I agree that a gateway effect in adolescents is unclear due to confounders. I think this uncertainty should motivate caution though, rather than a conclusion that the gateway effect is non-existent. What are your thoughts on the Adermark et al. (2021) systematic review?
I wouldn’t expect a clear pattern to arise in population data due to the opposing factors driving rates down, which you mention. However, those time-series on the U.S. and U.K. have led me to decrease my credence, so thank you for pointing me to them!
I confess that on the mechanism point, we appear to have completely opposing intuitions. I think there are very plausible social patterns that could be at work. A 13 year old vaping because some of her friends vape would be easy; smoking because some of her friends smoke less so. At 15, if she had been vaping for 2 years she would have experience buying, owning, sharing, and using tobacco and/or nicotine products—I would think it there would be much less of a barrier to her starting to smoke occasionally and then consistently, compared to the case where she never vaped. But these are just contrasting intuitions we have—maybe we could look into qualitative studies to calibrate ourselves better.
On bias, thanks for illustrating that the picture was more complex than I originally thought. However, I think I want to push back strongly on the idea that those pushing regulation have bias similar to those pushing against. Tobacco companies have an extremely strong financial motive, bordering on existential. Bloomberg, Freedman, Chapman, and others don’t have that motive, so far as I can tell. Your points about them mainly point to the fact that they have been pro-regulation for some time and at some volume, which shouldn’t be surprising, and perhaps with some methodological flimsiness. That flimsiness would be concerning, but I think it’s a quite different concern to the tobacco industry’s bias.
That’s a fair point that you were convinced by Philips’ arguments rather than his credentials or history. But I think in a report arguing for substantive action, and concerning a major counter-argument, it would have been better to explain and defend those arguments rather than just linking to them and saying that you found them persuasive. However, that’s a point of form and other readers may think differently.
Your final points on tobacco company strategy are interesting and thought-provoking. I certainly feel less resilient on my original point, especially since I don’t know corporate strategy well. On reflection, I think I am perhaps quite cynical, though I’d argue that cynicism is justified. Phillip Morris’ ideal world would be one with much more vaping and smoking, and their history in causing and then hiding millions of deaths has made me view them with great distrust.
Thanks again for your substantive and thoughtful reply, I think it’s likely my beliefs on this will shift with time!
Thanks for such a detailed and considered reply!
I agree that a gateway effect in adolescents is unclear due to confounders. I think this uncertainty should motivate caution though, rather than a conclusion that the gateway effect is non-existent. What are your thoughts on the Adermark et al. (2021) systematic review?
I wouldn’t expect a clear pattern to arise in population data due to the opposing factors driving rates down, which you mention. However, those time-series on the U.S. and U.K. have led me to decrease my credence, so thank you for pointing me to them!
I confess that on the mechanism point, we appear to have completely opposing intuitions. I think there are very plausible social patterns that could be at work. A 13 year old vaping because some of her friends vape would be easy; smoking because some of her friends smoke less so. At 15, if she had been vaping for 2 years she would have experience buying, owning, sharing, and using tobacco and/or nicotine products—I would think it there would be much less of a barrier to her starting to smoke occasionally and then consistently, compared to the case where she never vaped. But these are just contrasting intuitions we have—maybe we could look into qualitative studies to calibrate ourselves better.
On bias, thanks for illustrating that the picture was more complex than I originally thought. However, I think I want to push back strongly on the idea that those pushing regulation have bias similar to those pushing against. Tobacco companies have an extremely strong financial motive, bordering on existential. Bloomberg, Freedman, Chapman, and others don’t have that motive, so far as I can tell. Your points about them mainly point to the fact that they have been pro-regulation for some time and at some volume, which shouldn’t be surprising, and perhaps with some methodological flimsiness. That flimsiness would be concerning, but I think it’s a quite different concern to the tobacco industry’s bias.
That’s a fair point that you were convinced by Philips’ arguments rather than his credentials or history. But I think in a report arguing for substantive action, and concerning a major counter-argument, it would have been better to explain and defend those arguments rather than just linking to them and saying that you found them persuasive. However, that’s a point of form and other readers may think differently.
Your final points on tobacco company strategy are interesting and thought-provoking. I certainly feel less resilient on my original point, especially since I don’t know corporate strategy well. On reflection, I think I am perhaps quite cynical, though I’d argue that cynicism is justified. Phillip Morris’ ideal world would be one with much more vaping and smoking, and their history in causing and then hiding millions of deaths has made me view them with great distrust.
Thanks again for your substantive and thoughtful reply, I think it’s likely my beliefs on this will shift with time!