The past couple of weeks saw a spate of new journal articles about perceptions of and attitudes toward vaping. The authors — all tobacco controllers — lamented the bad news they found. This, of course, means that they found that valid scientific knowledge, consumers asserting their rights, and real public health messages are doing better than they hoped.
The least comical of the new studies was “Perceptions of Alternative Tobacco Products, Anti-tobacco Media, and Tobacco Regulation among Young Adults: A Qualitative Study,” by Betelihem Getachew et al., from the National Cancer Institute’s anti-tobacco shop at the Emory School of Public Health. They interviewed students at several Georgia colleges about their perceptions of various tobacco products. As with most “public health” studies of this kind, the report is a nonsystematic collection of quotes from the interviews and assertions about general themes. In other words, it is feature journalism rather than science: The authors tell the story they want to tell, and they season it with (probably unrepresentative) quotes that are chosen to support or illustrate their claims. However, in this case it is seemingly adequate to learn about the main theme: perceptions of comparative risk.
Subjects knew cigarettes are the most harmful product, and most knew vapor products are far less harmful. However, the authors claim there was substantial uncertainty about the risks. (Note: never believe authors’ assertions about such minor or unquantifiable points in studies reported like this; they are frequently just something the authors concocted themselves, and because they are the only ones to see the data, it is impossible to know if they are being honest.) The authors assert that this is because of “lack of available and easily accessible information about their health effects,” though of course it really results from the confusion created by the deluge of disinformation.
Subjects’ perceptions of smokeless tobacco, by contrast, grossly overstated the (basically nonexistent) risks, demonstrating the success of NCI and various institutions in Atlanta to misinform people about it. In the discussion they are all but screaming, “We tricked them into believing smokeless tobacco is harmful; why can’t we do it with e-cigarettes?” Naturally, the authors fished for quotes to try to support their political goals — the one subject out of the 60 who called for more regulation or endorsed faux-warning messages with emotionally violent imagery. This is an exercise in state propaganda, not science. Still, it was a reminder that the young people are mostly not falling for it anymore, and that tobacco control is finally starting to lose their disinformation war.
In a more honest study about a less honest topic — sending text messages containing disinformation about vaping — the researchers texted a group of high-school age volunteers. The kids generally asserted that they found the messages convincing and often took cues from the messages to say negative things about vaping to others. So the good news for tobacco controllers is that their disinformation has the intended effect, at least for the one week the volunteers put up with it. The bad news for them is that no one who is not already sympathetic to the messages are going to volunteer to receive them.
Similar problems exist for another study out of San Diego State University (funded by the National Science Foundation), which looked at messages about vapor products on Twitter. The authors seemed to have no serious idea of what they were studying. What does a random sampling of individual tweets even represent? Still, they lamented that two-thirds of them were generally positive about vaping. This is surprisingly low, actually, given that outside of politics people usually tweet about things they like or are promoting. The authors also judged about two thirds of the tweets to be from bots, suggesting they are tweeting spam about vaping to attract those seeking to follow anyone who tweets on the topic, accumulating targets for a future payload. There have been a few bot spam attacks against vaping, but no recognized instances of pro-vaping bot attacks. The authors seem oblivious to this and seem to think that these represent real “fake news” type messages that might actually affect opinions.
It is difficult to fathom how to draw any interesting conclusions about anything from this study. Nonetheless, the authors still conclude — surprise! — that “it is critical to communicate the public health stance on this issue in order to better inform the public and to provide counterarguments to positive sentiments presently dominating conversations about e-cigarettes on social media.” Of course, as is usually the case for the “public health stance,” they are calling for disinformation because the positive sentiments they want to counterattack are correct. Fortunately no one other than their own useful idiots pay attention to their tweets about vaping and anyone who looks at the replies will usually see plenty of rebuttals. Forums in which people are free to ignore the messengers or respond to the content are not very practical targets for tobacco control propaganda.
The best (which is to say, worst excuse for science but most amusing) recent paper was “Orthodox and Unorthodox Uses of Electronic Cigarettes: A Surveillance of YouTube Video Content,” from FDA’s pet research shop at Virginia Commonwealth (Thomas Eissenberg and company). The title pretty much says it all. The researchers watched 150 YouTube videos and concluded that “unorthodox” use of vapor products was three times as likely to be depicted as “orthodox” use. Naturally they concluded that this will “influence” young people. Amusingly, part of their argument is that “YouTube [is] the second most-visited Internet website in the world,” apparently not understanding the concept of a denominator (i.e., those views are divided among billions of videos).
What were these “unorthodox” uses? The majority were “using the e-cigarette for recreation and enjoyment beyond nicotine delivery” (i.e., not thinking of them as medicine), and most of the rest were some variation on dripping or engaging in sensory analysis of the vape (e.g., smelling the e-liquid). It is actually surprising how few of the videos were about modifying hardware or liquid, or anything else which genuinely pushes boundaries (though is still hardly unorthodox).
What is most amusing is that the authors seem to be suggesting that people normally make videos of mundane everyday use of a product. (Though if they had discovered that was happening, they probably would have tried to create a moral panic about how videos normalize vaping.) “Here I am taking a perfectly normal puff on my vape while working at my desk. [Five minutes of typing.] Here I am taking another puff.” It is kind of like, “I was going to post a video of me making and plating a perfect gourmet meal, but instead here is one of me eating takeout pizza while watching television.” I look forward to their next study, in which they discover that most videos of sex on the internet depict “unorthodox” activity. At least the research assistants reviewing the videos will have a more interesting time of it.
You have to laugh at them because that is the only way to deal with all this. These are not obscure papers from obscure make-work research groups, published in pay-to-play journals. This is the product of massive U.S. government grants to “respectable” research shops, published in what passes for legitimate journals in this area. But they were also not pure propaganda pieces; these people were really trying to do research. This is the best science tobacco control can do.