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By Carl V. Phillips - Original Article Published here.
Popular clichés suggest that academics regularly opine on subjects they know less about than average people who work or live those subjects. This is often unfair; many academics are steeped in the common knowledge of their subject matter, and their departures from common views are genuine expert insights rather than errors. Unfortunately, that is not the case in the field of public health, where the cliché is spot-on.
Researchers who write about vaping – people with credentials, respected institutional affiliations and funding, and academic journal publications – know far less about the subject than everyday vapers who are invested in the subject. The typical journal article about vaping reads like a newspaper story in which a generalist reporter had only a day or two to get up to speed on a complex topic.
Real scientists and other truth-seeking writers circulate research papers and other major works for comments before finalizing them. If they are unsure about key material, they make sure to get some expert feedback. But a typical public health journal submission – with, say, seven authors, two editors, and two outside reviewers – gets published with only about two people ever seriously scrutinizing and analyzing it. Note that this does not mean “two, in addition to the eleven individuals mentioned,” but “two among those eleven individuals, and no one else.” This is a disaster and a disgrace.
While top experts cannot weigh in on everything, most papers about vaping could be vastly improved by simply soliciting the input of a few vapers. They would gladly volunteer their services if someone appeared to be trying to figure out the truth.
To demonstrate this, I asked my “non-expert” Twitter followers to comment on a recent terribly journal article entitled, “Safety Assessment of Electronic Cigarettes and Their Relationship with Cardiovascular Disease.” In the tweet I asked readers who did not have official scientific credentials to look at the paper and point out one or more errors. Their exact responses and identities can be found in the replies to my original tweet. [Disclosure: I am an editor for journal that published this paper, though only for a semi-autonomous special collection, with no involvement in the unit of the journal that published the paper.]
One comment noted that the obvious errors begin with the title. The paper is not a safety assessment, nor is it focused on cardiovascular disease. It is a wandering survey of dozens of different observations and claims about vaping, apparently intended to promote the thesis that vaping is as harmful as smoking.
Commentators noted various bright-line problems with the references that were missed by the authors and reviewers, despite requiring no subject-matter expertise. Several assertions were cited to references that contained no support for them. One reference cited as evidence of the effect of vapor exposure on rats was published in 1964.
The most common criticism of the paper was referring to vapor as “smoke,” including “smoking e-cigarettes” and their “secondhand smoke.” While this could theoretically be excused as language issue (the authors are Chinese), the paper and most of its references are in English. Moreover, this is obviously an important distinction that anyone with even basic knowledge of the subject would understand. One commentator observed that this was similar to not apparently understanding the difference between gasoline and diesel in a paper about automotive engineering, which would certainly result in immediate rejection of the paper.
Commentators noted false claims about vaping involving greater exposure to various chemicals than smoking. There are a few misleading studies (usually involving absurd overheating of e-cigarette liquid) that can be cherrypicked to suggest that this is true for a couple of a chemicals. For most of the potentially harmful chemicals noted in the paper, however, there is not even that. Claims were both absurd on their face and based on nothing. Similarly, it was observed that studies were cited as having detected particular chemicals in vapor, but the authors failed to note that the quantities were a small fraction of the same chemicals in cigarette smoke. Specific claims about chemistry were identified that simply made no sense.
The authors claimed that there has been no systematic study of the safety of vaping and no evidence about it relatively safety. They further suggest there has been little research on the topic. These were easily identified as false by commentators.
Multiple commentators observed that the authors were, in effect, reciting debunked anti-vaping talking points as if they were scientific claims. These included “gateway” claims, the suggestion that trace quantities of environmental nicotine are harmful, and claims about particulates. The conclusions of the paper, it was observed, did not follow from the content, even with all its liberties. Indeed, at least one of the conclusions flatly contradicted some of the analysis.
A dozen other fatal flaws were pointed out in the Twitter thread.
Public health publishing is notoriously bad, with the journal peer-review process generally contributing very little value. Articles about vaping manage to make even these low standards look good. Any one of the non-credentialed commentators who offered one of the above observations would have been a better reviewer of the paper than the reviewers the journal used. (I asked editors of the journal to go on record about details of the review process, but they declined.)
This particular paper is a bit of an absurdity. After all, commentators observed that the authors seem to think that e-cigarettes are just cigarettes with some materials removed. They claim that the sensory experience of vaping is just like that of smoking. One commenter noted that he ran a search on the authors’ university to check the possibility I had created this paper as a hoax or experiment.
Still, there are few errors in this paper that cannot be found across many journal articles about vaping. They are just denser than usual. As a result, this paper serves a potentially useful purpose: This is a peer-reviewed journal article. Whenever vapers confront someone arguing that peer-reviewed journal articles about vaping should be believed, they can pull this one out. They can point out that a few dozen vapers on Twitter, each volunteering a few minutes of their time, were able to identify countless glaring errors, in addition to many points that are, at best, debatable, but were presented as fact.
In short, academic publishing about vaping is largely a joke. Those who cannot do teach. Those who cannot even understand basic facts about their subject matter, or even how to properly read and cite previous research, teach tobacco control.
[The author thanks everyone who responded to his tweet and apologizes that, in the interest of readability, he did not credit each one individually.]