US Science Council Cries Foul on Cessation Study

A recent study that found that vaping doesn’t prevent smokers from relapsing to cigarettes has a major flaw, according to Cameron English, writing for the American Council on Science and Health. The results seem to undermine the efficacy of e-cigarettes as smoking-cessation tools—”until you take a closer look at the definition of relapse.”

At first glance, the study seems to undermine the case for e-cigarette use as a smoking cessation tool. But first glances, as we all know, rarely tell the whole story, according to English. A closer look at the paper indicates that its authors improperly assessed how smokers utilize e-cigarettes, thus generating results that don’t reflect reality.

The researchers analyzed data on 3,578 previous-year smokers who had recently attempted to quit and 1,323 recent former smokers from the Population Assessment of Tobacco and Health (PATH) Study between 2017-2019. Participants self-reported their use of e-cigarettes or other products to quit cigarettes. The researchers then investigated who among the study participants had abstained from smoking or any tobacco products in 2019.

“The significance of this study is limited by the same flaw we found in an earlier paper by two of the same authors: relapse to tobacco use was measured by the question ‘In the past 12 months, have you smoked a cigarette/(used product), even one or two puffs/times?’ Using this metric, an individual who has almost entirely quit smoking, save for “even one or two puffs” of a cigarette, and someone who has gone back to smoking a pack a day would be counted as having relapsed,” English writes.

“This definition ignores the fact that many smokers gradually switch from combustible cigarettes to their electronic counterparts. This is known as ‘dual-use,’ and properly designed epidemiological studies (even those based on PATH data) and clinical trials try to account for this behavioral shift, correctly noting that replacing even some cigarette smoking with vaping is desirable because vaping is the far safer option.”

Additional high-quality research would be very helpful, but “preventing relapse” is an all but useless outcome, states English. “Unless the researchers evaluate how e-cigarettes are used in the real world, the only thing their next paper will confirm is that asking the wrong question inevitably leads to the wrong answer, he writes.