New study: profound ignorance about the basic facts of the potential for tobacco harm reduction

by Carl V Phillips

A new research report by Kaufman et al., a group of anti-tobacco people, primarily working for the National Cancer Institute (NCI), confirms how effective anti-THR lies have been in dissuading American smokers from switching to low-risk alternatives. It is not too surprising — though still utterly pathetic — that you would never know that from reading the abstract at the link. Still, Kaufman is apparently more honest than some of her coauthors and bosses, and the useful information is clearly presented in the paper itself.

The study used January 2013 data from the HINTS national survey of American adults, which has some issues that make it not quite nationally representative, but close enough for present purposes. The abstract reported only the result that about half of Americans did not know that the FDA regulates tobacco products. If your reaction to that is “who cares?”, you are in good company. But the abstract is an exercise in burying the lead — after hitting it on the head with a shovel and dragging it into the woods. I would love to see a transcript of the negotiation in which the honest researchers on the team were allowed to report the genuinely interesting results of the survey, but were forbidden from mentioning them in the abstract. I would also really like to see the “peer review” reports that allowed that travesty to stand.

The interesting information is in Table 1 (indeed, that is all that is worth reading other than the partial reporting of their methods — it is generally a complete waste of time to read the commentary that authors throw into these papers).

Subjects were asked, “In your opinion, do you think that some smokeless tobacco products, such as chewing tobacco, snus, and snuff, are less harmful to a person’s health than cigarettes?” Setting aside the stupid wording (“In your opinion, do you think”) which makes wrong answers technically correct, the correct response is obviously “yes”. It is more true than if they had asked “Is the Earth round” (since it is not perfectly round). There is absolutely no doubt about this (especially with “some” in the wording, though it would still be true, as far as we know, if that were “all”). But only 10% of the respondents got the question right, with three-quarters getting it out-and-out wrong with “no”. That is an impressive tribute to decades of anti-THR lies aggressively communicated by, among others, NCI, who we found was arguably the worst offender in the early 2000s.

The responses vary by demographics, but not much. The one bit of good news there is that smokers were more than twice as likely to know the right answer as nonsmokers. Interestingly, having more education decreased the chance of giving the right answer

As a survey geek, I am also struck by 15-20% of the responses that were “don’t know”, which illustrates the poor quality of the survey. Given the tortured phrasing of the question, the use of “In your opinion, do you think”, there cannot be a legitimate “don’t know” answer; you either think it or you don’t. If you don’t — even if it is because you have never given any thought to the issue — then the accurate answer to the question as asked is “no”. On the other hand, if the respondent is ignoring that phrasing and just answering the question, then no one should ever say “no”: If they are inexpert enough to not know that the answer is obviously “yes” then they should recognize that there might be “some” product out there that is less harmful (and thus answer “don’t know”). This further illustrates the effectiveness of the anti-THR propaganda; most everyone just recites the lies without thinking. The survey flaws do not stop us from generally interpreting the implications of the answers, as I am doing here, but that is no excuse for putting such inept questions on the survey. The question could have been asked so that the answer clearly meant what we think it probably means.

The news about e-cigarette is not nearly so bad — not good, but not so terrible. As I have noted before, the ANTZ were late in trying to spread lies about e-cigarettes. They are so busy with their silly down-the-rabbit-hole (or up some other hole) “endgame” exercises, and they are also not generally very bright, so it took them a while to recognize this threat to their goal of keeping all tobacco users smoking. In the meantime, the truth about e-cigarettes took hold.

Subjects were also asked, “In your opinion, do you think that some types of cigarettes are less harmful to a person’s health than other types?” Of course some are less harmful than others. The probability that they all happen to be exactly the same is zero. They might or might not be much different (we really do not know), but that was not the question, and two-thirds of subjects showed their fundamental innumeracy by saying “no”. This is another tribute to Tobacco Control propaganda — especially since the education gradient again goes the wrong way, with those with more education more likely to give the innumerate answer — because they push the absurd message that all cigarettes pose exactly the same risk.

The other two reported results are uninteresting, the one about FDA regulation and “Compared to people who smoke every day, do you think people who smoke just some days have less or more risk of getting health problems in their lifetime?” The latter is uninteresting because the question is so bad that it is impossible to know what an answer meant (we have no idea how the subjects interpreted “smoke just some days”, nor where they drew the line between “about the same” and “less”). The only thing we can learn from that one is that, given that almost 10% said “more”, a lot of people were answering randomly, since no one could really think that and I am aware of no Tobacco Control propaganda that tries to make people believe that particular absurdity.

To save you the trouble of doing so (you’re welcome), I decided to slog through the mercifully brief prose in the paper to see if there was any recognition of how badly misinformed people were, or perhaps any sign of contrition about helping cause that. You will be unsurprised to learn that the answer is no. Indeed, the commentary is rather bizarre, focusing almost entirely on the completely uninteresting association between not knowing the FDA regulates tobacco products and giving “don’t know” answers to other questions. Reading between the lines, the mission behind this paper seems to be about assessing whether FDA regulation reassures people about tobacco products — without actually saying “it shouldn’t! since it is not really regulation, which would imply they are trying to improve the quality of products.” Still, along the way they reported some useful information, and for that we thank them.