Stanton Glantz Produces A Study Which Proves Himself Wrong

We've always known that Stanton Glantz is a horse's arse, but he's galloped an extra few furlongs this week.

In order to rubbish e-cigs and the concept of harm reduction, the bonkers aircraft engineer has just had a study published in the science-averse rag Tobacco Control Journal where he claims that - between 1992 and 2012 - the fewer smokers there have been, the quicker they have quit. Here's how he explains it on his blog.

Smokeless tobacco and, more recently, e-cigarettes have been promoted as a harm reduction strategy for smokers who are “unable or unwilling to quit.” The strategy, embraced by both industry and some public health advocates, is based on the assumption that as smoking declines overall, only those who cannot quit will remain.  A new study by researchers at UC San Francisco has found just the opposite. 

The concept of harm reduction, first proposed in the 1970s, was based on the theory that as smoking prevalence declines, the remaining “hard core” smokers will be less likely or able to quit smoking, a process called hardening. The study found that the population is actually softening.

By 'hardening', he means the well-established and entirely logical theory that as the smokers most likely to quit do quit - the low-hanging fruit for tobacco control, if you like - then the rate of decline in prevalence will decrease; that making them quit becomes harder. But Glantz says that not only is this not happening, but the opposite is true; that 'softening' is happening instead and the rate of decline in smoking prevalence is speeding up.

OK, let's imagine for a moment that he's correct - yes, I know it's difficult, but stopped clocks and all that - and that as smoking prevalence falls the rate of quitting goes up, not down. In such a scenario, we could plot the data on a graph and the curve would show a steepening decline in smokers. Something like this.

However, this certainly isn't happening because other studies by less desperately delirious tobacco controllers have said so. Here's one studying England ...

The proportion of smokers in England with both low motivation to quit and high dependence appears to have increased between 2000 and 2010, independently of risk factors, suggesting that ‘hardening’ may be occurring in this smoker population.

.. and here's one looking at data from 187 countries from 1980 to 2012.

Global modeled prevalence declined at a faster rate from 1996 to 2006 (mean annualized rate of decline, 1.7%; 95% UI, 1.5%-1.9%) compared with the subsequent period (mean annualized rate of decline, 0.9%; 95% UI, 0.5%-1.3%; P = .003). 

It is the same predictable story everywhere in the world. In fact, considering Glantz is from California, he must be well aware of real life prevalence trends in his own state. It looks like this.

As you can see, what is actually happening bears no similarity whatsoever to the curve we would produce in Glantz's fantasy scenario. The prevalence curve has flattened over time, not steepened, and this is replicated all over the globe.

The reason is that Glantz has based his study on quit attempts, and not people who have actually quit. He doesn't bother to take into account whether or not the attempts are successful, almost as if it's irrelevant. It is, however, relevant because the number of quit attempts doesn’t matter, only the number of smokers does.

I'm sure it will come as no surprise to anyone that Glantz is either lying or showing himself up as a gormless wankwassock, but it gets better.

You see, his theory is based on a sheep effect, that as prevalence drops more people want to move away from the demonised smoking habit, so therefore more people attempt to quit.  Think about that logically, though, and Glantz has only proven that more people are embarking on quit attempts. However, since there is no steepening decline in prevalence from real life data - in fact it is the opposite - this can only mean one thing; that a smaller percentage of smokers are successful with their quit attempts than in the past and making people quit is therefore getting harder. Exactly in keeping with all previous studies and the polar opposite of what the nutter set out to 'prove'.

Add in the fact that with UK and US data over the last few years showing a downturn in smoking prevalence in direct proportion to the increase in vaping, without e-cigs Glantz's insistence that tobacco control is wildly successful without harm reduction would have looked even more absurd. The only reason the prevalence curve hasn't flattened out more is because e-cigs have come along, so it’s self evident that harm reduction does work very well, especially as we know that a large proportion of the rise in quit attempts Glantz mentioned would have been by way of using e-cigs instead.

He must be the first tobacco controller ever to have produced a study which comprehensively proves itself wrong. Remarkable!