Use e-cigarettes? Moffitt Cancer Center wants you to be ‘Forever Free’

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The Moffitt Cancer Center in Tampa, Florida, is recruiting smokers who vape (i.e., dual users) for a clinical trial that, according to spokesman Vani Nath Simmons, aims to answer the question: “Do e-cigarettes actually help people quit smoking?”

However, the study’s design suggests a broader agenda. The NIH website ClinicalTrials.gov reveals that researchers intend to recruit dual users nationwide and then supply them with:

[A] series of booklets and pamphlets modeled after the Forever Free booklets found to be successful at producing long-term abstinence among the general population of smokers, but adapted to the special needs, circumstances, and risk factors of dual users.

The “specific aim” of the study is to produce tobacco abstinence among subjects and to “terminate their e-cigarette use as per traditional nicotine replacement therapy (NRT)”.

Researchers are using three-quarters of a million taxpayer dollars to try to convince smoker-vapers to become fully abstinent rather than merely smoke-free. The group, led by Thomas Brandon, has published four studies in which smokers were sent “Forever Free” self-help booklets, teaching “how to resist urges to smoke.” The first two studies were conducted in the United Kingdom. The latter two in the United States were supported by two grants from the National Cancer Institute that totaled about $5 million over the period 2009-2013.

They assessed whether the booklets helped smokers quit or avoid relapse in higher numbers than with conventional brief advice. Each trial had minor variations in design and frequency of booklet mailings.  Here is a summary of their results:

Results Of Moffitt-Based Clinical Trials Employing Self-Help Booklets
Publication, date Main Outcome Main Result
Addiction, 2015 Relapse prevention No effect
Health Technology Assessment, 2015 Relapse prevention No effect
American Journal of Preventive Medicine, 2015 Abstinence Booklets better
Nicotine & Tobacco Research, 2016 Relapse prevention No effect

The booklets had no significant effect on preventing relapse, but they did help smokers abstain in one cessation trial, in which booklets were mailed to smokers at two rates, standard (8 booklets over 12 months) or intensive (10 over 18 months, with other mailings on alternate months). The control group only received one booklet at the beginning of the trial. At 24 months, 19 percent of this group reported they hadn’t smoked in the past week.  The non-smoking rates were 24 percent in the group and 30 percent in the intensive group, which were significantly higher.

Brandon has been quoted noting the relative merits of e-cigarettes compared to cigarettes and Moffitt spokesman Simmons shared this gross understatement:

We can say that it is very unlikely that they [e-cigarettes] are as harmful as regular tobacco cigarettes because you aren’t being exposed to the tar and the cancer-causing chemicals.

If this government-supported research was focused on gauging the effectiveness of e-cigarette use in eliminating smoking, as the researchers’ media spin would suggest, it could yield valuable data; instead, as revealed by the formal documents, it is, at heart, yet another all-out abstinence-promotion scheme that applies the disease-treat-cure model to consumer behavior. When the target outcome is nicotine and tobacco abstinence, bad results are all but guaranteed, especially when truthful information about the relative safety of e-cigarettes is withheld.

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