Tuesday, October 26, 2010

Article on Electronic Cigarettes Draws Conclusion Before Data Are In: Why is the Research Necessary?

A commentary published online ahead of print earlier this month in the journal Tobacco Control reviews the marketing of electronic cigarettes and calls for public health research on these new products to help inform regulatory strategies (see: Noel JK, Rees VW, Connolly GN. Electronic cigarettes: a new 'tobacco' industry? Tobacco Control 2010).

Curiously, however, the article concludes - before any of the research that it calls for has been conducted - that the results of this research should be used "to counteract e-cigarette industry marketing."

The article concludes as follows: "The emergence of the e-cigarette industry must be met with an informed public health response. Research on product design, toxicant exposure, abuse liability including dual use with tobacco products, youth initiation, and influence on cessation efforts is needed to counteract e-cigarette industry marketing and inform regulatory strategies."

In other words, the authors are concluding that research is necessary to inform an appropriate public health response, but that regardless of what the research actually shows, its purpose is simply to provide evidence to counteract e-cigarette marketing: that is, to discourage electronic cigarette use.

Apparently, it doesn't matter what the research actually shows. The authors have apparently drawn a pre-determined conclusion that electronic cigarettes are harmful to the public health and therefore we should discourage people from using these products. But this conclusion precedes the research they call for to determine whether or not the product is safer than regular cigarettes, how effective it is in smoking cessation, and whether or not it encourages youth smoking initiation or dual use with tobacco products.

What then, is the point of the research?

The Rest of the Story

Apparently, the purpose of the research is to support a pre-determined conclusion that we should discourage people from using electronic cigarettes.

But what if the research were to show that electronic cigarettes are very effective in helping people quit smoking and that they are much safer than regular cigarettes (two hypotheses for which there is very strong preliminary evidence)?

I guess it wouldn't matter, because according to this article, we need the research "to counteract e-cigarette industry marketing."

Clearly, according to this article, there is no point in doing the research in the first place. If the pre-determined conclusion is that electronic cigarettes are evil and will harm the public's health, then why waste the money on the research? Why not just ban electronic cigarettes, here and now? Doing the research would actually be devastating to the public's health, as countless lives would be lost from toxicant exposure, dual use, youth initiation, and decreased cessation during the mean time.

On the other hand, if the research ends up confirming preliminary evidence that electronic cigarettes are much safer than regular ones and that they are very helpful to many vapers in keeping them off cigarettes, then efforts to counter electronic cigarette marketing will be contrary to the protection of the public's health, and will end up killing people. How is that a good thing? And why would you want to promote an action that might end up killing people before you have the facts in place?

An additional troubling aspect of this story is that one of the authors is a member of the FDA's Tobacco Products Scientific Advisory Committee, and could end up being involved in decision-making regarding electronic cigarette policy. This would be unfortunate because we need experts who are willing to consider the evidence rather than those who make pre-determined conclusions before the research has even been conducted.

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