Mobile - NCBI

 

[Bill Godshall]

The full text of this junk study is behind a paywall at
http://aop.sagepub.com/content/48/11/1502.full.pdf+html

It would be appreciated if bigdancehawk sends me the full text version to BillGodshall@verizon.net

Not only did the abstract misrepresent some of the findings of those six studies, none of the six studies the authors reviewed evaluated e-cigarette "poisoning exposures among adults in comparison with cigarettes", which was cited in the author's conclusion.

In fact, I've never seen any study that evaluated e-cigarette "poisoning exposures among adults in comparison with cigarettes", as all of the reports on e-cig "poisoning exposures" (which the Poison Control Centers falsely define as any use of, or even touching an e-cig) focused on children.

 

[bigdancehawk]

The full text of this junk study is behind a paywall at
Sign In

It would be appreciated if bigdancehawk sends me the full text version to BillGodshall@verizon.net

Not only did the abstract misrepresent some of the findings of those six studies, none of the six studies the authors reviewed evaluated e-cigarette "poisoning exposures among adults in comparison with cigarettes", which was cited in the author's conclusion.

In fact, I've never seen any study that evaluated e-cigarette "poisoning exposures among adults in comparison with cigarettes", as all of the reports on e-cig "poisoning exposures" (which the Poison Control Centers falsely define as any use of, or even touching an e-cig) focused on children.

Bill, I haven't accessed the full text version. I quoted from PubMed summaries/abstracts of other studies that are inconsistent with the summary/abstract DrMA linked in his OP. I don't know what studies they reviewed. I note they only reviewed six English language studies, all "clinical." What e-cigarettes were given to the test subjects, how the test subjects were picked, what the test protocols were, etc., are all unknown. What is also unknown and a mystery to me is why these researchers (or whatever they are) pick subjects who profess to have no interest in smoking cessation and then publish results that purport to measure the efficacy of e-cigarettes as smoking cessation products.

 

[Lessifer]

Quit smoking "support" services do not make it any better, but are irritating, demeaning, and an affront to your intrinsic value as a human being.

This is the only thing I don't agree with. THIS support group is a majorly effective tool. Probably because we don't tell people that they are evil for smoking, or steer them towards ineffective means of cessation.

 

[Nate760]

What is also unknown and a mystery to me is why these researchers (or whatever they are) pick subjects who profess to have no interest in smoking cessation and then publish results that purport to measure the efficacy of e-cigarettes as smoking cessation products.

This goes back to the rather warped worldview that a lot of clinicians have with regard to smokers and smoking. They operate under the paradigm that smoking is a disease, and smokers are sick people who need a cure for their condition. Thus, there is no need to distinguish between people who want to quit and people who don't. These people all suffer from this terrible affliction, so obviously they all want to be cured. If someone says they like smoking and don't want to quit, that should be disregarded, because it's just the disease talking.

 

[Steamix]

Well, the ANTZ better put a sock in it. Spreading junk science may be tolerable upto some point.
But look at what happened to BT.
Got dragged in front of a court. And paying for it still.
Main reason it that they knew and didn't tell.

 

[DrMA]

This is the only thing I don't agree with. THIS support group is a majorly effective tool. Probably because we don't tell people that they are evil for smoking, or steer them towards ineffective means of cessation.

I'm sure you know that I was talking about the FDA-approved "official" quit-smoking lines who treat smokers as diseased lepers and offer "advice" as to how they might be "cured" of their "dirty habit" using "safe and effective" drugs sold by their paymasters at BP.

While ECF might be seen as a support group, I don't consider it a stop-smoking service. Rather, it's a platform for sharing and promoting THR, along the lines described here: http://www.sciencedirect.com/science/article/pii/S0306460313003729

 

[Lessifer]

I'm sure you know that I was talking about the FDA-approved "official" quit-smoking lines who treat smokers as diseased lepers and offer "advice" as to how they might be "cured" of their "dirty habit" using "safe and effective" drugs sold by their paymasters at BP.

While ECF might be seen as a support group, I don't consider it a stop-smoking service. Rather, it's a platform for sharing and promoting THR, along the lines described here: http://www.sciencedirect.com/science/article/pii/S0306460313003729

I did, I was just clarifying. I happen to think ECF is more along the lines of a what a support group should be. That's not all that ECF is of course, but a community of like minded people who have/are experiencing the same thing as you, can be effective.

 

[DrMA]

This goes back to the rather warped worldview that a lot of clinicians have with regard to smokers and smoking. They operate under the paradigm that smoking is a disease, and smokers are sick people who need a cure for their condition. Thus, there is no need to distinguish between people who want to quit and people who don't. These people all suffer from this terrible affliction, so obviously they all want to be cured. If someone says they like smoking and don't want to quit, that should be disregarded, because it's just the disease talking.

Yes, and this is another great opportunity for me to cite one of my favorite blog posts on the topic. Known as the "demonic possession" fallacy, Dr. Phillips defines it as: «the obvious discrepancy between (a) there are no benefits and (b) lots of people choose to do it. So it fell to me to fill in the missing step: possession by demons. Those billions of daily acts of consumption by hundreds of millions of people occur, contrary to the consumers’ true preferences, because the consumers are all possessed by demons. Thus their actions are not based on volition, which is based on preferences, but are arbitrary. Once you assume that people are acting arbitrarily, everything we know about welfare economics goes out the window.» Full post here: Economic illiteracy about tobacco, from the antepode | Anti-THR Lies and related topics

 

[Bill Godshall]

bigdancehawk wrote

Bill, I haven't accessed the full text version. I quoted from PubMed summaries/abstracts of other studies that are inconsistent with the summary/abstract DrMA linked in his OP. I don't know what studies they reviewed. I note they only reviewed six English language studies, all "clinical." What e-cigarettes were given to the test subjects, how the test subjects were picked, what the test protocols were, etc., are all unknown. What is also unknown and a mystery to me is why these researchers (or whatever they are) pick subjects who profess to have no interest in smoking cessation and then publish results that purport to measure the efficacy of e-cigarettes as smoking cessation products.

Sorry, I thought you had posted details from the full text of this new review, which misrepresented the findings of the six clinical trials.

The six clinical studies they reviewed had to include two or three of those conducted by Polosa et al, and the Bullen et al study, all of which found e-cigs effective for smoking cessation and cigarette consumption declines.

I'll send Polosa and Bullen the abstract of this new review so they can respond.

 

[Nate760]

The six clinical studies they reviewed had to include two or three of those conducted by Polosa et al, and the Bullen et al study, all of which found e-cigs effective for smoking cessation and cigarette consumption declines.

I think we should take great care in how we approach the cigarette consumption issue. While it's tempting to argue that a causal relationship exists between the increasing uptake of vapor products and the continuing declines in cigarette consumption (especially since it's almost certainly true), it's problematic if not impossible to find a sound evidentiary basis for such an argument that doesn't discount or ignore a large number of other relevant factors and variables.

Now, that's not to say declines in cigarette consumption aren't a valuable rhetorical tool that we should be using to its full advantage; they are and we should. But that use should be limited to what is demonstrably true, e.g. that vapor products are quite obviously not ......ing or reversing the downward trend in cigarette consumption, and that this fact renders utterly false all ANTZ/"public health" assertions about vapor products "renormalizing smoking" or driving any sort of increase in cigarette use.

 

[bigdancehawk]

I think we should take great care in how we approach the cigarette consumption issue. While it's tempting to argue that a causal relationship exists between the increasing uptake of vapor products and the continuing declines in cigarette consumption (especially since it's almost certainly true), it's problematic if not impossible to find a sound evidentiary basis for such an argument that doesn't discount or ignore a large number of other relevant factors and variables.

Now, that's not to say declines in cigarette consumption aren't a valuable rhetorical tool that we should be using to its full advantage; they are and we should. But that use should be limited to what is demonstrably true, e.g. that vapor products are quite obviously not ......ing or reversing the downward trend in cigarette consumption, and that this fact renders utterly false all ANTZ/"public health" assertions about vapor products "renormalizing smoking" or driving any sort of increase in cigarette use.

While they are clearly not reversing it, it would be hard to prove they aren't ......ing it, as is the case with any other negative. The "gateway" and "renormalization" arguments are speculative. There is no evidence to support them. Zero. The ANTZ have the burden of persuasion on these claims.

 

[Nate760]

While they are clearly not reversing it, it would be hard to prove they aren't ......ing it, as is the case with any other negative. The "gateway" and "renormalization" arguments are speculative. There is no evidence to support them. Zero. The ANTZ have the burden of persuasion on these claims.

Here's the tl;dr version of the point I was making:

"E-cigs are causing the downward trend in cigarette consumption" is a problematic argument that we should avoid using.

"Downward trends in cigarette consumption have continued, unabated, since e-cigs entered the marketplace" is a good argument that we should be using all the time.

 

[Oliver]

Absolutely x X^N

Interestingly, I caught Prof West being asked about this on Twitter just this morning, and he made the same point. He also stated that he's looking at deriving a relapse curve from his data.

Here's the tl;dr version of the point I was making:

"E-cigs are causing the downward trend in cigarette consumption" is a problematic argument that we should avoid using.

"Downward trends in cigarette consumption have continued, unabated, since e-cigs entered the marketplace" is a good argument that we should be using all the time.

 

[Oliver]

Also - this just underscores the need for a US based population-level study to be carried out properly. With the right question items, you could certainly derive a good estimate as to the "real world" effectiveness of the products.

But, until this is carried out we must content ourselves with "Downward trends in cigarette consumption have continued, unabated, since e-cigs entered the marketplace"