Tag Archives: chiiiildren

San Francisco is the stupidest place in the world to think of the children

Posted on 27 March 2019 by | 2 comments

by Carl V Phillips

As anyone who follows the news about vaping policy in the U.S. knows, San Francisco is considering banning the sale of all vapes, on the heels of their ban on “flavored” vapes (which, of course, means flavors that are not identified as tobacco-ish or minty [Correction: I was reminded that this particular flavor ban, unlike most, also bans minty and allows only tobacco-ish]). Not at all surprising, the claim is that this ban is all about protecting the chiiiildren.

Amelia Howard had the brilliant insight to realize that San Francisco simply does not have that many children. She checked it out and posted this image on Twitter: Continue reading →

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All people like better products. Teenagers are people. Therefore….

Posted on 12 September 2018 by | 13 comments

by Carl V Phillips

So today FDA Commissioner Gottlieb is pumping cigarette company stock prices by threatening to ban flavors in vapor products (or something — not entirely clear), unless the manufacturers magically get teenagers to switch back to smoking instead (or something — not entirely clear). I wanted to address one aspect of this rhetorical game that does not get talked about enough. I doubt there is any serious observer of this space who does not get this, but much of what is said seems to overlook it rather than drilling down to it as it should.

The prohibitionist’s simplest rhetorical game here is to confuse “this product feature is appealing to teenagers” with “this product feature is particularly or uniquely appealing to teenagers.” But there is a deeper game, trying to cement the premise that intentionally lowering product quality is a good thing. This applies not just to interesting flavors of e-liquid, but also everything from attractive packaging to convenient unit quantities. The standard response to the “teenagers like flavors” rhetoric is to counter that adults like them too, and thus they seem to be critical for smoking cessation. Both systematic data and a deluge of testimonials make this point. It is a great point, and those making it are doing a great job.

However, the prohibitionists at FDA and elsewhere are obviously not unaware that adults also like and buy interesting flavors. Similarly, adults and teenagers both like it that e-cigarettes are less than five kilograms and come in colors other than day-glo orange. They like it that they are affordable, that cartridges last for a while, and that the devices do not burn your lips. They like it that there is no regulation that says tobacco products must be smeared with feces before they are packaged. All of these are aspects of product quality. The same features that make a product appealing to people (and thus, the banning of which would make them less appealing to people) make it appealing to teenagers. It turns out that teenagers are very similar to people, and many would argue that they are people. Lower the quality of the product, and fewer teenagers will choose to consume it. Fewer adults too. This works for food, movies, and pens also. There is no magic here.

The magic exists entirely in the rhetoric, in which the prohibitionists trick people into endorsing (or at least not actively pushing back against) their underlying premise: Intentionally lowering product quality is a good thing because it discourages teenage use. Never mind that intentionally lowering people’s welfare is a phenomenally radical action for a government to take, one that ought to be based on a lot of open and honest analysis, not sneaky rhetoric. I find it is a useful clarifying thought to replace whatever quality-lowering regulation is being debated with “mandatory smearing with feces” (assume the feces are sterilized so they are not a health hazard): If it is okay to intentionally lower the product quality by doing X (flavor bans, “plain packs”, punitive taxes, etc.), then it must be okay to mandate feces smears.

Consider the usual scientific response to flavor ban proposals, that there is no evidence that particular flavors or categories are particularly appealing to teenagers. This is accurate; there is no such evidence and no reason to believe it is true. If someone wanted to lower vapor product quality in a way that particularly affected teenagers, perhaps the orange coloration or increased mass options would be the better bet. After all, isn’t the usual claim that teenagers are taking advantage of the products being so subtle that they can hide them from parents and teachers? Adults would not like ugly heavy products, but they could deal with them.

The thing is that FDA et al. are not actually claiming that the flavors are particularly appealing to teenagers, just that they are appealing. This is obviously true (see above observation that teenagers are very much like people). A casual reader might conclude they are claiming that this is a targeted lowering of quality that affects teenagers but not adults. In fact, the serious actors in the space seldom actually claim that, and when they do it seems usually to be a matter of sloppy word choice. They do not actually consider it a problem that a regulation lowers the appeal of a product for everyone (and thus hurts all consumers). To them, this is a feature, not a bug. They want to ruin the products for everyone.

In getting opponents to go along with their fiction that this is not their motive, they win their greatest victory. One of the important skills of a conman like Scott Gottlieb is to get people to adopt his hidden premises without him ever stating them, let alone defending them. When the arguments hinge on “but adults like flavors just as much as teenagers do”, they effectively concede a key prohibitionist premise: If there were a way to intentionally lower product quality, such that it hurt teenage consumers more than adult consumers, then doing it would be fine. Not just fine, but good or even clearly the right thing to do. No doubt there are some vape advocates who accept that, but presumably most are not ready to agree that their e-cigarettes should have to look like traffic cones. But by just fighting the empirical claim (which is not actually even being claimed), they are often implicitly endorsing the normative premise.

Some advocates lead with the message that there are already laws about teenage access and these just need to be enforced. This is good in that it does not endorse the premise that it goes without saying that harming adults for the good of the chiiiildren is  justified (though usually this is not explicitly stated). The problem is that Gottlieb has cleverly turned this on its head, and threatens to hurt adults if they do not somehow better enforce the government’s laws, magically figuring out how to do what the government has never been able to do with cigarettes. Today’s rhetoric was mostly threatening the industry (though it is consumers who would suffer, of course), but he has directed that same demand at vapers themselves. Those who have been tricked into endorsing the underlying premises are cornered by this. They have effectively already conceded that destroying product quality is acceptable if minor bans cannot be enforced.

Advocates need to do a better job of backing a few steps up the prohibitionists’ chain of reasoning, rather than being tricked into conceding so much ground. Every argument should begin with the observation, “this policy is about intentionally harming people (vapers, smokers, other product users).” This should always be pointed out, because in itself that is a radical use of government power that should not pass without comment. It should be followed with a demand for an answer to, “by what right do you harm me/adult consumers/your citizens, even if it is true that this harms others more and harming them is a good thing because it changes their behavior?” Only after making those observations, and trying to never let the audience forget them, is it time to add “discouraging teenage vaping probably encourages teenage smoking”, “there the evidence does not support your implicit claim that teenagers like flavors better than adults do”, and other arguments about the scientific facts.

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Index of my Daily Vaper articles (2)

Posted on 11 November 2017 by | 1 comment

by Carl V Phillips

In my last post, I noted that most of my writing is currently at The Daily Vaper. I also promised that I would keep an index of those publications here for those who following this and not those, highlighting the ones that fans of this blog might be particularly interested in. This also provides an option for commenting on them, which DV does not have, and a chance for me to add a bit more about some of them.

[Update: Indexing is hard and unrewarding. I stopped after this one. Maybe someday I will circle back.]

Here is my belated second entry in the series. I will try to do this more frequently so the list is not so long (sorry — maybe keep this tab open and take a few days to get to all of them you want to see).

In rough descending order of what I think regular readers of this blog would find most interesting (I expect you will want to read at least the first seven):

1. I wrote a science lesson about anchoring bias and why it means that we should really stop describing the risks from low-risk tobacco products in relation to smoking (e.g., “99% less harmful”). I have hinted at some of this here, but I have never really nailed it before. This is new analysis. Anyone interested in my evolving thinking about accurate messaging — based on more years of experience and thought than anyone else involved in this realm — should definitely read this.

2. I reported on a court ruling that is fairly obscure, but truly delightful: The usual gang of anti-tobacco groups petitioned to be co-defendants, alongside FDA, in a suit against FDA by cigar manufacturers over aspects of the deeming regulation. The judge denied it. Why should we care? Because the ruling basically said that they are not stakeholders. For those of us constantly frustrated by the bullshit suggestion that they are (let alone that the primary stakeholders, tobacco product consumers, are not), this is just too good. Unfortunately I suspect I am the only one who will try to make anything of this. I strongly encourage those of you who are involved in advocacy (and especially those involved in lawsuits) to run with it. It really is a huge potential lever.

3. This piece is about the unethical scientific practices of tobacco controllers, specifically their flouting of human subjects protection rules. These are bright-line violations of codified rules, unlike the usual unethical behavior of tobacco control which is evil but not unlawful. I mention a couple of the reports about that which I have written here along with some new material. I suggest that perhaps a blanket boycott campaign would make sense. If I have time, I will write a piece about that specifically for this blog.

4. My personal favorite is this one, where I catch FDA chief Scott Gottlieb, in congressional testimony, offering basically the NIDA definition of “addiction”, a definition that clearly excludes tobacco products (including cigarettes). As my readers know, I have made a study of what people mean when they say “addiction”, and how there is apparently no viable definition that anyone wants to defend that actually includes tobacco/nicotine. In this case, Gottlieb was stuck because he had to talk about opioid addiction, and so was forced effectively undercut all the CTP rhetoric on the subject. Well, undercut it if anyone decides to challenge them based on this, which probably will not happen. The industry is not exactly known for being that clever.

(Foreshadowing note: I actually think I have figured out how to characterize what people mean when they say smoking etc. are addictive. One of these days I hope to write a major piece on this.)

5. In what could basically be an uncharacteristically terse version of a post here, I wrote about a recent “what parents need to know” statement about vaping in JAMA Pediatrics. It was all the terrible you might expect. I shredded it. If your appreciation for shredding exceeds your inclination to be annoyed by the terrible, you should find it a satisfying little read.

6. I reported how, after Senator Chuck Schumer launched an amazingly stupid attack on vaping in a press conference, Gottlieb practically fellated him on Twitter. (No, I did not put it quite that way.) This suggests that despite all the overly-optimistic talk of regime change at FDA, nothing has really changed in terms of who they consider their political patrons. (*cough* *told you so* *cough*)

5. My most recent piece was about the FDA’s Orwellian-named “Real Cost” campaign. I noted that they are about to aim this anti-scientific propaganda campaign, currently focused on smokeless tobacco and smoking, at vaping. I recount some of the campaign’s content and assess what they will do regarding vaping. I will write more about this shortly.

6. I did some original data analysis in this article, based on a recent CDC report of vaping rates across demographics and occupations. The authors could not see past the raw vaping rates. This is merely an uninteresting echo of the smoking rates; whoever smokes most is going to vape most. I looked at the ratio of vapers to smokers, which is actually useful. I found that across almost every group, the ratio is very close to the overall average. This effectively shows that the rate of switching from smoking to vaping is about the same across the different groups. The one big exception was African-Americans, where the ratio is much lower. That is, few smokers in that population are switching to vaping. I suppose this is worth a journal article, but I do not have time. (Free easy publication for any student or academic who wants to take the lead and write that with me! Seriously, let me know if you are interested.)

7. In this brief piece, I review the results of a recent paper that shows the anti-vaping bias in mainstream media reporting. It just confirms what we all know, but does a nice job of it. Most notably, it observes that anti-vaping statements tend to be attributed to people with supposedly expert credentials (though obviously they are really either clueless or liars), while the truth is attributed to advocates who the average reader will (mistakenly) consider less credible.

8. Here I analyzed a research paper out of FDA which is part of their assessment of how MRTP labeling might affect consumers. Unsurprisingly, it seems designed to make the case that allowing manufactures should not be allowed to tell the truth about their products. The study was bad, and they clearly intend to spin it worse.

9. I reported on FDA’s release of “adverse event” type records that they collect for tobacco products, which are really mostly about vapor products. I noted it is pretty much meaningless, but that it might be used in anti-vaping advocacy. I indicated my suspicion that FDA released it for just that purpose, not because of some belief it should be available because it is genuinely informative (it is not).

10. In this science lesson, I summarized my analysis that shows that the optimal tax rate for low-risk tobacco products is zero if the goal is to promote population health, or any other defensible stated goal. Not “lower than the tax on cigarettes” or “proportional to the risk”, but zero. My readers will already be familiar with these arguments, though if you are looking for a short summary, this is it.

11. I tried to assess the recent FDA “guidance” about the ban on free samples of vapor products (e.g., sampling e-liquid flavors), now that they are deemed as tobacco products, with all the rules that apply to them. I say “tried” because the guidance sort of says that it does not apply to adults-only venues (e.g., most vape shops). But how exactly this will play out — i.e., will flavor sampling be banned? — is not clear.

12. I analyzed a recent survey by BAT about beliefs about the risks from vaping. It is pretty straightforward “latest study” reporting, though I got some additional data from the researchers that allowed me to offer a better assessment than those who were just working from the press release. The main takeaway is that even in the UK, a ridiculously large portion of the population does not understand that vaping is much less harmful than smoking.

13. I introduced readers to the CASAA Testimonials collection that I created in 2013. Long-time readers of this blog will be familiar with it. I plan to publish more little articles that are excerpts from that collection.

14. Finally, I reported on the fight over vapor product taxes in Pennsylvania. The upshot is that tax structure, not just tax rates, matter a lot. A rather more interesting aspect of that story — and of another story that got spiked — does not appear there. I hope to get time to report it here sometime (ooh, more foreshadowing).

(Damn, that is a lot of material. Comments welcome. I suggest using the serial numbers if you are commenting on one in particular.)

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California ecig “regulation” hearing: a catalog of lies (part 1)

Posted on 21 April 2015 by | 11 comments

by Carl V Phillips

On April 8, the California Senate Health Committee held a hearing on an anti-ecig bill. This was an amazing job of cataloging the many anti-THR lies about e-cigarettes. The main immediate impact of the bill would be to ban vaping in all the private and public (mostly private) places where smoking is banned, but the preamble of the bill makes clear that the plans are much worse than that, including licensing and laying the groundwork for punitive taxes on vapers. (That would be to punish them for denying California the buck-and-a-half per pack (approximately) that they were paying the state when they smoked.) Continue reading →

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CDC lies about ecigs and children again (wait, have I used that title before?)

Posted on 11 December 2014 by | 11 comments

by Carl V Phillips

The CDC issued a press release about children and e-cigarettes again today (which is basically just another way of repeating the title of this post). Their headline claim itself is actually true (assuming they know how to count — not a foregone conclusion): More than 16 million children live in states where they can buy e-cigarettes legally. Of course, they don’t happen to mention why this is the case, and they go on to offer other lies. Continue reading →

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Jane Brody turns up the NYT’s lies about THR, e-cigarettes, etc.

Posted on 28 January 2014 by | 3 comments

by Carl V Phillips

The New York Times has some good health science reporters, but their best known health writer, Jane Brody, has been a reliable embarrassment for that newspaper for decades (and it takes a lot to embarrass the newspaper that led the drumbeat to start the disastrous war with Iraq, repeating and even embellished the claims about WMDs).  It might not be fair to blame the newspaper itself for one writer who seems to have managed to learn nothing of the science she has written about forever, but for the fact that the paper has been editorializing against THR also.  So blame for the lies should go to both the author and the editors.

The first of her two-part series on tobacco product use is no worse than typical Brody standards.  It focuses on the 50th anniversary of the 1964 Surgeon General report on smoking, and the burst of associated activity.  It is typical naive transcription of the standard claims, many of which are exaggerations of the risks from smoking or are otherwise not quite right, but are mostly not too harmful.  It is specifically remarkable that someone who is supposedly an expert would declare that her husband’s cancer death — 15 years after he quit smoking — was definitely caused by smoking.  (Yes, it is certainly quite possible it was caused by the smoking, but that long after cessation, there is a good chance it was not, as anyone who understood the science would know.)

It is tiresome to read the naive and self-serving claims of the tobacco control industry repeated once again (hey, we can’t expect a reporter to bother to check whether there is any real basis for what she is being told, can we? reporters are far too busy to do that).  But most of them do relatively little damage to the world.  That is, until they spill over into denigrating proven-effective smoking cessation methods in favor of the self-serving failed approaches of the TCI, which is where Brody goes in her second post.

She claims:

[CDC Director] Frieden and public health specialists everywhere are seeking better ways to help the 44 million Americans who still smoke to quit and to keep young people from getting hooked on cigarettes.

And she might actually be naive enough to believe that claim.  As I said, she is known for having a remarkably poor understanding of what she presumes to write about.

The reality, of course, is that “public health” people are the active opponents of the better ways that are emerging.  The only proven method of substantially further reducing smoking is THR.  But instead of embracing it, “public health” continues to come up with even more absurd and socially burdensome interventions that accomplish approximately nothing.

Brody’s litany of claims about the wonderful effectiveness of the ruling class’s anti-smoking methods is so antiquated it appears to be a joke.  She spends a quarter of the post on WHO’s 2008 pabulum regulatory guidelines and even mentions, as if were news, a year-old proposed tax increase.  Strangely, she apparently did not read her own first post, which laments how all interventions to date have proven inadequate.  Logical consistency has no place in tobacco control or, apparently, NYT reporting.

Before getting to the part that matters most, it is worth calling out this:

“A higher cigarette tax is not a regressive tax, because it would help poor people even more than the well-to-do,” Dr. Frieden noted.

Frieden and Brody should both take a minute and look up what “regressive tax” means.  But even aside from this being a bald lie,  just pause and think about the mindset behind it.  The ruling class has decided that imposing a huge punishment on poor people helps them.  After all, if the savages are not beaten, they will continue to sin.  The only thing missing is “qu’ils mangent de la brioche.”

Brody’s actively damaging lies start after that, as she concludes her discussion of how not enough has been done to reduce smoking with an attack on the one recent innovation that has dramatically increased cessation:

Electronic cigarettes are being promoted by some as a way to resist the real thing. E-cigarettes, invented in 2003 by a Chinese pharmacist, contain liquid nicotine that is heated to produce a vapor, not smoke. More than 200 brands are now on the market; they combine nicotine with flavorings like chocolate and tobacco.

Setting aside the first common misconception (e-cigarettes were invented at least as long ago as the 1960s and the current form was invented by an American in the 1990s), how clueless do you have to be to say they contain “liquid nicotine” (rather than a very diluted nicotine solution) and that there are only 200 brands?  Ok, so far it is just illiterate, but not harmful.

But their contents are not regulated, and their long-term safety has not been established. In one study, 30 percent were found to produce known carcinogens.

Not regulated — just like the vast majority of the (largely useless) cessation methods she recommends in her post.  Not established — as opposed to the wonderful long-term safety of the approach her husband used, which was to repeatedly fail in his attempts to quit smoking until (according to her) smoking finally killed him.  Seriously, is she even reading her own prose?  And don’t even get me started on the NYT’s supposed expert health reporter falling for the “produce known carcinogens” silliness (hey guess what, Jane, 100% of humans tested produce known carcinogens).

Dr. Frieden said that while e-cigarettes “have the potential to help some people quit,” the method would backfire “if it gets kids to start smoking, gets smokers who would have quit to continue to smoke, gets ex-smokers to go back to smoking, or re-glamorizes smoking.”

Yes, and it would also backfire if it caused a resurgence of smallpox, triggered a nuclear war, or was a prelude to an invasion by space aliens (as I have speculated it might be — have you seen some of those mods?).  Too bad we do not have an institution in society whose job it is to ask questions of government flacks, like “so, is there any reason to believe that is a real risk?”

Nearly two million children in American middle and high schools have already used e-cigarettes, Dr. Frieden said.

And, of course, that was a lie.  But, hey, it is not up to the transcriptionist to check the accuracy of what she is writing.

In an editorial in the Canadian Medical Association Journal last year, Dr. Matthew B. Stanbrook, an assistant professor of medicine at the University of Toronto, suggested that fruit-flavored e-cigarettes and endorsements by movie stars could lure teens who would not otherwise smoke into acquiring a nicotine habit.

Well then, a random medic speculated about this.  And demonstrated his expertise by being able to write it down.  Must be true.

A survey in 2011 of 75,643 South Korean youths…

A minor aside, but anyone who does not even know how to round numbers to leave out irrelevant detail should not be reporting about science.  Nor should anyone innumerate enough to quote Stanton Glantz as if he had even half a clue about science.

…in grades 7 through 12 by researchers at the University of California, San Francisco, revealed that four of five e-cigarette users also smoked tobacco. It could happen here: Stanton A. Glantz, the study’s senior author and a professor of medicine at the university, described e-cigarettes as “a new route to nicotine addiction for kids.”

That is the note she ends on:  most teens who even tried e-cigarettes were already smokers, and therefore we better put a stop to it.

Ms. Brody, I suggest you go back and read your own posts, and then ask yourself:  Who is it that is dooming millions of people to keep smoking, as your husband did?  Could it perhaps be those who are lying about the benefits of switching to a low-risk alternative, a group that now includes you?

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Smoking initiation getting older, what does it mean?

Posted on 8 January 2014 by | 4 comments

by Carl V Phillips

This is a bit tangential at the start, but it is a good science lesson and you will see how it relates to THR, particularly the common claim that there is no value in THR because everyone is just going to stop using tobacco soon.

I was monitoring the tweets from today’s tobacco control industry’s (TCI) meeting to celebrate the 50th anniversary of the U.S. Surgeon General’s report on smoking (you can find the tweets at #SGR50 if you are interested — you will need to scroll down to today to find the comments on the meeting because there will be a lot going on at that tag over the next week).  There was a lot to despise about it.  Primarily it consisted of a bunch of people who were not even born yet (and a few who were children) trying to take credit for the historical anti-smoking measure that mattered far more than any other: telling people about how risky it is.  This seems to be an attempt to distract people from the fact that what they are doing now is basically useless — except when it is harmful, as when they try to prevent THR.

Apparently several of the speakers took this celebration of a report on smoking as an excuse to attack low-risk alternatives.  A few others, notably Matt Myers of CTFK and the president of the American Academy of Pediatrics (AAP), made the claim that a large majority of smokers start as kids.  The thing is, smoking initiation in the U.S. is now almost exactly half adults and half children, as shown here.

It is not clear whether they are simply illiterate, not understanding verb tense (a large majority of current smokers started as kids, but that appears to no longer be true of those who start).  More likely they are innumerate (that would fit their historical bad science, certainly) and do not understand the basic epidemiologic concept of age/period/cohort.  It is actually quite simple, though it confuses a lot of people who have never had it explained to them when they try to understand events that are happening over time.  A cohort is a group of people born within a particular period (for simplicity, just call it a year); period refers to calendar time; age is obvious.

It turns out that if you fix two of those, it determines the third.  For example, if you want to look at people born in (cohort) 1970 when they are (age) 44, that would mean you are looking at (period) 2014.  (Yes, I know — more precisely you are looking at part of 2014 and part of 2015 for each individual, but we tend to ignore that for convenience.)  Most important, for understanding these things, is that if you are looking at a particular age range (say 12- to 17-year-olds) over changing time (as is done when we chart how many children are starting smoking each year, as in the above link), then you are talking about a series of different cohorts.  That is, it is about different (though in this case, overlapping) groups of people.

To make this more concrete, most current smokers are members of cohorts that started smoking during periods where smoking initiation was at younger ages.  But the current cohorts are not doing this, and therefore in the future more smokers will have started at later ages.  If one does not understand the concept of cohort (as is apparently the case for those speaking today), it might be difficult to understand this.

This also lets us better understand the significance of the fact that smoking initiation is shifting to older ages.  As the tobacco controllers like to brag when they are touting their accomplishments (and like to hide when they are demanding more funding), smoking initiation among children is definitely trending down.  In particular, the TCI uses this observation to claim that THR is not useful because smoking is disappearing (never mind those who are already smoking — they can just die from it).  But initiation among the population as a whole is almost keeping pace with population growth.  With an understanding of cohorts (and being able to not conflate them with periods), it is relatively easy to hypothesize an explanation for this.

Hypothesis: Aggressive anti-tobacco (not just anti-smoking) propagandizing of children is causing them to avoid it until they reach an age where they throw off the manipulations of their younger self.  At that point, however, the portion of the population inclined to try or use cigarettes or other tobacco products is barely changed.  That is, pushing initiation to a later age does not substantially change the behavior of the cohort in the long run.

To better understand this, consider two other behaviors:  If children are effectively discouraged from engaging in the risky activity that is American football, they will never play it; basically no one takes up football as an adult. But if children are effectively discouraged from engaging in the risky activity that is sex, the percentage of the population that will eventually become sexually active is barely changed.  These represent the polar cases of whether stopping early initiation stops initiation entirely, or whether it basically does not reduce eventual initiation within the cohort at all.

The TCI wants us to believe (and themselves desperately want to believe) that tobacco use is more like football — that anyone who avoids starting it as a child will never start.  But the data is suggesting it is more like sex — where the inclination is not substantially changed by delay.  That is, a relatively constant portion of each cohort that is interested (obviously, a much smaller portion for tobacco than for sex).

If the above hypothesis is correct, we would expect that causing a decrease in children initiating would cause an increase in young adults initiating a few years later.  This generally fits the data — not perfectly, but better than does tobacco control’s hypothesis that if you stop a would-be child initiation, that person will therefore never start.  (To maintain that fiction, they try to maintain the fiction that most initiation occurs in childhood, despite the very simple data that shows otherwise.)  There will be a reduction in the number of smokers in this scenario (due to the lower rate in the cohorts who are currently children), but not the cohort effect that tobacco control claims:  There will be about the same number of 24-year-old smokers each year in the future as there are now.

If the hypothesis is basically correct, there will presumably still not be perfect substitution.  The trend will be at least a little bit of the football effect, with some who avoid starting as children losing all interest before become adults. So the current tactics for blocking childhood initiation will reduce total smoking in the cohort, but it appears that it will not be very much.

Getting this right has obvious implications for THR.  First, it shows that while the 1964 Surgeon General report and related education efforts mattered a lot in lowering the inclination to smoke, the near-plateau that has been reached in initiation is not actually changing.  This is contrary to what one might naively conclude from the data on current children that ignores the rest of the cohort’s lifecycle.  Thus, THR remains the only proven method for getting smoking rates to drop much below 20% of the population.  Second, it is further evidence against the TCI’s demonic possession theory of why people smoke.  It shows that people use tobacco because they like it.  Just as delaying sexual behavior initiation does not cause people to not like sex, delaying tobacco initiation does not substantially change the number of people who like tobacco.  Thus having low-risk tobacco products will make a lot of people happier, even apart from making them less likely to smoke.

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CDC lies about kids using e-cigarettes

Posted on 7 September 2013 by | 23 comments

by Carl V Phillips

In a story that is practically a carbon copy of the lies from the Florida Department of Health that I discussed a few days ago, the CDC is lying to the public about statistics on school-aged e-cigarette use.  But this time, the lies are officially coming from our nation’s government, not some second-rate local department.  (Note, by calling them “second-rate” I am giving Florida the benefit of the doubt: in my experience, state health departments start at second-rate and go down from there.)

The CDC results were published in the agency’s newsletter/blog, Morbidity and Mortality Weekly Report and the lies were blasted out to the public via this press release.  Any American who is still shocked to find that their government is lying to them is an idiot (I doubt I will insult even a single one of my readers by saying that), and yet many reporters tend to blindly transcribe what CDC says rather than, say, bothering to read beyond the headline to see that it is clear based on only what CDC themselves reported in their press release that the claims are lies.

The headline of the press release manages to fit in one lie and two misleading claims, “E-cigarette use more than doubles among U.S. middle and high school students from 2011-2012”.  The biggest lie is that they report nothing about use.  All the reported statistics are about about trying the products, perhaps only once, which is obviously not the same thing (and CDC knows this).  Some statistics reported are for “ever having tried” and the others are “tried at least once in the last 30 days”.  They misidentify anyone who has tried in the last month as a current user, which is a rather blatant lie.  (Of course, some of those who tried recently may well actually be users, but there is nothing in the report that lets us conclude that even one single student is actually an e-cigarette user.)

The second sneaky lie was listing “middle school” ahead of “high school” even though the results for the former are trivial.  But it is scarier to imply that this is mostly about 12-year-olds and not 18-year-old high school students, isn’t it?

The third lie in the headline requires a bit of numeracy and data that is right there in the press release.  (This opens the question of whether our nation’s government’s top health officials are themselves innumerate.)  The number that more than doubled is for “ever tried”.  When your study population is 3/4 the same people from one observation to the next (as it the case with students who are in high school in 2012 compared to those in 2011), and the phenomenon you are studying is new enough that most of the trying is recent (as with e-cigarettes or whatever the latest offering McDonalds or Pepsico has added to their menu), then of course you are going to see a sharp increase in the number who have ever tried it.  It is almost impossible to see a decrease, and moreover, if the exact same number tried for the first time each year, that would come close to doubling the number who had ever tried.

You are with me there, right?  An 11th grader, in 2011, who tried an e-cigarette in 10th grade is still part of the “ever tried” group when he is in 12th grade in 2012.  If one of his classmates tried one for the first time in 11th grade, he joins his friend in the “ever tried” group in 2012.  Though the rate of trying was the same for this two-person population each year, the “ever tried” statistic DOUBLED!!!!  Scream it from the rooftops!

Did I mention that CDC are lying to people?

CDC apparently did not actually measure e-cigarette use.  They could have, of course.  Presumably they knew that the results would contradict the alarmist prohibitionist message they wanted to deliver, and so avoided the truth intentionally.  Actual use is clearly trivial.  If you actually wade though their breathless rhetoric to find information, you learn that 2.8% of high school students reporting trying an e-cigarette in the last month.  How many are actually using them?  If it is even as high as 1/10th of that, we are talking 0.3%.  But, hey, if you report something like that people will not be worried.  And worrying people is the goal.  So stick with “doubled!!!!!”.

Identifying the other important lies requires a bit of knowledge rather just the level of math that we can hope every subject of the studies learned many years ago.  (Am I being too optimistic about the quality of our schools?  Perhaps.  But that is off-topic.)  It turns out that almost all the e-cigarette triers had also tried cigarettes and indeed that almost 80% of them were “current smokers” (which, given CDC’s misuse of terms may be an overstatement of how much they actually smoke, though we do know that — unlike with e-cigarette trying (“hey, what is that? can I try a puff?”) — a large portion of those who puff a cigarette in a month are genuinely current smokers).  So this means that it is quite conceivable that most of those kids who tried an e-cigarette were pursuing THR!  That is, they consider themselves to be hooked on smoking and are seeking a low-risk alternative.  But we can’t have that, can we?

A comparatively minor point in the context of their more blatant lies, but still quite poisonous, is CDC converting their statistics (via the estimated size of the cohort they are studying) to “1.78 million” total students having tried e-cigarettes.  This level of precision implies that they have their result estimated so precisely that they know it to 1 part in 1000.  But their trying statistics, even if about as right as they could possibly be have precision in the range of maybe +/-20% at best.  (That is the best case scenario — when someone is lying about their statistics, always be concerned that they are lying about the data quality too.)  If they had said “almost 2 million” that would be reasonable, but even rounding to 1.8 million would imply more precision than they actually have, let alone 1.78.

Another comparatively minor but not trivial point is that quite a few high school students are of legal age to use tobacco products, and so it would be useful to break out the statistics for under-18 (which, of course, would be lower than those that include the 18- and even 19-year-olds).

It is also worth noting something that we know but apparently CDC does not:  Not all e-cigarettes even have nicotine in them.  How many of the kids tried e-cigarettes with nicotine?  No one knows.

Of course, the biggest lie is the “gateway” lie.  You know that when prohibitionists start making claims about a gateway that they have given up on pretending that a behavior is a problem in itself.  So they have to make up some reason for prohibiting it, so they claim that it leads to something that is a problem.  There is never any evidence to support those claims, about anything, as far as I have ever observed.  That is certainly the case here.  And yet the CDC makes claims that their data show that we should be worried about gateway effects even though there is no actual hint of that.

You can tell someone is starting with a conclusion and fishing for claims to support it when they contradict themselves over it within a few thousand words.  They claim both that the statistics showing almost all e-cigarette triers are smokers (or have tried cigarettes) suggests that there is a worry of a gateway and also that the statistics showing that a few (1/5th) of the (very few) younger kids who tried e-cigarettes had not tried cigarettes means that there might be a gateway.  So, guys, what would the evidence need to show to refute the claim there is a gateway?  The answer, of course, is that whatever the evidence shows, it supports the claim — this is religion, not science.

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