NewZ ecig clinical study, an “I told you so”

by Carl V Phillips

Yesterday I explained why the new clinical trial out of New Zealand should not be touted as important news for e-cigarettes or THR in general.  In addition to the general message that clinical cessation trials are not the right way to study THR products and are just as likely to produce bad results as “good” ones, I pointed out a few particular issues.  First, it was damningly faint praise, claiming that e-cigarettes perform just barely better than nicotine patches, which grossly misrepresents everything we know about their effectiveness.  Additionally, with a plausible different level of luck (random sampling error) that study would have “shown” that e-cigarettes are less effective than patches.  Of course, such a result would have been no more informative about e-cigarettes than the “good” result was, but that is the point.

Sure enough, no sooner had I finished writing my analysis when anti-THR liar Stanton Glantz pretty much made my point for me.  In a post on his pseudo-blog (not really a blog because he censors any critical discussion) Glantz claimed that the study

found no difference in 6 month quit rates among the three groups.

And in a hilarious bit of “do as I say, not as I do”, opined,

Hopefully this study will get ecig promoters to stop claiming that ecigs are better than NRT for quitting.

Of course, the study showed that e-cigarettes did a bit better.  Glantz probably thinks this bald lie is justified by a common misinterpretation of statistics, wherein different numbers that are not statistically significantly different are incorrectly called “the same”.  Anyone with a 21st century understanding of epidemiology knows that this is not the right thing to say, but since Glantz’s paltry understanding of the science seems to be based on two classes he took three decades ago, perhaps this is simple innumeracy and not a lie.

Still, he has a point about the numbers not being very dramatic.  The real lie (and a case of innumeracy much worse than using incorrect terminology) is suggesting that this one little flawed artificial study somehow trumps the vast knowledge we have from better sources.  It is quite funny that he, who has made a career out of ignoring evidence, suggests that everyone else should pay attention to this “evidence” and change their behavior.  Not so funny is my role as Cassandra:  If we start touting misleading studies like this one as being great news when they happen to go our way, it is pretty much guaranteed to hurt us rather than help us.

(Glantz goes on to post some utter drivel about the nature of RCTs and what previous evidence shows about e-cigarettes, which I have debunked before and will not bother with here.  After a few decades, you learn to not try to fix every little flaw in a particularly slow student’s writings.)

Of course, Glantz does not have the skills to figure out that this study is flawed.  But he might have had some hope had he actually read it.  Or the press release.  Or even one of the news stories.  Instead, it is appears that he just heard some garbled sentence or two about it and wrote his post based on that.  How can we know that?  Because when his post first appeared (screenshot below), it described the comparison as between nicotine gum and e-cigarettes, even though someone who actually spent three minutes studying the material would not have made that mistake.

Oops. That’s what happens when you don’t do the reading.

Notice that in both the headline and the first sentence he describes the study as using nicotine gum.  Oh, but wait, it gets better.  A few hours later, he changed the first sentence (see screenshot below).  Of course, being who he is, he did not include any sort of statement of correction as an honest researcher or reporter would.  (Quietly fixing a grammar typo or garbled sentence is no big deal — I do that — but when you actually told your readers something wrong and then you try to memory-hole that, rather than actually noting you are making a correction, it is yet another layer of lying.)

And this is what happens when you don’t know how to operate your software.

Notice now the first sentence is changed but the headline is still the same.  Did he just not realize he needed to fix that too, or did he have no idea how to change a title on his blog and was desperately calling tech support to try to get them to help hide his error.  Apparently tech support came through, though, because the version you will see if you follow the above link has memory-holed the evidence suggesting he did not even read the study (though you will notice that the link I gave still has “gum” in the URL, but now redirects to the new page where the URL has “patch” in it).

So that is all quite hilarious.  But don’t let it distract you from the main message.  We need to focus on the real sources of knowledge about THR and not buy into a research paradigm that is — often literally — designed to hide THR’s clear successes and benefits.  When e-cigarette advocates embrace studies with bad methods and misleading results (even if they seem to be “good” results), rather than objecting to the bad approach, it hurts the cause.  In this case, even the “good” study can be spun against the truth about THR.