Ecig consumer wants and “needs”

by Julie Woessner and Carl V Phillips

[Julie Woessner JD is the Executive Director of CASAA and President of its Board of Directors.]

One more post about GTNF2015. Julie presented in a session titled “Consumer wants and needs”. It was one of at least three sessions with titles that, if interpreted generically, made them about the general question of what consumers care about regarding developments in tobacco products (which in practice made it mostly about e-cigarettes, since that is where most of the developments are). We decided to make this talk a little more specific, and deliver one of CASAA’s key messages, by taking advantage of the exact wording of the session title.

The following (between the “—–”) is Julie’s talk. It is the prepared script, not a transcript.


The basics of what consumers and would-be consumers of low-risk tobacco products want is no mystery. You have heard it a thousand times: Consumers want high quality products, innovation, variety, and the freedom to choose which products they want to use, along with freedom from punitive taxes and other unjust laws that restrict use and enjoyment.

That being said, what do consumers need in order to get what they want?

First, industry competition, which promotes innovation, price competition, and all those other wonders of the free market system. Second, freedom to choose, both literally and practically (which means allowing sales and distribution channels for a variety of products). Third, accurate information so that consumers can make informed choices that reflect their tradeoffs, particularly information about comparative risks within and between product categories.

You might notice that I qualified the word “need” with a rather simple phrase: “in order to.” So the question becomes not simply what do consumers need, but, rather, what do consumers need in order to — in this case — get what they want. A discussion of “need” in and of itself is largely meaningless — and sometimes rather dangerous — without that “in order to” qualifier.  

In fact, presenting something in terms of “wants” and “needs” usually implies that wants are self-indulgent and frivolous while true needs are properly determined by those who are in positions of authority, since consumers can’t be relied upon to know what they need or what is truly in their best interests. This is a terrible, but common attitude. Thus, when someone asks what consumers “need” without including the all-important “in order to” clause, we should be wary of hidden agendas and moral positions.

Regarding e-cigarettes, the most common agenda among those posing the question, “what do consumers need” is that they are actually asking, “what do consumers need in order to ‘cure smoking,” or even “in order to be just good enough to cure smoking, but not any better than that.” If one sees e-cigarettes and other low-risk alternatives to smoking as simply a “cure” for smoking, then they are much like medicines. For those with this mindset, things like medicines and nourishment are “needs,” which make them somehow superior to mere wants, like enjoying life. And, of course, there is no “need” for medicines to be enjoyable. Rather, they merely need to work well enough.

And so we see regulators and many members of public health seeking to impose restrictions that make e-cigarettes less enjoyable and less acceptable because simple enjoyment and pleasure are wants, but not “needs.” Consider the EU Tobacco Products Directive where e-cigarettes as consumer products can only have a maximum level of nicotine of 2% nicotine. The rationale? “This concentration has been shown to be adequate for the majority of smokers that use an e-cigarette to substitute smoking.” (emphasis added) Leaving aside the fact that this is a mischaracterization of the science, it is troubling that anyone would consider it to be acceptable to impose limitations that have the effect of making something merely “adequate” for a “majority” of smokers.

In the U.S., there is an outcry against all flavors other than tobacco and menthol. Some phrase their opposition to flavors as being about protecting the children from target marketing — because the feeling is that only children could want fruit or sweet flavors. Others will acknowledge, perhaps somewhat grudgingly, that adults do enjoy such flavors, but believe that it is nonetheless acceptable and appropriate to eliminate those flavors to make the products less appealing to children. Again, they would argue that pleasant flavors — and an enjoyable product more generally — are not a “need” if one views e-cigarettes as merely being about smoking cessation.

But even if one is inclined to see the only legitimate role for e-cigarettes as a “cure” for smoking, given that there are hundreds of millions of smokers out there, any quality improvement in e-cigarettes is, for some of them, going to be the tipping point between continuing to smoke and switching. And likewise, for every restriction or limitation placed on e-cigarettes — whether it be nicotine strength, cost, flavors, or various other factors — there will be some smokers who will find e-cigarettes a less acceptable alternative to smoking.

I would suggest that when we talk about “needs” rather than “wants,” we are in danger of buying into an anti-consumer, anti-humanitarian view. There is nothing inherently wrong or immoral with consumers enjoying a consumer product, and there is absolutely no justification for purposely ignoring or deliberately reducing the enjoyment factor associated with the use of that product.

At the end of the day, the reason why e-cigarettes are such a tremendously successful alternative to smoking is because they are enjoyable, and anything we do to reduce the enjoyment will necessarily reduce their acceptability as an alternative to smoking.


Economists — which is to say, the scientists who study wants and needs and the like — generally object to the word “need” when it is used to imply something that is qualitatively different from a want. To paraphrase the great Jedi economist: Want or want more; there is no need. Of course, the word is legitimate with an “in order to” clause, whether you are talking about economics (“people need insurance to have access to modern healthcare”) or some other science (“you need to heat water to 100 degrees as standard pressure to make it boil”). But lacking such a stated condition, the word is economically meaningless. The typical response to that is “but you need food, water, shelter, oxygen, etc.” But buried in that is an implicit statement of “in order to still be alive next month.” Also, *yawn* — no one who is not discussing how to colonize Mars is ever actually talking about the minimal conditions for survival.

No, when someone uses the word “need,” there is always an implicit “in order to” statement buried there, and it is almost always “in order to get what I think they should want.” Put another way, the word is often a way of burying an illiberal and often anti-humanitarian premise that the author is trying to hide from the debate it deserves. Sustenance and medicine can be legitimately called adequate or inadequate, but such words are absurd for consumer goods. Even if you do not have the slightest urge to own a Ferrari, you do not want a car that would be described as “adequate” — which would basically mean “really lousy.” For an enthusiast, the concept becomes even more absurd.

This relates closely to the divides among different political factions that have emerged in the neighborhood of THR, but that are not actually about THR. For the first decade and a half of the THR movement (measuring from Rodu and Cole’s seminal 1994 paper), there was a pretty clear dichotomy: There were supporters of THR who were also supporters of smokeless tobacco (which was the only viable option) versus the “public health” people who opposed any tobacco product use more than they favored health. But the e-cigarette phenomenon has divided both groups.

There was no important political movement around smokeless tobacco enthusiasm — consumers merely wanting to defend their personal consumption choices, without it really being about THR, let alone “need” — but there now is for e-cigarettes. The “public health” faction also divided, with a few backing e-cigarettes as a cure for smoking, a de facto medicine. This is not about THR either, since it runs contrary to that philosophy’s ultimate grounding in individual empowerment and freedom. For this new faction of tobacco controllers, “need” is a natural concept and is used in the typical way: “needed in order to achieve what I think they should do.”

Right now, the three pro-ecig factions (consumers who are just motivated to defend their personal consumption choice, along with merchants who want to supply them; those who see them as a de facto medicine; and supporters of the THR agenda) are almost perfectly aligned in terms of practical political positions, due to the extremism and stupidity of the opposition. This has resulted in many proponents of either the enthusiast or “cure” factions, and even some who are strong supporters of the THR mission, failing to recognize the important differences among the groups’ goals, which are evident in language, occasionally manifest in practical contexts, and will become substantial divisions if the current round of fights is successful.

That Tobacco Products Directive clause is an example of the stupidity that maintains the alliance. As alluded to in the talk, it is not actually the case that 2% nicotine is adequate to provide a cure for smoking. The rule was slapped together by people who are clueless about nicotine use. We can guess that the thinking was that smokers should be forced to “step down” their consumption as they would with NRT. But the reality is that the ceiling increases the chance that a heavy smoker will try e-cigarettes and not compensate with enough extra puffing, and find that they do not deliver enough nicotine to make switching attractive. Meanwhile, experienced users who want more nicotine can just consume greater quantities, though this might not be what they really want. Thus, this rule pointlessly interferes with both wants and “needs”. But if the rule had been made thoughtfully by smart tobacco controllers who did not want to derail this cure for smoking — those from the faction that accepts e-cigarettes as a needed cure for smoking, but nothing more — they might have focused on a floor rather than ceiling. That is, they might have attempted to allow only the high concentrations that are the better “cure for smoking” while banning the low concentrations that could arguably be said to be used for the “mere want.”

The response might be that some people “need” the ritual or whatever to stay off cigarettes, but that is a difficult case to back (unlike the case higher concentrations being useful for transitioning smokers). The real objection to such a restriction, from the consumer or enthusiast perspective, is “I want to puff copious quantities of my 0.3%, and what possible business do you have telling me I can’t?” But if the “need” faction were ascendant (i.e., those who are pro-ecig as a medical cure for smoking), then this “mere want” would not be considered important.

Sunday Science Lesson: How they estimate deaths from smoking etc.

by Carl V Phillips

This continues, and finishes, the series that started here and continued here. (FWIW, the second one is probably more interesting than either the first or this one, if you want to read just one.) Recall that this series is the very long answer to a question along the lines of “how do they determine how many deaths among smokers, and especially among ex-smokers, are attributable to smoking?” In the first post, I discussed the causal contrast that anyone addressing that question should be thinking of (but probably is not), and noted that the outcome is badly defined (caused the death to occur how much sooner? they never say and probably do not even understand that is an important question).

Continue reading

Is “ecigs are a gateway” the new “addiction”? (i.e., fiercely debated in the absence of defining the term)

by Carl V Phillips

Just a quick note to vent my amusement about the never-ending war of commentaries about whether e-cigarettes are a gateway to smoking. That war apes a scientific debate, but it is not one for several reasons. Most notably, no one (on either side) ever explains what they would mean by “there is a gateway effect.” There are also serious problems about what would constitute useful evidence.

I suppose you don’t vent amusement, do you? You vent frustration. And it is frustrating that I recently spelled most of this out and yet even the ostensible scientists in the debate do not seem to have bothered to read that or any of the other serious scientific analysis on the topic. And they won’t read this either, so it does not seem to merely be a matter of tl;dr. I blame social media and the motivations it creates to write without doing the reading. And the thirty-second news cycle. And blogs. And Twitter. Also, would you kids please be so kind as to get off my lawn. Continue reading

Complaints about conflict of interest are designed to maximize conflict of interest

by Carl V Phillips

A colleague who found himself the target of the “you have a conflict of interest!” bullshit game was invited to write his analysis of the nature of conflict of interest as it relates to e-cigarette research. He asked me for input and several points occurred to me. I am writing them up here, in an admittedly disorganized fashion, for possible use in that project. Continue reading

Toward beneficial and practical standards for e-cigarettes

by Carl V Phillips

At the GTNF2015 conference I was on a panel discussing e-cigarette standards. The standards being discussed include manufacturing practices (e.g., clean rooms, hardware materials), specific technologies (e.g., whether a heating coil is capable of overheating, safe batteries), and ingredients (e.g., the perennial debates about whether some flavoring agents pose too much of a hazard). I decided to take the approach of addressing what the proper role for standards is, from a political economy perspective. What follows is the talk I gave (not word-for-word, and with a few additions to make it a document better suited for reading, taking advantage of the lack of time limit here). I follow that with some additional thoughts I voiced during the course of the Q&A and discussion. Continue reading

Sunday Science Lesson: Efforts to lower quality of tobacco products are poor substitutes for taxes

by Carl V Phillips

I am back from Italy and the GTNF2015, and mostly recovered. I have more to say about that meeting, particularly posting the content of my talk, and a backlog of a dozen unrelated or semi-related posts I want to write. Not knowing where to start, and it being Sunday, I will go for a science lesson. And, yes, I know I am in the middle of a science lesson series (and being a proper scholar, I am also in the middle of numerous other series) — next week, I hope.

I went to an interesting session about “plain products”, which was a cryptic way of referring to the intentional lowering of the quality of products, using anything from unattractive packaging, to limitations on flavoring, to lowering nicotine concentration. Interestingly, none of the presenters actually came out and said “lowering the quality of products” until I pushed them to adopt such plain language in the Q&A. I suppose their oft-repeated “affecting the value proposition” is the British synonym for that more pointed American phrase. But the former just does not seem to make it clear enough that these tactics are about lowering the benefits that are experienced by consumer — i.e., intentionally hurting consumers in order to manipulate their behavior. Continue reading

Attacking ecigs to encourage continued smoking: predatory lawsuit and goofy California law edition

by Carl V Phillips

I have finally realized that there is an answer to “what benefit results from FDA jurisdiction over tobacco products?” FDA regulation (and I use that term very loosely) has harmed consumers and commerce by gumming up free markets, damaged public health by interfering with THR, and threatens to do far more of each in the future, all for no apparent benefit. When asked to explain what they have accomplished, even FDA CTP or their umbrella agencies have no answer. They invariably lead with the banning of flavored cigarettes when trying to brag about their accomplishments, even though this happened basically on day one, was specifically mandated by Congress, and did not do anything other than deprive the few thousand adult smokers who actually used those products of a bit of life’s pleasure. I would have to call that self-damning with faint praise.

But there is an answer to the question: Without federal preemption, California would have a free hand to regulate these products.

I am obviously not saying this justifies the enormous social harm that has been and will be caused by FDA “regulation” of tobacco products. After all, most of us think of Californians much as we do Saudi Arabians or Australians — we might feel a bit sympathy about their welfare-reducing governments, but their lives are still better than most humans’, so it is hard to feel too bad. But still it is the answer to the “name even a single benefit” question.

California has a law known as Proposition 65 whose anti-science is just one step better than executing people for witchcraft. It requires that every building that the public is allowed in post a warning that there are chemicals present that are known to cause cancer and reproductive harm. Ok, strictly speaking it requires that only if those chemicals are present, but since they always are present everywhere, that is a distinction without a difference. This is not a warning about actual risk — an inconsequential quantity of one chemical that breaks the ridiculously low threshold requires the same warning as the air being thick with toxins — so this obviously serves no useful purpose. There is a similar requirement for many consumer products. Selfish lawyers can make a nice living shaking down businesses that violate the utterly useless provisions of Prop 65.

Ironically, cigarettes do not have to have the California warning about carcinogens or harm to fetuses, thanks to federal preemption. At the moment, though, e-cigarettes do not benefit (and, again, I refer to a single benefit, not overall net benefit) from that preemption. Thus, some lawyers — in this case operating under the guise of being a public interest charity — are using Prop 65 to shake down e-cigarette manufacturers. The group fancies itself “The nonprofit health watchdog Center for Environmental Health” (CEH), even though most of its income from the last year reported came from awards from lawsuits and “fees” (which I am guessing are shakedown payments, since it is not clear who they could be legitimately charging for their “services”) and it was described as the “most predatory litigant” in the Prop 65 space. They describe themselves thusly:

The Center for Environmental Health (CEH) is the leading national nonprofit committed to ending health threats from toxic chemicals in our air, water, food and in products we use every day. CEH protects children and families from harmful chemicals by working with communities, consumers, workers, and government to demand and support safer business practices. We also work with major industries and leaders in green business to promote healthier alternatives to toxic products and practices.

It would be funny if they were not so harmful. You would think that the “leading national nonprofit” would be a household name. Had you ever heard of them before this week? I didn’t think so. You probably have heard of the NRDC — there is a lot bad to say about them too, but at least when they use the word “leading” you do not giggle. I also like the “children and families” bit — if you are single, then you can just go suck benzene. But of course, the real problem is the claim that forcing business to put an utterly pointless “warning” everywhere — a statement which ACSH cleverly describes as “ignored by the populace, except for Prop. 65 lawyers” — does anything whatsoever to help anyone other than the lawyers.

It was CEH that attacked e-cigarette manufacturers over Prop 65 warnings earlier this year. At least that produced some humor. But their true harmful nature came out this week when they not only filed a notice that makes demands of and threatens legal action against numerous of e-cigarette companies which would provide no conceivable health benefits, but released a “report” (which is really a marketing-style brochure) that made junk science claims that would tend to scare smokers away from switching to e-cigarettes. In particular, their headline claim in their press release was “High Levels of Cancer-Causing Chemicals in the Majority of Nearly 100 E-cigarettes Tested”. How high? They offer absolutely no context for that word in the press release and nothing clear in the “report”.

We know that the real answer is “not high enough to worry about”. The two chemicals they are talking about are formaldehyde and acetaldehyde, which have been measured in pretty much every study of e-cigarette emissions and found not to be present at levels that pose a concern. The thing is, the Prop 65 exposure limits for these are such that everyone will exceed them. You exceed the formaldehyde threshold merely by breathing (and recall that dead people were not included in that list with children and families). So their vague reporting of how many multiples of these meaningless numbers they found are not informative about their results, and offers no support for their attempts to scare consumers.

Your first question about how they got their results might be what lab methodology did they use to produce those quantities? They do not say, other than saying it was done using smoking machines, which very likely resulted in the overheating that produces far more pyrolysis products than actual vaping does. They insist that they did not overheat the devices, but offer no substantive support for this dubious assertion. But those observations are not anywhere near the top of their failures to report their methods. That list starts with them not even reporting what quantity of consumption generates the supposed results. As far as we know, they estimated the total exposure that would result from taking every waking breath as a puff on an e-cigarette. The failures continue from there. Gregory Conley sought more information about their methodology, but reports that they refused to provide it. Not exactly surprising.

Of course, those problems are only failures if one models their behavior as attempting to help people or to do science, rather than to shake down manufacturers for a few million dollars, and perhaps get a piece of the tobacco control industry gravy train. Since most of their “report” has nothing to do with their actual Prop 65 complaint, but is just a simplistic shoveling of every anti-ecig myth and complaint that tobacco controllers recite, it seems like the latter is part of the goal.

I am not sure whether CEH ever did anything that actually improved anyone’s health. But if they did, any such benefit could easily be swamped by what they are doing now. If the public even notices this money-grab, and if they believe the claims (or others cause them to), it will probably cause a lot of would-be vapers to smoke instead.

Already a few ANTZ are gleefully reporting on this travesty as if it has information value about e-cigarettes causing harm. We can come back to that question I started with, “is there any benefit whatsoever?” In this case, there is information value: Anyone who touts this anti-scientific attack as if it were informative is making clear their utter scientific illiteracy and lack of ethics. Not just the tobacco control standard level of illiteracy, lack of ethics, and generally cluelessness, but something deeper still. They are repeating meaningless rhetoric that is based on completely unreviewed assertions whose actual meaning cannot even be determined because of missing information. This does not even rise to the level of being junk science — it is non-science, as should be obvious to anyone who reads even the press release.  Moreover, that claim comes from an organization with no scientific credibility, and for whom the term “conflict of interest” does not even apply because their only apparent interest is bolstering their legal claims.

So which particular bottom feeders sunk to this new depth? That would be the World Health Organization (FCTC), as well as a few of the worst pseudoscientists (GlantzChapman, Malone) and others among the least credible anti-THR activists (World Lung Foundation, Leno (this guy)). But most of the other usual suspects have been sensibly silent about this travesty, refusing to stoop to quite this level. We can thus now have a new measure — the CEH Test — for differentiating standard tobacco control levels of evil and/or stupidity from the worst of them. Let’s see if anyone else sinks below this line by citing the CEH claim.

More on the ecig advocates’ descent toward junk science

by Carl V Phillips

There is a cliché about certain types of institutional crimes, that it is not the act itself but the cover-up that causes the real trouble. The erroneous headline claim in the recent Public Health England (PHE) paper, that e-cigarette use is 95% less harmful than smoking, would generate nothing more than a fleeting rebuttal and represent nothing more than footnote to the history were it not for the equivalent of that cover-up. But some of the more serious commentators in the e-cigarette advocacy world, along with countless others, have rushed to defend the error. And I have found this truly scary.

For context on the subject matter, see my previous post, which you can follow back for more detail. The short version is that the PHE authors repeated what is just a made-up number (and not even a made-up number that is (a) plausible or (b) even supposedly a measure of comparative risk) that appeared in a junk science paper by Nutt et al., presenting it as if it were scientifically valid; this claim appeared in the headline under which PHE published the paper. For context on what I am responding to below, you can look at my twitter feed, at the comments others directed toward me. (I trust it is obvious that while Twitter is a great medium for announcements, quips, and simple observations, it does not offer a sensible way to try to have a conversation. Thus I mostly did not try to respond there, but rather wrote this post, which has a comments section that allows for better discussion. See the previous post for a good example of such conversation. Also, you presumably realize that this extrapolates to me not intending to “discuss” this on twitter in response to the next round of quips there.)

Why is it scary? For one thing, it is difficult to not fear where we end up a year from now, moving down this path. Pro-ecig advocacy’s relationship with science went from being way ahead of the legitimate science c.2008, to mostly highly serious and science-based c.2010, to the movement becoming so large that the science was part of the conversation but was mostly treated as a weapon c.2013. But even as that last bit occurred — as is almost inevitable when a mass activist movement forms — the serious opinion leaders remained anchored in a commitment to good science. But the recent events show that there are cracks in that anchor, suggesting we may be approaching the point where many other good and legitimately science-based causes took a permanent turn for the worse, becoming both less effective and less beneficial.

In addition, down the path of even the serious opinion leaders treating science as a mere weapon for a political cause lies disdain for any good science that does not benefit the politics. Sometimes a “bad” result is correct and represents useful information for consumers. But if the responses to every concern about a possible harm from e-cigarettes degenerate into knee-jerk rebuttals — and we are getting rather close to that point — then potentially beneficial knowledge will be ignored. When scientific claims are just weapons, the ability to detect whether a concern is legitimate tends to be lost to those within the cause. Consumers need accurate health information, not claims that are most convenient for advocacy, so that they can make informed choices that are best for themselves.

Even more information is lost to those outside the cause. Consider the various “healthy eating” movements, many of which contain bits of good advice for consumers. But the useful information is embedded in a corpus of junk science that exists to defend the cause against all critique. As a result, people either subscribe to a particular food cult, buying into a lot of misinformation, or dismiss everything they say, losing some good information. It becomes something like cheering for one sports team over another, as is common for impersonal political issues (e.g., macroeconomic policy, climate change). Similarly, there are legitimate concerns about childhood vaccines, particularly for some identifiable individuals, but anti-vaxxers and their junk science have so poisoned the well that there is little useful discussion or understanding of this point.

The following are responses to some of the claims I have seen over the last few days that the 95% claim was just fine. I have ignored the ones that were less cogent and I have tried to distill them down to their best essence.

“But we need to make such claims because….”

This is nonsense at multiple levels.

First, even if this were a valid response, it would only be a response to a statement that included “…and therefore we should….” But it is being presented as a rebuttal of the mere observation that the claim is junk. If someone writes “I concede that this claim is junk science, but we should endorse it anyway because…”, then perhaps they are being serious. But instead the implicit claim is often “we need to make such claims, and therefore the scientific criticism of the claim is wrong.” Um, no.

Second, what possible good can come from making up a clearly wrong number and pretending it is scientific when the truth is sufficient to make the point? It makes no sense. Is the target audience more likely to be persuaded by junk science that is easily debunked rather than a true statement that sounds pretty much the same to the audience? It is difficult to imagine why. Meanwhile, when the specific claim is debunked by those hostile to the overall message — and it has been already — it makes it much easier for those who are inclined to dismiss the entire legitimate message to do so.

Just in case I have to repeat this five times (and I have a feeling I do), the scary problem is not the initial mistake, but the desperate response to defend it. It is my assessment, based on my knowledge of advocacy movements from the inside and via study, that the initial mistake is itself actively harmful. But even if you doubt that conclusion, it should be obvious it was not helpful compared to just substituting something accurate. So why man the barricades to defend the mistake? It reminds me a lot of the tobacco controllers’ code of omerta, to never criticize any anti-tobacco claim that anyone makes, no matter how wrong it is.

Third, if trafficking in junk science really were required to make our case, then we would face a serious ethical problem. This is not just because of the moral case against lying, though that is fairly compelling argument in itself. But if you need to lie to make your case, you should probably stop and ask yourself whether what you are trying to argue is actually right. As noted, this is moot in the present case because the truth can be used to make the same point even better. But the mere willingness to say that a junk science claim is needed suggests a rather scary degradation of ethics.

Fourth, the unstated premise is that trafficking in junk science would be good for the cause, so long as it is the right junk science. Oh, really? I cannot think of a single example of a cause like this (insurgent, narrowly focused, consumer oriented) where that was a good strategy. I suspect that most of those implicitly making this argument have little experience with such causes, either personally or by way of study. I am open to suggestions, but I cannot think of anything. I can, however, think of movements that foundered there, and reasons why we should expect exactly that to happen. Plenty of good and defensible causes have turned into fringe cults that no one outside the cult takes seriously because they pursued the junk science track.

Keep in mind that trafficking in junk science is an effective strategy for those in particular positions, but this does not generalize. It works great if you have a powerful echo chamber and are just using it to keep the useful idiots in line. The upsides (when they exist, unlike in this particular case) can outweigh the downsides when you have pet media, are a government, or otherwise have a very loud megaphone, and thus can just shout-down the debunking. Junk science is often very effective at attacking science-based insurgent movements. I trust it is obvious that none of these describe the situation for pro-ecig advocacy, though it happens that all of them describe the tobacco control industry’s situation. Wars are often asymmetric, and so adopting the enemy’s tactics can be a losing strategy. In this case, given the lack of a loud megaphone and only a tiny non-influential echo chamber which does not really need to be stoked, it is undoubtedly a losing strategy to mimic tobacco control’s dishonest tactics, even apart from the ethics of it.

It is worth noting that the anti-smoking movement started out science-based and honest. Almost all the reduction in smoking from its peak was caused by honest education. The morphing into the lie-based tobacco control industry came at the same time that they stopped succeeding at reducing smoking beyond the steady downward trend that was caused by the honest approach from past decades (not to say this is causal; it just points out that they clearly cannot be said to have become more successful when they started lying).

The modern success of tobacco control in keeping people smoking, by opposing THR, is attributable to them seizing power and money, not to some magical effect of their junk science. That is just fodder for their echo chamber. It is difficult to argue that the trafficking in junk science has itself made any difference in terms of policy: The American, Canadian, and Australian governments shovel out tons of anti-THR junk science to their people, while the Europeans and Asians basically just impose autocratic rules from on-high. Yet all of these places have e-cigarette bans or severe restrictions, either in place or in the pipeline. It is the power, not trafficking the junk science, that makes that happen.

“This is not using junk science to further a political aim”

This is really a subordinate point, but it bugs me enough that it gets its own entry. In response to arguments that it is simply never ok to employ junk science to further one’s political goals, there have been responses along the lines of “this is not political: this is an effort to correct widespread misperceptions.” Um, yeah.

If someone wants to argue that it is acceptable to use junk science to further a political aim, they can try to defend that. But claiming that this is not political is a truly awful step on the descent toward becoming a cult. If the goal is changing the world, then you are talking about a political act; that is what the word means. If someone genuinely thinks “this is not political because it is doing something good”, that is a serious problem. News flash: every political activist thinks they are doing good, including the ones who want to create the misperceptions you object to. As soon as your defense of what you are doing descends to the point of saying “whatever I do is fine because I am doing it for a good cause” — and “this is not political” claim is a version of that — there is a severe erosion of the barriers that normally provide a check against very unfortunate actions.

“The estimate is close enough to the real expert estimate”

This is actually false, and not in a harmless way. As I and others have noted, the affirmative claim that vaping causes 5% of the health risk that smoking causes is a claim that vaping is quite bad for you. Parsing that with the accepted propaganda about smoking, it means that about 1 in 40 vapers will be killed by vaping. That makes it worse than any other common behavior other than smoking — far worse than driving, worse than all but the most extreme overeating. Also keep in mind that estimates are properly interpreted as being point estimates with some uncertainty on both sides (in spite of the PHE authors reciting their claim as if it were exactly precisely right), which means this claim says that there is roughly a 50% chance the risk is worse than that. Defending that is not clever.

But if it were true, why source it to a made-up number — and one that does not even say what the PHE authors claims it did, even apart from it being just made up (see previous post) — and declare that to be a source of scientific information? Why not instead present this real expert estimate that is being referenced? (Note that I am not entirely sure what real expert estimate such claims refer to. The evidence-based expert estimate I am aware of is an analysis along the lines of: “The chemistry of vapor suggests that vaping is almost certainly only slightly worse for you than smokeless tobacco (which is our only measure of the effects of using nicotine without smoke). ST use appears to be about 99% less harmful than smoking, though it may be completely harmless or even beneficial. Therefore the risk from vaping is most likely in that same range.” Yes, it is possible that vaping is so much more harmful than ST use that it is 5% as harmful as smoking — as I noted in the previous post, some versions of it undoubtedly are — but this seems vanishingly unlikely for “normal” vaping. It is worth mentioning that the junk paper by Nutt et al. made up a number for the risk from ST use that are enormously higher than the number they made up for vaping. There is no conceivable scientific basis for making such a comparative claim, further emphasizing the worthlessness and of their made-up numbers.)

But most important, and here is the crux of all of this again, why would it ever be a good idea to man the barricades to defend the junk claim based on this? If a claim that is sourced to junk science is close enough to what the real science shows (which is not true in this case, but imagine some other case where it was true), then why defend the use of junk science, making the credibility of the whole message depend on defending the original junk source? Instead, push for the substantive claim to be based on real science. This might seem to entail a bit of short-run cost, due to not being able to uncritically embrace some particular publication, but it is far better in the long run. Moreover, it is not as if the particular publication will stand up to scrutiny, so the apparent short run cost is probably moot. It is better to get ahead of the inevitable criticism of the junk science that will come from those who wish to dismiss the entire substantive claim.  

“Just an estimate”

Some commentators have sought to excuse the reporting of a clearly inaccurate made-up number under the claim “the best estimate” by suggesting “hey, they said it was just an estimate.” But the word “estimate” does not mean “we are reporting something that is wrong.” It is a scientific term that refers to the best available scientific measure of a quantity (with an implication that we think it is a pretty solid measure), as in “the estimated speed of light in a vacuum”, or if clearly specified as such it can mean the specific measure that comes from a particular measurement effort, as in “the estimate of the increase in heart attack risk from nicotine consumption from this data and model is…..” The number reported by the PHE authors was neither of those.

Perhaps that observation gave you a sense of “where have I heard something like this before?” It is remarkably similar to the anti-scientific games played by those who deny the history of the planet and life by saying “evolution is just a theory.” Presumably if you are savvy enough to be reading this blog, you know the response is that a scientific theory is the best evidence-based understanding of a phenomenon that we have available, and moreover one that is well enough established that we are pretty confident about the core claim. But the anti-scientists think (or, more realistically, pretend to think, and try to trick others into actually thinking) that “theory” refers to a mere musing, as it is sometimes used in common language. In a scientific context, authors cannot just make up a story and call it a theory or just make up a number and call it an estimate.

“What they really meant was….”

If they really meant something different, why did they not say something different? If these same authors were previously on record as saying “at least 95% less harmful” and that is what they meant to communicate in this report, they sure picked a funny way of trying to do it. (Besides, that claim is also wrong, as explained in the previous post.) If they really meant to claim that their estimate was based on something more than the one junk science paper, why did they just cite it to that paper (along with mentions of  some commentary papers that included no attempt to construct a scientific estimate for this figure) and say nothing about any other basis for the number? In any case, saying they really meant something different is not a rebuttal of the observation that what they said was wrong, but an endorsement of it.

If they really meant something different, you would think the authors would be anxious to post a correction. Some commentators have suggested this can be found in a subsequent note by the PHE authors in which they seem to be trying to imply — without stating this as their purpose — that they were not basing their claim entirely on one junk paper. But if you look at their text, they say just the opposite. The have a couple of sentences about why we can be sure the risk from vaping is much lower than from smoking, but this is not in dispute and is obviously quite different from asserting a particular quantity. They then assert (without further methodological elaboration) that they are not aware of any new research, appearing after the number was concocted, that shows the Nutt et al. number to be wrong and state that it “remains valid as the current best estimate based on the peer-reviewed literature.” This is not a denial that they are just channeling the original made-up, clearly inaccurate, junk science claim, but an explicit confirmation of it. If they had any legitimate scientific basis for their number, they undoubtedly would have mentioned it in their note. Also — and I really hope this goes without saying — if you just make up a number and then observe it has not definitively been demonstrated to be false, this does not make it true.


One of the authors of the original junk paper apparently tried to defend their “methodology” of just making up numbers on the basis of that all science is subjective, and some others have picked up on this. This is another word game. It is true that if you divide everything into objective and subjective, then all empirical work and scientific conclusion-drawing is subjective. It is done by people and includes countless human judgments. Indeed, when someone tries to claim that a scientific process is objective, or that some particular scientific process is suspect because it is subjective, they clearly do not know what they are talking about. However, the subjectivity of science is not license to just make stuff up.

As with “estimate” and “theory”, which imply a solid scientific basis for a claim, for a subjective process to be scientific some minimum standards are required. It is true that we cannot write down a set of clear rules and call it “the scientific method”; there is no such objective concept, which creates a lot of consternation for people who cannot handle complication. But that does not mean that any method of arriving at a number is as good as any other.

“But that report was great, and it is helpful, and the authors were so brave, and….”

What does any of that have to do with the issue at hand? Yes, the existence of the report is a good thing for the cause, and the vast majority of it is valid. Both of those would still be true had they not headlined it with a junk science claim. Both would still be true if others did not man the omerta barricades over that claim. Neither changes if someone agrees that the particular claim is not valid.

The fact that such non sequitur statements are made in response to criticism of a particular scientific claim is extremely disturbing. The apparent reason is the notion that we have to defend every single word written by “our team”, just like the ANTZ do. That is not a good place to be.

I assume that some of those making these “but…and…and…and…” claims are genuinely worried that this flaw is a threat to all the benefits that the existence of the PHE report offers. But it is not e-cigarette proponents challenging “our team’s” junk science that poses that threat. Opponents will run with it. They are running with it. This is the type of mistake that serious opinion leaders can easily get out in front of, conceding the flaw with a shrug and pushing the focus elsewhere. That can be done based on a moral belief that telling the truth matters or as purely a matter of political tactics. If it is the latter and you find a situation where defending some bit of junk science really seems to be tactically useful and can actually be pulled off… well, I am probably still going to argue the moral position, but you might have a case to make. But this is not that situation.

Instead, this is a situation that needlessly give opponents an opening to claim that the core scientific claims of the movement are junk science. That is not true, obviously. But since it also sends the signal that junk science will be tolerated and actively defended if presented in an important context, it also dramatically increases the chances there will be plenty more of it generated. This will make it even easier for opponents to claim that e-cigarette advocacy is not science-based. It will also dramatically increase the chances that consumers will not be able to trust their own advocates to provide accurate decision-relevant information.

A political movement that ultimately relies on scientific information cannot afford this. If sciencey talk is just used to rally the faction, then accuracy does not much matter. If the crux of the cause were, like many causes, about emotion or “morals” or zero-sum fights, then the sciencey stuff would just be window dressing and the details would not matter. Indeed, if this fight were grounded in freedom of informed choice, as I have suggested it ought to be, it might not matter so much (though I would still be deeply concerned about what this would do to the “informed” bit). But so much of the focus of this fight is selling scientific claims, so there is no room to allow the impression that the scientific basis of e-cigarette THR is fast and loose. Moreover, consumers need to be able to make informed decisions about their own lifestyles, but embracing junk science to try to manipulate the uninformed masses — even if it were an effective tactic — makes it likely that even relatively informed consumers will become immersed in bad information. The well-worn path of other insurgent consumer movements that turned to junk science suggests that this will result in most consumers making their decisions based on whichever cult guru they end up falling in with, rather than on real evidence.