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An easy demonstration of what is wrong with science journalism and why public perceptions on the dangers of vaping are wrong.

10, Feb, 2017

The science editor at the Telegraph has just provided a great demonstration why 'experts' are losing trust, how not to report on science, and why misinformation is rife.

The Telegraph published this story - “E-cigarettes act as gateway to smoking for teens, scientists warn”.

The Telegraph article (authored by their science editor) tells us that:

The new study 347 teens were questioned [sic] about their views on drug use, vaping and smoking and followed up a year later to see if their opinions and habits had changed.

One in three teens who were not smokers during the first survey, but had used e-cigarettes, said they had smoked by the second survey compared to just seven per cent for those who had not vaped in the interim.

Among teens who said they had never smoked by the time of the 2014 survey, recent vapers were four times as likely to move away from the belief that cigarette smoking poses a great risk as those who hadn’t vaped

This research has, to put it politely, some flaws. This isn't the fault of the journalist, but her attempts to defend it really serve to highlight how little she understood the paper (Twitter thread here).

You see, the problem is that out of the sample of 347, only 13 never smokers had used an e-cig within the 30 days before the survey (a little under 4%). Since the paper reports that “First use of a combustible cigarette at follow-up was reported by 31% of those who had recently vaped at the baseline survey”, the firm conclusion is therefore based on the behaviour of 4 people (or around 1% of the overall sample).

Oddly, the raw number of 13 isn't actually cited in the paper (it's in the supplementary data) instead weighted data is used. In effect, this applies a model of what you think affected the results to the data. As the authors describe:

We developed and used attrition weights to control the potential influence of panel attrition. The attrition weight was the inverse of the predicted probability of follow-up response, based on a regression equation modelling panel retention as a function of respondents' baseline characteristics, which are defined in table 1. Final weights were calculated as this attrition weight multiplied by a weight used to control the panel's intentional oversampling of individuals with higher levels of illicit drug use at baseline.

Now I'm not a any kind of statistical expert, but basing firm conclusions on small sample sizes is rarely a good idea. Additionally, in the words of someone vastly more stats savvy than I am “Fitting those complex multivariable models on such a small sample size is not good practice “.

There is also another problem. You might assume from the paper, and the reporting of it, that the people progressed from regular vaping to regular smoking. But this is not the case.

All we know about the vaping habits of the thirteen is that they had vaped at least once in the 30 days leading up to the first survey.

What we know about the four 'new smokers' is more informative, but not really suggestive of a gateway into addiction:

Among the group of new smokers at follow-up who had recently vaped at baseline, all reported that they had smoked cigarettes at the level of ‘once or twice’ in the past 12 months at follow-up.

Or, in other words, the 'new smokers' were people who, at some point in the last year had had somewhere between one puff of a cigarette and two whole cigarettes. To put it mildly, this does not seem very suggestive of an addicted smoker.

 

Alas, the intrepid Telegraph journalist appears to be unaware of any of this.

 

But then we move onto the interesting case of the dog that didn't bark. The rather flawed 'gateway' paper was not the only bit of e-cig related science published. A 6-month study of biomarkers of exposure to a variety of toxins was funded by Cancer Research UK, and generated quite a few headlines, For example:

The Independant “Vaping backed as healthier nicotine alternative to cigarettes after latest study

The Sun: “VAPING'S OK...NO BUTS Vaping dubbed ‘very low risk’ and less toxic than tobacco in first major study into e-cigarettes

The Financial Times: “Is it better to vape than to smoke? Reports are conflicting but the science is clear

 

And how did the Telegraph report this study?

 

It didn't.

 

Now you might think that while an array of other papers thought it was newsworthy, the Telegraph might have decided it was unimportant.

And you'd be wrong.

The reason they didn't cover it was not that they thought it wasn't newsworthy, or important. In the words of the science editor (Twitter thread here):

We're not interested in benefit to smokers. We're interested in harm.

Not surprisingly, the rather obvious question was asked:

So harm to smokers is acceptable by denying them harm reduction?

To which the rather disturbing response was:

Their condition is entirely self-inflicted. Non-smokers may take up vaping believing its safe based on findings like this.

 

Quite why non-smokers would take up vaping because it's less harmful than smoking is anyone's guess (almost everything is, after all). Based on the data in the study, vaping (for the specific biomarkers looked at) is comparable with risk to NRT, so would we expect the Telegraph to demonise NRT? Somehow, it seems unlikely.

By contrast, here's a report of it that manages to both highlight the relative safety and the potential for some risk, from the San Diego Tribune: “Smokers who become vapers drastically cut inhaled toxins, study finds

This to me is what science reporting on an issue should be like – it's balanced, detailed where it's useful, and doesn't just rely on the press release.

 

So there we have it, a 'Science' editor who would rather embark on a moralistic crusade than report on science (or provide unbiased information to her readers), and who is seemingly unable to dig deeper into a study than it's press release.

 

Some days, the state the world is in doesn't seem so surprising.

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