Thursday, September 22, 2016

“ENDS” Don’t Justify the Means with E-Cigarettes

E-cigarettes and vaping are transforming tobacco use in the U.S. and worldwide.  The innovative products are being used almost exclusively by smokers looking for substitutes for more harmful conventional combustible tobacco.  This revolution is progressing despite widespread opposition from public health officials and tobacco prohibitionists, some of whom are combating the products with linguistics. They’re trying to label e-cigs “electronic nicotine delivery systems,” or ENDS (here). 

Carl Phillips (here) traced the beginning of ENDS to a World Health Organization report in 2010 (here).  To be fair, it is common for researchers to invent terminology and acronyms as shorthand to communicate efficiently; Dr. Philip Cole and I used ANDS – alternative nicotine delivery systems – in a 1999 professional article describing safer nicotine substitutes for smokers (here). 

Still, obfuscating popular terms as a form of social engineering is not appropriate, as two recent publications in Tobacco Regulatory Science (here) and Nicotine & Tobacco Research (here) demonstrate.

In the first study, staff at RTI International and the FDA in 2014 interviewed 12 focus groups of vapers.  They found that “participants understood the umbrella term ‘e-cigarettes’ to refer to a variety of device types,” that “vaper” was an acceptable term among e-cigarette users, and that “‘vapor’ was generally well-known overall.”  More importantly, they wrote that “conceptual clarity, including using specific and familiar terminology and descriptions of products for users and nonusers alike, is crucial,” but they concluded that ENDS did not meet that standard.

The second study, by researchers at the American Legacy Foundation and several universities, was more critical of ENDS.  Examining the public posts of 1,023 users of a Legacy quit-smoking website, they found “that ‘e-cigarette’ and ‘vape’ are recognizable terms among US treatment-seeking smokers. Conversely, terms such as ‘ENDS,’ commonly employed by researchers and public health advocates, are not used by smokers and may be an impediment to tobacco control research.”

FDA and tobacco prohibitionists: When you talk to smokers and vapers, use the right terms.  End the ENDS.

Note: This isn’t the first time anti-tobacco forces have attempted to abuse linguistics in order to change behavior.  In 2010, I advised the American Cancer Society and federal agencies that their use of the term “spit tobacco” instead of “smokeless tobacco” was disrespectful, unprofessional and perjorative (here and here).  All agreed to discontinue the practice (here).  


Brian Carter said...

These people still haven't changed the name of their conference.
Judging by the grotesque image at that link, these people are incapable of feeling shame over the mere use of "spit tobacco."

Carl V Phillips said...

I started a post about this, but probably will not finish it. So some thoughts here:

It is truly hilarious that they ever thought anyone else bought into "ENDS" at all. That shows just how deep their insularity goes.

As I pointed out in the linked post, this fails as a made-up technical term because it is wrong. Your "ANDS" could serve a useful technical purpose of defining a category that does not have a natural name. But "ENDS" always just mean "e-cigarette", a category that already had a natural name. They used it to refer to e-cigarettes that did not contain nicotine, so the N was wrong. The literal meaning of the E would mean that an electronic injection pump, or perhaps a cigarette vending machine, would qualify. At the same time, the E exclude a few (not yet marketed) versions of e-cigarettes that presumably they meant to include. Thus, the *only* apparent reason for the made-up term was to denigrate.