Tag Archives: gateway

My recent contribution to Clive’s weekly reading list

by Carl V Phillips

As some of you know, Clive Bates puts out a weekly somewhat-annotated list of PubMed-indexed articles that are related to low-risk tobacco products and/or tobacco harm reduction (the search string for that appears at the end of what follow). It is a great resource; if you do not receive it, I am sure he would be glad to add you to the distribution list. As part of a planned projected that I have alluded to before, I am working on how to reinterpret this as an annotated weekly suggested reading (or knowing-about) list. To that end, this week I was a “guest editor” for Clive’s distribution list, and I thought I should share what I wrote here to broaden the audience. Yes, it is a little weird to publish a one-off “weekly reading” that is mostly based on an existing format that you might not be familiar with. But you should be able to get the idea. Hopefully I will be producing one every week before too long.

In the meantime, here is what I wrote that went out via Clive’s distribution lists. Sorry for the weird formatting — it is an artifact of the way the original PubMed search was formatted. Yes, I could have fixed the for aesthetics to re-optimize for this blog’s formatting, but since they do not hinder comprehension, I am not going to bother — sorry.

Greetings everyone. Carl V Phillips here, doing Clive’s list this week. I am trying out a new format for it, as follows: (1) They are not listed in the order that popped from the PubMed search string, but rather is in order of how worth reading they are. Obviously this is my own rough blend of various considerations, including importance of what is being addressed, value of what was produced, how potentially influential it is, and how much reader effort it takes to get value from it (note that I put relatively little weight on the latter). I have left the serial numbers from the search on the entries in case anyone wants to recreate the usual ordering. I add a full-text link if I think there is anyone other than specialists in the particular area would want to look at the full text. (2) I am not limiting this to PubMed-indexed papers. I am including popular press and policy statements (and would have included blogs but there were not any apparent candidates this week).

Continue reading

Note to readers: look for me at @TheDaily_Vaper

by Carl V Phillips

Those of you who follow this blog but do not follow me on social media may be unaware that I am now writing for The Daily Vaper, a unit of The Daily Caller newspaper. Since the time and energy I spend doing that is basically the same time and energy I spent on this blog, there may not be a lot here. Not none, but a lot less.

I will try to do a periodic post here to index my Daily Vaper articles, particularly calling attention to the ones that would have been good fits for this blog. Continue reading

Sunday Science Lesson: Misconceptions about the gateway effect

by Carl V Phillips

Disturbingly close to 100% of writings about whether there is a gateway effect among tobacco products, particularly about e-cigarettes being a gateway to smoking, are nonsense. That includes most metas on the topic, where someone tries to explain what mistakes others are making. Perhaps addressing a few simple misconceptions can clear some of this up (and it is a favor to a few of my tweeps — I hope I have addressed all the points our conversation left hanging). I have written about all of this much more extensively and comprehensively (see this in particular), but not in soundbite form. Continue reading

“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

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

Sunday Science Lesson: Identifying bullshit is usually easy (it just seldom happens in tobacco-land)

by Carl V Phillips

In the previous post, I quoted from Jon Stewart’s farewell monologue in which he alluded to how it is usually relatively easy to identify utterly bullshit claims and call them out. This includes utterly junk science. There are stories of master fraudsters in science, who carefully cook data and convince the world for years they have made game-changing discoveries, only getting caught after too much contrary evidence piles up. For some immediately detectable cases of junk science, it requires a bit of clever expert analysis to detect it. But these cases should not distract from the fact that most junk science is junk on its face. Continue reading

New Phillips-Burstyn-Carter working paper on the failure of peer review in public health

by Carl V Phillips

Our new working paper is available at EP-ology, “The limited value of journal peer review in public health: a case series of tobacco harm reduction articles”, Carl V Phillips, Igor Burstyn, and Brian L Carter (all of the authors are affiliated with CASAA, for those who may not know).


Background: A widespread belief holds that the journal peer-review process has magical powers to ensure that published claims are correct. While this misperception has limited consequences in many fields, in public health it results in consumer, clinical, and policy decisions being based on blind faith in the accuracy of published claims. At best, the review process is merely a couple of readers — perhaps, but not necessarily, highly expert — reading through a paper to ensure the research and presentation are reasonably sound. In reality, even this is often not accomplished.

Methods: We conducted reviews of 12 articles that focused on tobacco harm reduction published in a mainstream public health journal, BMC Public Health, consecutively during 2012-15. We each wrote a reviewer report of the manuscript version that was sent to the journal reviewers, as if we were writing a review for a journal. We then compared these to the reviews written by the journal reviewers. Additionally, we reviewed the changes made to the papers as a result of the journal reviews.

Results: Almost all the papers in the dataset suffered from major flaws, most of which could have been corrected, but none were corrected by the journal review process. The journal peer reviews were almost all inadequate and many contained no substantive comments. Those that contained substantive observations still did not identify most of the blatant major flaws that we noted. In the single case where a journal reviewer identified many of the major flaws, the comments were basically ignored by the authors and the paper was published with no substantive changes. Other than cosmetic improvements, the journal review process was about as likely to make the published version worse than the submitted manuscript, rather than better. Papers with no apparent value were published by the journal and the potential value of other studies was lost because serious flaws in the paper were ignored. Unreported conflict of interest was common among both authors and reviewers.

Conclusions: Faith in the journal peer-review process is misplaced. Even at best, the process cannot promise that a published claim is correct, but in reality it does not even ensure that patent major flaws are not present. In public health, the phrase “according to a peer-reviewed journal article” seems to mean little more than “I read this somewhere.”

It should be evident from the abstract that the primary study aim is not about THR. However, readers of this blog may be interested for several reasons. Most obviously, the case studies are based on articles about THR. But also, the idolatry of journal peer review is one of the more important causes of the persistence of anti-THR lies. Analyzing the reviews of the papers, not the papers themselves, was the purpose of the research, but that required assessing the papers en passant, which means that readers interested in that aspect will should find a fair bit of the content interesting (particularly delving into a few of the appendices).

Some of the material has already been covered here. The previous post was basically written as a footnote for the paper. The post about the terrible paper by Hughes (“Associations between e-cigarette access and smoking and drinking behaviours in teenagers”, by Karen Hughes, Mark A Bellis, Katherine A Hardcastle, Philip McHale, Andrew Bennett, Robin Ireland, and Kate Pike) was basically an excerpt from that research project. The extensive analysis of the Popova-Ling travesty was incorporated as part of the analysis in the paper.

There are few other papers in the analyzed case series that also fall solidly within the anti-THR lies category. There is this one (“Portrayal of electronic cigarettes on YouTube”, Chuan Luo, Xiaolong Zheng, Daniel Dajun Zeng, Scott Leischow) whose value lies entirely in it being unintentional comedy. Strangely, despite being a useless, silly, and badly conducted study, that was then written up as a political broadside that had nothing to do with the study results, it was probably only the 10th worst of the 12 papers in our case series.

Two of the papers were written to try to vilify snus. This one (“Snus user identity and addiction. A Swedish focus group study on adolescents”, Ingrid Edvardsson, Margareta Troein, Göran Ejlertsson, Lena Lendahls) is mostly just uninteresting in terms of what it claims. This one (“Predictors of smoking among Swedish adolescents” Junia Joffer, Gunilla Burell, Erik Bergström, Hans Stenlund, Linda Sjörs, Lars Jerdén) relates more closely to recurring themes from this blog. In particular, it makes the naive gateway claim that fails to distinguish between association and causation. This is particularly pathetic in this case because the paper is ostensibly about predictors and not causes.

Comments on the working paper are welcome, either in the blog comments at EP-ology or via email.