In 2013, The Consumer Advocates for Smoke-free Alternatives Association started a collection of testimonials from ordinary people who successfully practiced tobacco harm reduction (THR). That is, they lowered the risks associated with their use of tobacco (typically combustible cigarettes). These stories are told in people’s own words, ranging from simple case reports to expressions of deep personal emotion, containing what they felt were the important parts of their own story. Today the collection stands at more than 11,000, and new contributions are always welcome.
Most of the testimonials are from former smokers who quit by switching to vaping. A few of the stories are about switching to smokeless tobacco. (CASAA welcomes all THR success stories). The collection also contains third-party accounts by friends or relatives of people who switched, as well as testimonials about substantially reducing smoking by partially substituting a low-risk alternative.
CASAA, the leading American consumer group supporting vaping and THR more generally, intended the project to aid political advocacy, inform science and provide inspiration.
At the time the collection was started there was still widespread doubt that e-cigarettes were causing many people to quit smoking. In public hearings for legislation that would restrict vaping or product sales, live testimony from individuals who successfully switched to e-cigarettes was powerful and effective. But only a few stories can be presented in-person. Within two weeks of CASAA starting the project, advocates were already printing out testimonials to submit as written testimony. In 2015, when CASAA testified at the Office of Information and Regulatory Affairs in the failed last-ditch effort to stop FDA’s deeming regulation, they submitted four shelf-feet – 8000 pages – of testimonials from the collection.
[Disclosure: I conceived of and helped design the testimonials projects when I worked for CASAA, and I led the OIRA testimony effort.]
To date, it does not appear that the testimonials have been used in any formal scientific analysis. But with the constant improvements in computer-aided free-text analysis, it is only a matter of time before someone applies those tools.
Some people who half-understand science like to quip, “The plural of anecdote is not data.” But this is simply wrong. It is technically true only because the “plural” is not actually needed. One anecdote is data. Vaping opponents often try to dismiss someone’s vaping success story as “a mere anecdote.” The sheer number of testimonials in the collection is an immediate rebuff to this dismissal. But vapers who retort “I am not an anecdote” are selling their own stories short.
Testimonials offer tremendously useful data about harm reduction behavior that is absent from checkbox surveys. It allows the reader to understand feelings and timelines associated with THR success. Like any data, these testimonials cannot answer every question. We cannot use them to estimate what portion of those who try to switch succeed. They do not offer an estimate of the total number of switchers (beyond showing it is at least as many as there are testimonials).
But we can learn the details of many vapers’ experiences, including that many tried repeatedly to quit smoking and gave up, only to then discovered vaping. If these stories were about discovering a way to quit using heroin or cut down on sugar, they would be shouted from the rooftops by the same people who are dismissing them.
Indeed, it is clear that most tobacco control researchers are completely unfamiliar with what they could learn from a few hours of reading these testimonials. The nanny state wing of public health is about the only area of scientific inquiry where it is considered acceptable to analyze data, let alone design a study, without any intuitive familiarity with the subjects of study. When they do seek insight, they concoct costly studies instead of just listening to what people will happily tell them.
The Daily Vaper plans to periodically publish excerpts from the CASAA testimonial collection, sometimes with further analysis and sometimes letting them speak for themselves. (If you would like us to consider featuring a particular testimonial, yours or one you have read, please suggest it by emailing firstname.lastname@example.org.) Those wishing to see more highlights can do so by visiting the CASAA homepage, where a few short excerpts run in a sidebar or by just browsing the collection.
To start, the following is excerpted from one of the first entries in the collection, from Karen Carey, a member of the CASAA leadership group that launched the project. It tells the very familiar story of someone who thought she would die a smoker before she discovered vaping:
I failed at numerous attempts to quit. I tried cold turkey, the patch, the gum, Chantix, hypnosis, you name it, I tried it. Short term success always turned into long term failure, which I now know is the typical experience most long-term smokers have with FDA-approved NRT.
After 36 years I had given up on quitting. I resolved myself to the fact that I would always be a smoker.
In August 2010 I saw an article in a local newspaper about an electronic cigarette store that had opened in my town. I was curious, so I bought a kit. I was amazed at how easily I was able to transition to this device. I quickly went from the familiar menthol flavor to cinnamon, vanilla and fruit-flavored e-liquid. As my taste buds improved, I no longer wanted anything that remotely tasted like a cigarette.
I was no longer smoking, and unlike any of the times I had quit previously, I had absolutely no desire to smoke.