Tobacco controllers are notorious for abusing science and using police powers to force others to obey their whims about proper behavior. This “How Low Will They Go” series of articles is about the countless less obvious ways in which they demonstrate their disregard for social norms and basic decency. The most recent example is a new paper by Rui Chen of the Johns Hopkins Bloomberg School of Public Health and colleagues that analyzed the results of the surreptitious monitoring of the air quality at a vape convention. I previously blogged about previous similar research, which was funded by the FDA.
There are many aspects of this research that are problematic. First is the usual misconstruing of the science. In the recent case, the authors inappropriately compared the air quality to outdoor air standards, reporting that it would have violated those standards by a large margin. But this is a blatantly misleading choice of comparisons. Indoor air typically has far higher concentrations of most pollutants; it contains whatever pollutants are in the outdoor air (since it starts as outdoor air), plus many added by materials and activities. Outdoor air is comparatively pristine and subject to much more stringent expectations because people must breathe it all day every day.
It is true that if a region were blanketed in a fog of e-cigarette vapor thick enough to limit visibility to less than a hundred meters, as is typical at a vape convention, that would be a problem. It is true, but it is also irrelevant. Even if the air pollution were harmful, people attending a vape convention are only there for a few hours, and probably only once a year.
The research produced no evidence of a health hazard, though the authors tried to imply otherwise. The data focused on counts of “particles” in the air, presumably because the equipment they could smuggle into the convention could only make such crude measurements. But as previously explained, the liquid droplets created by vaping are entirely unlike solid particles that are a major health concern, though some equipment is incapable of distinguishing the two. Outdoor air quality standards for small particles are based on the typical composition of air pollution — primarily the solid particles created by combustion — and tell us nothing about the health implications (if any) of droplets.
But the more insidious subtle point here is the blatant disregard of the ethics of research conduct. This research was conducted by carrying hidden equipment into the convention. It is theoretically possible that the researchers had permission to do this from the event organizers, but since they offer no such assurance, it seems safe to assume they did not. It is an even safer bet that they did not have the consent of everyone else at the event.
It is grossly unethical to conduct health studies on people without their informed consent. This principle has a storied history dating back to the Nuremberg trials, and includes such detours as the crimes of the Tuskegee research. It is codified into laws and regulations that most researchers — including the authors of the recent paper — are obligated to adhere to. Those informed consent pages you are given when you are asked to participate in research, or allow data about you to be used for research, are a result of this principle and these rules.
In addition, anyone conducting this type of research on human subjects is obligated to seek and obtain the sign-off of an independent human subjects ethics committee (often called an IRB). Such protections are often imperfect — the committees may be political allies of the researchers — but it offers some protection, and it is required. It appears that the recent researchers, like the FDA-funded researchers before them, ignored this requirement.
Presumably the researchers sought refuge in the technicality that they were studying the air, not the people. But this excuse fails for several reasons. First, they did study the people who attended the convention — they counted them. While this could not directly harm anyone, it does mean people were subjects of study, and thus the appeal to the technicality fails.
More important, the physical manifestation of a vape convention is an obvious extension of the people who participate. Everything there represents the intentional, focused and private activities of an identifiable group of people. Air pollution and everything else that happens there is because of them, and they are the only ones affected. It is not like the accidental impact on outdoor air quality of people using energy. A vape convention is not just a random public gathering or commercial venture. It is a gathering of an oppressed minority to celebrate a behavior that the researchers seek to condemn.
More important still, the entire purpose of this research is to harm the people who were the subjects of the research. If this research did show that the air pollution at vape conventions was harmful (which it was incapable of showing), the only possible interest of these authors would be to use that result to try to ban vape conventions or try to convince venues to refuse to host them. The results are irrelevant to any other venue. The vapor concentration at a convention is uniquely high so offers no information about vaping in bars, for example. Restricting future vape conventions harms the study subjects, people who chose to attend such an event. Needless to say, conducting secretive research on people, without their consent, for the purpose of harming them, is far worse than merely ignoring their right to refuse to be studied.
It is possible for someone to study vape conventions, including their air quality, in order to benefit vapers, or just out of sociological curiosity. If there actually were genuine concern about the air quality, it could benefit vapers to figure out how to reduce the risk. But no researcher conducting such research would have to hide it. They would seek human subjects ethics approval, as well as the consent of the event organizers (which a decent ethics committee would demand anyway). Their presence would be made known to the attendees. Of course, it is unlikely that tobacco controllers would ever be trusted enough to get such consent, and with good reason. But the apparent failure to even try makes clear that their intention was to do harm.
The listed corresponding author for the paper, Ana M. Rule, also of Johns Hopkins Bloomberg School of Public Health, was contacted for comment. She was given a complete list of the accusations and speculations that appear here, which she could have denied or clarified. She ignored the invitation.
Imagine if university researchers went into mosques or black churches, surreptitiously and without consent or permission, to gather data whose only possible purpose would be to justify a crackdown on those institutions. You can add to the story that the the government paid them to do it, or that they misrepresented the implications of their data, but those details are not even necessary. It is a safe bet there would be an outcry. It is a safe bet that most tobacco controllers would be among those who oppose it. Yet they express no concern when those actions are aimed at another oppressed minority.
Tobacco controllers simply do not believe that ethical norms and rules apply to them.