There are three problems increasingly evident in ‘tobacco control’ science when it comes to tobacco harm reduction:
- Contrived and phoney research designed to support pre-existing policy preferences (see previous post).
- Spin by scientists and activists designed to create some sort of moral panic or adverse change in risk perception out of absolutely nothing.
- The exhaustion of rational, fair-minded and ethical actors arising from Brandolini’s law: the bullshit asymmetry principle – see his seminal tweet.
All three drain the energy and time of real scientists, consumers and legitimate public health advocates. They distort regulatory and legislative decisions and create false perceptions of risk in the media and general public. All are evident in the following study:
Goniewicz ML, Lee L. Electronic Cigarettes Are a Source of Thirdhand Exposure to Nicotine Nicotine and Tobacco Research 2014.
Firstly, the study purports to show that ‘electronic cigarettes are a source of thirdhand exposure to nicotine’. It does nothing of the sort. It measures deposition of nicotine on inanimate surfaces, not uptake and exposure in the human body. It seems designed to create (by which I mean ‘fabricate’) a new category of risk arising from e-cigarette use which will help to make the case for vaping bans indoors.
Secondly, a whoop of joy from the activist academic Professor Stanton Glantz… who repeats the title, Electronic Cigarettes Are a Source of Thirdhand Exposure to Nicotine on his blog, and then says that “the title says it all”, before reproducing the abstract.
Thirdly, it will persist in the literature for all time and require refutation over and over again. It’s already taken some of my Sunday.
I left a comment on Professor Glantz’ blog, but he tends not to publish anything that disagrees with him or his campaign. So here it is…
Actually the title does not ‘say it all’. It actually says nothing useful at all, and it is misleading and irrelevant. This experiment did not measure ‘exposure’ but ‘deposition’ on surfaces in a chamber. For there to be ‘exposure’, a pathway between the inanimate surface and the blood or brain needs to be identified. The main risk appears to be to people who lick windows – or ‘window-lickers’ as they are known on the Internet. However, even these people, who have other problems and priorities, would have to lick the deposition from 38 square meters* of glass in this chamber to be exposed to 1mg of nicotine (47/6*1000/205). Obviously, in a full sized room, where the deposition density might be expected to be lower than in a chamber, the area required for window licking would be greater. What is the point of publicising and spinning this sort of research as if it somehow helps to articulate a meaningful risk? If it tells us anything at all, it is that this is irrelevant.
Obviously, the literal reference to window-lickers is to mock this experiment, its ridiculous title and the view of Professor Glantz that ‘this says it all’, when it says nothing useful and much deceptive.
But it raises serious issues too. So I would like to make some additional comments for people who want to reflect more seriously on this. First some suggestions for a revised abstract:
- Title. A more accurate title would be: “Electronic cigarette vapour deposition poses no plausible risk of harmful exposures to anyone.
- Method. A note on method might have clarified: “We have been unable to identify pathways from deposition on room surfaces to the human body that would lead to more than trivial exposure.”
- Results. The results could have stated: “At the levels found, transfer of surface deposition to the body would require direct contact between permeable human membranes and very large areas of floor or window“
- Conclusion. A better conclusion would be “There is no further need to conduct studies of this nature or to purse the concept of third hand exposures from vaping. To do so would be a waste of public or charitable funds.“
Some further observations:
- Is this good science? This is not good science or genuine open-minded inquiry. Good science starts with a hypothesis (in this case it would be something like “that vapour deposition can be a risk to to health of non-vapers”) . The authors would explain why they believe this hypothesis is plausible, based on their understanding of science so far. Then they would devise experiments that would allow them to reject the hypothesis. If the hypothesis survives multiple attempts to reject it through experiment, then the authors could gain in confidence and recommend further ideas for testing it. There is no credible hypothesis advanced or justified; no attempt to design an experiment to test it; no reason for the findings to justify further experimentation.
- Surely we are better off knowing about this than not? No. This is because there is an ‘opportunity cost’ of research – funds and time that cannot be spent on other more valuable things (like Goniewicz’ earlier work). The research community is wasting money when it could be conducting useful surveys into how people are using these products and what effect it is having on their smoking, health and well-being.
- Nicotine as a harmful agent? The idea that nicotine is an important exposure is wrong, and a recent ‘innovation’ by people who oppose e-cigarettes. It is only recently that 2nd hand and (absurdly) 3rd hand exposures have raised nicotine as a source of bystander risk. In the entire debate about 2nd hand tobacco smoke I don’t recall anyone making the case that nicotine was the problematic agent – the science at the time assumed it was whatever was causing harm to the smoker – i.e. not nicotine – but in lower concentrations. This is coincidentally an argument that emerged at the same time as vaping.
- If it isn’t good science what is it? I can only say what it looks like to me. As a set of measurements and reporting of results, I have no reason to think it is wrong. It is the reason it was done in the first place, the positioning and the interpretation that is at fault. At some level it looks like an effort to fabricate a novel risk from e-cigarettes – and invention rather than a discovery.
- How will it be used? The fabricated elevation of a novel risk into a science journal will create further political pressure to ban vaping in public places, and may even add to pressure to ban in private rented accommodation. It looks designed to give some (pseudo) scientific back-up to activists – the enthusiasm of Professor Glantz is reason to believe that will be the effect, even if not the intent. It will be used uncritically in state and city legislatures to build support for vaping bans. The FDA will be asked to take it into account.
- Who is behind it? I don’t know. It could be at the initiative of the authors within their own grants. It might be the idea of the institution (Roswell Park Cancer Institution) via its research funding committees. Perhaps it is the plan of a funder who wants to see this done and has paid researchers or the institution in a kind of mercenary arrangement.
- Why was it published? How exactly did the journal Nicotine and Tobacco Research conclude this contributes anything of value, and why were its obvious deficiencies, and especially its misleading title, not picked up at peer review or by the editorial team? This sort of science is more likely to distort perceptions and understanding of tobacco harm reduction than to enlighten.
In a comment below we show that the first order estimate of exposure to nicotine would be at least 20,000 times lower than wearing a patch for equivalent skin area …and remember, patches are not harmful.
* Shout out to Vinny Burgoo, who pointed out that my initial estimate of five square metres for 1mg exposure applied to that darker sub-cult, the ‘floor lickers’. Deposition on windows is lower than on the floor and therefore a greater window area would need to be licked.