Friday, May 02, 2014

Congratulations to the Tens of Thousands of "Anecdotes" Who Have Successfully Quit Smoking via Electronic Cigarettes

On this Friday afternoon, I want to give a huge shout out to the literally tens of thousands of "anecdotes" out there who have successfully quit smoking via the use of electronic cigarettes.

You may wonder why I am calling these people - smokers who have quit smoking via electronic cigarettes - anecdotes.

The reason is this:

According to CDC Director Dr. Thomas Frieden, the thousands of smokers who have quit smoking via electronic cigarettes are nothing but anecdotes. As Dr. Frieden told the Los Angeles Times in this article, referring to smokers who have quit using e-cigarettes: "the plural of anecdote is not data."

The complete quote from this article:

"Frieden acknowledged that “stick to stick, they’re almost certainly less toxic than cigarettes" and that many people have quit smoking tobacco cigarettes with the help of e-cigarettes. However, he said, “the plural of anecdote is not data.”"

The Rest of the Story

There is one thing you almost never hear most anti-smoking advocates and groups say to smokers who have quit via electronic cigarettes ...

... "Congratulations."

I have long found it curious that anti-smoking advocates and groups fail to praise and congratulate vapers who have completely quit smoking for having completely quit smoking. Apparently, in tobacco control, it is not just important to quit smoking, but you have to quit smoking the right way (a.k.a., with Big Pharma drugs).

Today, I'd like to clearly and unequivocally say, as a staunch anti-smoking advocate:

"Congratulations to all the tens of thousands of vapers out there who have quit smoking using electronic cigarettes. You have helped to improve your health and perhaps save your life. You have taken the most important step in improving your health. And you have done a tremendous favor for your family, friends, and loved ones."

"Do not listen to what the CDC and the FDA are telling you. There is no question that by quitting smoking, you have greatly improved your health. There is no question that vaping is much safer than smoking. Do not allow yourself to be deceived by the propaganda. Do not return to cigarette smoking in fear that somehow there are hidden risks in vaping that could render them just as dangerous as cigarettes."

"And most importantly, you are not just anecdotes. Each one of you is a real, courageous person who has accomplished one of the most difficult personal struggles that a person can face in terms of health behavior: quitting smoking, one of the strongest and most powerful addictions. Congratulations!"

Incidentally, it is just not true that the plural of anecdote is not data. In fact, a single anecdote is "data." One of the most basic study designs in epidemiology is something called a "case study." That is the "anecdote" about a single individual. The next basic design is a "case series," which is simply a number of "anecdotes."

Some of the most important conclusions in epidemiologic research have come not from large case-control or cohort studies or clinical trials, but from case studies or case series, or as Dr. Frieden would say, "anecdotes."

For example, I am proud of having been part of a team that was the first ever to report that the dietary supplement L-tryptophan can cause pulmonary hypertension via the eosinophilia-myalgia syndrome. This important conclusion - which had major public health policy implications - was based on a single reported case of pulmonary hypertension. In other words, it was based on a single "anecdote." Had we dismissed this finding because a single anecdote is not data, then we would have failed to report this relationship and many more patients would have suffered that fate, possibly leading to fatalities.

Anecdotes are in fact data. Of course, what you do with that data and how you interpret it is affected by the nature of how the data were obtained. But anecdotes are data. Remember, the connection between smoking and lung cancer itself was first uncovered by a case series. Physicians started to note multiple cases of lung cancer - which was very rare at the time - all occurring in smokers. While these patients could be called "anecdotes," they were also people who provided very real and important data that led to the discovery that smoking causes lung cancer. That connection would not have been found had these "anecdotes" been dismissed.

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