Monthly Archives: June 2016

“E-cigarettes are a gateway” is a genuine scientific claim

by Carl V Phillips

The latest entrant into the Dunning-Kruger gateway follies is ASH Wales, with this report that is headlined, “New research shows e-cigarettes are not a gateway for young people to take up smoking”. What evidence do they present that supports this remarkable claim that a universal negative is true? None.

The gateway claim, that using e-cigarettes causes some would-be never-smokers to smoke, is a legitimate scientific hypothesis. As such, it should not be asserted to be true (to a nontrivial extent) without useful evidence, especially since it is such an unlikely causal sequence, as I have explained elsewhere. The assertions that gateway effects are occurring have been based on evidence that does not actually show that. This is certainly the major problem in this area. But similarly, the claim should not be dismissed with word games or junk science. In this particular case, ASH Wales — like many others before them — seem to not understand a 101-level point from epidemiology, the difference between “not many people are at risk” and “it never happens among those who are at risk.” They claim that because a large majority of e-cigarette users among teens have already smoked, there is therefore no gateway effect. Um, yeah.  Continue reading

Next round of gateway claims

by Carl V Phillips

Tomorrow a new paper about the supposed gateway effect from e-cigarettes will come out of “embargo”. Over the last few days, Clive Bates and Michael Siegel have published pre-rebuttals of it (Clive basically declared as much on Twitter. Mike did not, but the timing seems like more than coincidence.) Sometime I will analyze the paper based on the framework I developed for assessing whether evidence actually supports a gateway claim (which the authors of the paper ignored). For now it is interesting to go meta. Continue reading

My new article in Tobacco Reporter: The Limits of People Power

by Carl V Phillips

You can find it here (PDF; you have to page through to p.32). I thought I would drop this here since most of my readers do not see the trade journals, and also because I always welcome comments and debate and there is no comments section in the journal, so that can be done here if anyone wants.


Social media and enthusiasm about vaping have created an unprecedented consumer voice for tobacco/nicotine product use. Tobacco control messages from government and anti-tobacco organizations are met with floods of opposing responses. Vapers rallied to soften the restrictions on vapor products in the EU’s Tobacco Products Directive. There is a resurgence of smokers’ rights, such as NYC CLASH’s “smoking is normal” campaign, pushing back against “denormalization”. The expanding “nanny state” has inspired wider sympathy for those who were once its main targets. With the exception of smokeless tobacco users, who remain as voiceless as ever, there is a heady belief that a “people power” revolution is changing everything.

Unfortunately, history shows that people power seldom generates more than a show of enthusiasm, and for good reason….

Continue reading

The weakness of ethical thinking in public health: a case study

by Carl V Phillips

I continue to be appalled by what passes for ethical analysis in the realm of THR. This is clearly a symptom of the ethical failings of public health in general. Of course it is somewhat better to see someone actually trying to analyze ethics as compared to the normal “public health” approach of simply making a declarations about what should be done without any mention of what ethical goal they are basing that upon, let alone defending the legitimacy of that goal. The latter is a level of political discourse comparable to the average social media or comments section “debate”. But the attempts at analysis seem only to rise to the level of a freshman term paper. Continue reading

Understanding ecig politics all comes back to snus

by Carl V Phillips

Chris Snowdon has a very nice post today, recounting the history of the UK quango, ASH, in getting snus banned in Britain (and as a result, all the rest of the EU, save Sweden). His thesis is that the attacks by ASH and others on e-cigarettes are history repeating. On this page, I have frequently made the same point more generally. In particular, I pointed out the foolishness of expecting U.S. government agencies to voluntarily “do the right thing” regarding e-cigarettes, as many have insisted they will (for reasons I cannot fathom), given what they did to smokeless tobacco. Continue reading