The what is and why bother with a critical public health

The what is and why bother with a critical public health

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Truth-telling, trust and e-cigarettes

Truth-telling, trust and e-cigarettes

Headshot of Dana Scully from The X-Files, with caption "MULDER, THE TRUTH IS OUT THERE, BUT SO ARE LIES."

Lange, M. (1994, February 11). The X-Files. Young at Heart. 20th Century Fox Television.

It should go without saying that public health institutions and researchers have an obligation to tell the truth. In principle, there aren’t many stakeholders in e-cigarette research who would argue otherwise. But questions about whose truth and how information about e-cigarettes should be communicated have been highly controversial.

Partly this is because e-cigarettes haven’t been around long (relatively speaking), and research takes time.

But while influential figures on all sides of the e-cigarette debate in the US have increasingly acknowledged a body of evidence that vaping is less harmful than combustible cigarettes, the US public has increasingly come to believe the opposite. It’s unlikely that this outcome results from even-handed cautions against jumping to conclusions. People have been inundated with a particular message about the current state of research on vaping, and that message is false. Continue reading

Stories have weight

Stories have weight

The past two years have been exciting for our team at the Center. Our first project interviewing Black youth about stigma and tobacco use has been eye opening, and we’re spending most of our time now coding interview transcripts and conducting analyses. We’ll be posting more on that in the future. We’ve also started a new project on Intoxication and Gender (Geoffrey Hunt is the Principal Investigator on that one) which will be included on the website soon. And, we are cautiously optimistic about the potential funding for two additional projects coming on board in the next few months. It’s been busy but so rewarding.

Because of all of these new projects, we’ve spent a lot of time thinking about ways to disseminate our research—that is after all an important part of our projects. But, questions have come up over the course of the past two years that we take with us as we start up new projects and develop new approaches to dissemination.

One issue in particular, that we’ve been thinking a lot about recently, is how to be both transparent in our research process (e.g., by sharing anonymized fieldnotes from our researchers, audio segments from interviews) while also not misleading the public about the results of our research. How do you showcase an interviewee’s perspectives in a way that both validates her lived experience but doesn’t lend more weight to her experience compared to others who participate in the project? We’ve rightly received criticism about this exact question in reviews of our grant applications and responded by talking about disclaimers and such that we can put up on the website.

But I’m not sure that’s sufficient. It’s funny because over the course of my career I have heard qualitative researchers talk about how we have to struggle to highlight the results of our work within a society that values numbers. But in our experience so far with dissemination, people’s stories have weight. I have never liked to talk about qualitative data as “stories”—it feels like it invalidates qualitative data as scientific knowledge. But interestingly in this context of online dissemination, when we have shared segments of our participants’ “stories”, they have reach and, perhaps one day as our social media network expands, they will have power.

Our goal is explicitly to highlight participants’ voices so that their perspectives about issues relevant to public health are highlighted. But what if one participant’s voice is heard above all others, and yet doesn’t represent the experiences of the group? As a qualitative researcher, I believe that a single experience is important. But what if a single person is an extreme outlier—the perspective may be interesting, but what if that extreme outlier is interpreted in such a way that it is presumed by the public to be representative? What do we do with that? Continue reading

E-cigarettes

E-cigarettes

E-Cigarette (CC BY-SA Izuan Izam)

E-Cigarette (CC BY-SA Izuan Izam)

There’s a lot of discussion today about e-cigarettes. Will they help current smokers quit smoking? Will they jeopardize public health efforts that aim to make cigarette smoking socially unacceptable, or could their popularity further denormalize cigarette smoking? Will they be a gateway into cigarette smoking for young people? If e-cigarettes are less harmful than conventional cigarettes, does stigmatizing e-cigarettes threaten public health efforts?

Our current California Smoking Study, which focuses on cigarette smoking and the ways in which smoking stigma may have variable impacts on different communities, suggests that there is a need for additional research into the social and cultural meanings of e-cigarettes specifically, so that we can begin to understand their “promise or peril”. Continue reading