Monday, January 9, 2023

“Poorly Designed, Conducted, and Interpreted” Research Deters Smokers From Life-Saving Safer Cigarette Substitutes


I recently published research in Internal and Emergency Medicine demonstrating that a dozen prior articles describing diseases in vapers were flawed and unreliable.  Subsequently, the journal editors commissioned a commentary on our work from eminent tobacco harm reduction experts Riccardo Polosa and Konstantinos Farsalinos.  Following are extracts from their article.

“[Rodu and Plurphanswat] have provided cogent and convincing evidence based on a creatively simple assessment of data from the first wave of the PATH survey that smoking-related diseases…were only rarely diagnosed in respondents who had initiated e-cigarette use prior to the age of diagnosis of these disorders...these diseases were nearly always diagnosed following (mostly many years after) the…initiation of smoking…97% of all cases for COPD, 96% for emphysema, 98% for myocardial infarction and 93% for stroke. Indeed, most of these diseases were ultimately diagnosed in respondents who initiated smoking prior to 18 years of age.”

“What [Rodu and Plurphanswat] accomplished was so conceptually simple and fundamentally important that we are very surprised that no one, particularly any of the authors of the PATH survey publications, had carried out a similar assessment previously.  Moreover, reviewers of the many PATH, BRFSS, and NHIS based papers showing a relationship between e-cigarette use and smoking-related diseases appear not to have considered the critical importance of the timing of events.

“And this relates to the next question. How was it possible that the peer review process at highly respected scientific Journals has failed to detect such fatal flaws and has allowed publication of low-quality papers lacking inclusion of such key factors essential for the interpretation of their analysis? The unopposed acceptance of these (low-quality) papers by prestigious journals is symptomatic of a significant dysfunction in scientific publishing, which is distorting the practice of science.”

Polosa and Farsalinos provide an insightful observation:

“Research on tobacco harm reduction (THR), and particularly on electronic cigarettes (e-cigarettes), remains a highly controversial topic in the scientific community. The controversy is also sustained by research, which is often poorly designed, conducted, and interpreted [1]. Dissemination of inaccurate information on smoke-free alternatives in the media contributes to public skepticism and uncertainty, particularly among smokers, who as a result are discouraged from adopting reduced-risk lifestyles.”

Jacob Sullum, an editor at Reason and a long-time supporter of THR, covered my article and the Polosa-Farsalinos commentary here.  He concluded: “The bias against e-cigarettes, in turn, shapes public perceptions. Although authoritative sources such as the Food and Drug Administration, the Royal College of Physicians, and the National Academies of Sciences, Engineering, and Medicine acknowledge that vaping is far less hazardous than smoking, surveys find that most Americans believe otherwise.”

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