Sunday Science Lesson: spookiness bias

 

by Carl V Phillips

The story of the week in the vaping space has been an outbreak of lung diseases cases, with at least one death, that has apparently resulted from a bad batch (or, perhaps, due to wild coincidence, two simultaneous bad batches) of vapeable synthetic cannabinoids. Of course, this has nothing to do with what we call vaping, other than sharing approximately the same delivery system. As I mentioned in my last post, the reason there was a bad batch is because the Drug War causes these drugs to be produced without regulation of any sort (including producers’ need to maintain a good reputation, which is really the most important form of regulation). The reason synthetic cannabinoids even exist in a world that grows perfectly good cannabis is also the Drug War.

Again, nothing to do with vaping, except in a cautionary sense: If the march toward banning most nicotine vape products continues, this might happen in our sector too.

Anti-vaping activists have been aggressively using these events to attack vaping (proper nicotine vaping, that is — I will stop including that clarification now). Of course they have. They are not exactly known for sticking to legitimate criticisms. This has included the U.S. CDC and FDA, as well as others who obviously know this is disinformation. There is no better evidence of the fact that they care only about the propaganda value, rather than the bad outcomes, than:

But that brings up the interesting question: Why is this successful? That is, why do news reporters, politicians, and other clickbait artists freak out about vaped poison when they are blasé about smoked (or injected, or snorted, or swallowed) poison? Whether a particular author is among those who were tricked by the anti-vaping activists, or whether they knew better but just wanted the clickbait, this remains a good question.

The answer, I believe, can be found in the work on cognitive biases about risks, mostly from the 1970s and early 1980s. Search under Tversky, Kahneman, and Slovic to learn more. Researchers, led by those three, compiled lists of characteristics of a risk that systematically make people irrationally worried (or, conversely, irrationally comfortable) with the risk. For example, people fear flying more that driving, even though flying is much safer, because: (a) they are in control of the car and not the plane (as if they are a better at driving than a professional pilot is at flying), (b) airplanes are a mysterious technology while cars are not (never mind that anyone who really understands how cars function, and the physics of why they are dangerous, probably generally understands airplanes), and (c) they have driven a lot more, without dying from it, so are confident they are at less risk than average when driving (never mind that they do not have nearly enough data to have updated their priors that way — i.e., even a bad driver with double the average risk is extremely unlikely to die from a few decades of driving).

[Aside: It is a frequent source of amusement for me when someone stumbles across this work on cognitive biases or its current iterations (which, as far as I can tell, have really added nothing useful to the original work), and breathlessly reports its implications for current policies. Um, yeah. We kinda already knew that 35 years ago.]

When I taught this material, I collected a few of the items in the Slovic-Tversky-Kahneman lists into what I called spookiness bias. People are irrationally afraid of risks that involve novelty, magical (to their understanding) technology, invisibility, and in general things that they cannot translate into the everyday physical world they understand. There is also often some element of imagining some evil supervillain behind the exposure. The mystery of flying in an airplane is an example of magical technology to most people. So are irrational fears of nuclear power (which is also invisible and brought to us by “big energy”) and pesticide residues (also invisible, and is ~chemicals~, and is inflicted by big evil chemical companies). Similarly, cancer is spooky (mysterious invisible biological action) while deaths from falls are largely ignored and little is done to prevent them.

The behavior is uneven: For a while, cellular phones were a target of similar irrational fears, but then they became non-novel and much beloved and so the fears went away, even though they remained a magical source of invisible radiation. It is difficult to guess whether a technology is going to provoke spookiness bias. Claims to the contrary seem to just be ex post just-so stories.

Vaping should not be a victim of spookiness bias. Nicotine is not novel or mysterious. Smoking is normal and common, after all. There are thousands of OTC and prescription medicines that deliver droplets of drugs into the mouth, lungs, or nose. But anti-vaping activists have cleverly managed to slip vaping into the spookiness bias space. Well, that probably gives their bumbling machinations too much credit: They just attacked in every way they could, as they always do, regardless of the truth-value of what they were saying, and it so happened that this was a point of vulnerability they stumbled upon.

So, as noted in the tweet, smoking a bad batch is ho-hum deaths of no-good druggies. But vaping a bad batch! Well, that is spooky!

The particular points of this bumbling that seem to have landed include: tricking people into believing the nicotine content of vapes is fundamentally different from cigarettes, listing spooky-sound chemicals that are detectable in vapor, talking about mysterious “particulate matter”, and constantly implying there is something novel about this exposure even though there has been in the neighborhood of a hundred million person-years of cumulative exposure. These are all spookiness factors. Never mind that (real) particles and all of those chemicals are present in cigarette smoke, mostly at concentrations that are orders of magnitude greater. People are comfortable with cigarettes (and smoked bad batches) and medical inhalers, so they are post-spooky like mobile phones. But vaping has been carved out from them.

For those who lack the knowledge of our history, and so think there is anything new under the sun: This is exactly what tobacco controllers did with smokeless tobacco (snus) in the 1990s, in order to discourage smokers from switching. The anti-THR activists associated snus with oral cancer (never mind that the evidence shows it does not cause measurable risk), which seemed like a novel scary risk. Of course, it is not novel. Smoking (though not snusing) causes a substantial increase in oral cancer risk. They also discussed spooky sounding chemicals (tobacco-specific nitrosamines, etc.) only in the context of snus. As with vaping, particular diseases and chemicals were “reserved” for attacking the smoke-free alternative, even though they are more part of the smoking exposure.

Again, I am not giving credit for this being their clever plan from the start. Tobacco controllers just happen to have not bothered to emphasize those aspects of the smoking exposure. They thus created the opportunity to pretend these were something novel about the low-risk alternative, a reason to stick with the normal — and thus non-spooky — option of smoking.

One of the burning questions of the week is, “Why are people blaming the delivery system for a (sadly) commonplace illicit drug poisoning incident?” The answer is that they have been tricked into believing the delivery system is spooky, despite it really being unremarkable. Fighting back on the specific claims in this case is worthwhile, of course. But that is just a skirmish, and the real battle is about overcoming the spookiness perception that is associated with vaping.

8 responses to “Sunday Science Lesson: spookiness bias

  1. I like your term ‘spookiness bias’, it gathers the cog biases nicely. Combined with the all too prevalent argument-from-authority, there’ seems to be an odd public reassurance that ‘somebody is doing something’ – of course that perception is granted our “heroic” ANTZ who are working to save “our children” from this spooky threat.

    Eliminating, or effectively reducing the spookiness is a difficult problem. Every article on vaping includes some description (battery+liquid+heat -> vapor) and descriptions of e-liquid abound yet “We don’t know what’s in it” becomes the trope reinforced by “Acrolein, Diacetyl, Formaldehyde, etc” chemophobia runs unchecked (magic bias). Tens of thousands of grateful users extol the virtues, physician reports, and research, dismissed as anecdotes (blind spot). Add the “Kids are being lured” (Evil actor) and now the “Vaping causes sickness / death” (personal threat). We’re now in a “perfect storm” of propaganda trapping most of the public’s perception.

    The in-group association (bandwagon effect), belief, and stereotyping bias against smokers transfers to vapers. Thus, even if we could reduce the spookiness bias we still have this guilt-by-association to deal with (vaping = smoking). This is more familiar territory for harm reduction advocates. Ask them how long it took to differentiate harm reduction from the public perception of enabling / encouraging the target vice – a long time, and many preventable deaths. It appears in each case that two factors worked together: 1) the number of loved ones affected by the unchecked carnage reached critical mass; and 2) enough of the “authority figures” left the field for more open-minded fellows to become ascendant.

    Right now, today, it appears that the course is being set for the long haul. The spookiness bias and argument-from-authority will win the day with the increased probability of ever more draconian laws / regulations being passed. Of course this will accelerate the formation of the illicit market (where anything goes). The bandwagon effect will be reinforced (“I always knew vaping was bad”) with each new adverse event. More people will be harmed until the number of loved ones left behind reaches critical mass. This will likely take long enough for certain actors in the TC space to die or retire. “History doesn’t repeat itself, but it does echo.”

    While this looks rather gloomy, for me it is not an unexpected outcome (confirmation bias?). Advocates need to strap in for the long haul, they are more essential than ever. Persevering though troubled times is the hallmark of our predecessors in other areas of harm reduction. Embrace the victims and those left behind, they are our best hope to change public perception. They weren’t ‘stupid’, they faced a choice where the risks were unknown, there is no ‘approved’ product. Stick to the basics, it’s about people.

    I was reminded of a story recently, told in a different context originally:
    By 1906 Heinz had developed his company to be the safest provider of condiments, using sound public health science (clean room, hand washing, sterile canning, cradle-to-table accountability of ingredients).His competition did not use all (or any) of these techniques. He went before the chair of a committee in Congress and set before him two bottles of whiskey, both top shelf. One was pure, the other cut with 10% methanol. He asked the congressman to do whatever he wanted to discern which was the pure product. The congressman looked, smelled, and tasted each and made his choice. Heinz famously asked “Would you bet your life on that? That’s what millions of people have to do every day with their food.” That year Congress passed, and the president signed the Food, Drug, and Cosmetics Act of 1906, the foundation of what became the FDA. The new law put most of Heinz competitors out of business. The public could trust Heinz products. It appears the FDA has lost sight of its most basic duty-of-care; assuring the public that what they buy poses the least risk to them.

    Would appreciate your thoughts here, hoping I’m farther off than nearer the truth.

    • Carl V Phillips

      There is a lot going on, of course. I was not suggesting that the illusion of spookiness was more of the whole picture than it is. However, I would say that it is sufficient, all the rest of that aside, to facilitate a devastating category of attacks. Anti-pesticide activists don’t need any source of authority or loud megaphones to trick a lot of people. Thus undoing that is a free-standing need.

      Part of the problem is that there is no strategic response to anti-THR anymore. Everything is ad hoc and reactionary, and often working at cross-purposes. A few of us have strategic vision, but there is no mechanism available to pursue it. I suspect that many of those who are anti-anti-THR are just counting on market forces to eventually win out, so it is just fine to fight only skirmishes until then. This contrasts with what illicit drug HR advocates needed to do, and it may very well be an accurate assessment.

      • Thank you very much for your reply Carl.

        The insight on the spookiness bias confirms what I’ve observed as well in other areas, particularly in the medical/health arena (Woo medicine). It does need further work on effective undoing.

        I agree that a coordinated strategy is needed to be effective and that the mechanism to pursue it is unavailable, though I believe it is a matter of resources and will. If there was a focused commitment the resources could be found – but it is a big ask from those needed to participate.

        The drug and HIV HR activists were focused on clear goals and willing to die on their respective hills. Not so much for this space right now, its too factioned and siloed [dedicated THR anti-anti-THR, anti-smoking, anti-BigTobacco, anti-PhRMA, anti-FDA, etc, etc] to coalesce, let alone goal-set.

        • Carl V Phillips

          I think there are plenty of resources. But FSFW is off doing who the hell knows what. PMI has everything devoted to their cringe-worthy “unsmoke” campaign. CASAA let itself become reasonably irrelevant.

          Otoh, AVA (Conley) is laser focused, but under-resourced. Same with Bates. And, I would like to think, me. There is a mismatch of strategic vision and resources.

          The good news is that everyday vapers are focused and while not quite as motivated as people who use IDs, they are a major force. I am optimistic they will win the day in spite of the lack of strategic support.

  2. Peter Sandman has a great discussion closely related to this in relation to risk communication, describing it in terms of hazard and outrage https://vimeo.com/channels/162087

    • Carl V Phillips

      I just read the captions (video? please!). Enough to see that this is one of the ones on the S-T-K list: risks with high salience because of high variance of number of bad outcomes in a short time period (i.e., a bunch of deaths happen at once, though the random events are rare so the EV is still low). That is another one that applies to the airplane phobia. For outbreaks the size of the recent one, it really doesn’t apply unless you compartmentalize the heck out of them. Outbreaks of *something* like this, with a death or two and a few dozen serious illnesses, occur weekly. Of course, this one was one-off in its details, like most are if you slice and dice. Again, I did not watch the videos, but I would guess the “outrage” in this case is not analogous to what he is talking about, which is driven by a large body count, while the recent case is a “even one is too many!!!!!” reaction.

      • I generally share your view on video, but I’d actually recommend watching (some of) these. ‘outrage’ is more fear based than body count based – he makes the point that the correlation between outrage and actual risk is very poor. People get upset by things that scare them (i.e are spooky, by your analogy), rather than than things that are genuinely dangerous.

        • Carl V Phillips

          Still not gonna watch. But I can surmise that outrage-fear is going to be driven in part by spookiness, and especially related to the sideline of spookiness about there being a supervillain behind it. So a lot in common. But it seems like it would also be driven by high-body-count events.

          Sigh, ok, maybe I will watch sometime while I’m falling asleep.

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