The National Cancer Institute is wasting taxpayer dollars on slanted e-cigarette research that didn’t ask or answer an obvious and important question.
Consider the recent NCI-funded study by Drs. Erin Maloney and Joseph Cappella at the UPenn Annenberg School of Communication (abstract here).
Maloney and Cappella recruited daily smokers, intermittent smokers and former smokers (there were no significant results in the middle group so I won’t discuss them). They divided smokers into three subgroups: controls who didn’t see an ad, those who saw e-cig ads with vaping (called a cue) and those who viewed ads with no vaping. Participants answered questions about their inclination to smoke a cigarette, to quit smoking or to continue to abstain. Maloney and Cappella developed a scoring system to measure responses. The results they pitched to the media are in the table.
All groups had lower urges to smoke after the experiment, but smokers who saw the cue had less of a lower urge, which was significant in the authors’ scoring. Similarly, all former smokers had high scores for continuing to abstain, but those who saw the cue had a lower high score.
|E-Cigarette Ads and Urges in Daily Smokers and Former Smokers|
|Daily Smokers||Former Smokers|
|Cue||No Cue||No Ad||Cue||No Cue||No Ad|
|Urge to Smoke|
*Significantly different than No Cue or No Ad.
The authors acknowledged that “effect sizes reported in this manuscript were not large.” In fact, the differences are so small that they may not be meaningful for actual behavior. Take 12.39 versus 13.14 in the table as an example. The authors reported that higher numbers are better, and both numbers look “high” when compared with a previous study by Cappella that used the score (abstract here). He showed former smokers anti-smoking ads in that study and got scores around 3.0 to 3.5. This looks like e-cigarette ads are far better for former smokers than anti-smoking ads.
There is a glaring defect in the report. The researchers collected a lot of basic information (e.g., education, quitting history and time since last cigarette) that could affect how participants responded to questions, but the results weren't adjusted for these important characteristics. It is possible that the cue, no-cue and no-ad groups had important differences in basic information that affected their scores.
The study’s biggest weakness is that no data was collected on urges and intentions to VAPE. After all, that is the most important goal of e-cigarette ads, and it is an obvious outcome to measure.
This study is a failure to communicate.