| category | factcheck |
| claim | "E-cigarettes don't help smokers quit" |
| url | https://www.cnn.com/2022/02/07/health/e-cigarettes-quit-smoking-wellness/index.html |
| author | CNN / Sandee LaMotte |
| score | 2/Mostly False 🟥🟥🟥🟥🟧 |
| tags | ['third-party-fact-check', 'source-verification', 'popcorn-news', 'nicotine-addiction', 'gateway-hypothesis', 'not-quitting', 'vaping-epidemic'] |

<img src="/img/rating/mostly-false.png" width=200 height=175 align=right alt=mostly-false>

## Flawed e-cig quitting denial

When performance journalism meets retired ideologues, you get gems like
this. Based on a flawed study and obliviousness to peer review sites, CNN
again doubles down on e-cigarette misinformation. Notably this wasn't
tagged as opinion article, but as "CNN health" information.

Claiming that the selection bias of this study disproves any quitting efficacy
of e-cigarettes is barely false. The results mostly apply to US context
and smokers that did predominantly fail other cessation attempts. The
propagated conclusion hence somewhat farfetched. Given the researchers history
(very much a rehash of Pierces` previous study), probably a conscious lie.
It's another frail attempt at denying empirical reality.

Apart from parrotting PR science and quotes without any hint of assessment,
the author employed the usual masquerade. A flurry of numbers and dates obfuscate
the lack of substance and rational explanation, as well as lackluster contact to
domain experts.
Well-established side scares round up the research and writing effort:

 * More than 2 million US teens use e-cigarettes (obfuscating actual frequency)
 * EVALI now vaguely attributed to vape liquids (in an article on e-cigs)
 * "gateway drug" theory is back baby!


#### study

UC has a bit of a history with creative interpretation of PATH data.
The fatal flaws of methodology and conclusions were quickly documented:

* [SMC: expert reaction to ecigs for quitting](https://www.sciencemediacentre.org/expert-reaction-to-ecigs-for-quitting/)

  > The findings of this observational study of quitting and e-cigarette
  > use in the USA are fundamentally flawed by confounding by severity,
  > whereby the heaviest (most addicted) smokers, having tried and failed
  > to quit using NRT or other treatments in the past, or who have declined
  > to try to quit in the past, then try e-cigarettes.

* [UC San Diego Claims No Evidence for Quit-Smoking Via E-Cigarettes, Medicines or Cold Turkey](https://rodutobaccotruth.blogspot.com/2022/02/uc-san-diego-claims-no-evidence-for.html)

  > To render e-cigarettes as “less popular,” Dr.  Pierce first gamed the
  > numbers by combining smokers trying any prescription medicine and/or
  > six different nicotine products, four of which are available
  > over-the-counter.

* [ACSH: Another Strange Cigarette 'Relapse' Study](https://www.acsh.org/news/2022/02/10/vaping-doesnt-help-smokers-quit-another-strange-cigarette-relapse-study-16121)

  > Additional high-quality research would be very helpful, but "preventing
  > relapse" is an all but useless outcome.  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.

* Statistic interpretations receiving praise from disgraced Stanton is never a quality indicator

* CNN ignored ample feedback on their tweety
   * [https://twitter.com/cnni/status/1490832845396496392](https://twitter.com/cnni/status/1490832845396496392)
   * [https://twitter.com/cnni/status/1491061784328949761](https://twitter.com/cnni/status/1491061784328949761)

A more important confounder (the study authors play oblivious to), is the
anti-vaping FUD ecosystem in the US.  
There's little chance of getting a clear picture now on e-cig efficacy,
since the relentless harm exaggarations take a toll on user confidence
and thus success rates. (And there's no reason to assume this is unintentional.)

The [misclassification of e-cigs as tobacco](https://doi.org/10.1093/ntr/nty130)
product, and the superficial understanding of "[nicotine
addiction](wiki/nicotine-addiction)" should already have disqualified the paper, IMO.
Obvious omission of potential COI declaration, cheugy self-referentials of main author,
and a bit of buzzword stuffing round up the picture.

Notably I wouldn't score the study as entirely useles. But doesn't add
many noteworthy insights to the corpus of academic research.
Unlikely to find recognition in the Cochrane report - which still scores
NVPs above NRT, despite the concerted FUD campaigns.

#### motivation

Doesn't appear to provide any rationale for not-quitting claims, other
than reducing it to insufficient nicotine delivery. It's largely the
usual abnegation and distraction from tobacco harm/death reduction.

#### verdict

Technically "Study says, CNN reports" would have led to a "Mostly True"
score, despite all flaws in the source. But since Sandee once more resorted
to embelleshing claims and battering it up with unsupportable quotes and drivel,
"Mostly False" seems apt. Also, you know, it's just CNN.


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