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Appropriate and inappropriate methods for investigating the “gateway” hypothesis, with a review of the evidence linking prior snus use to later cigarette smoking

Overview of attention for article published in Harm Reduction Journal, January 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)

Mentioned by

news
1 news outlet
twitter
21 tweeters
wikipedia
2 Wikipedia pages
googleplus
1 Google+ user

Citations

dimensions_citation
4 Dimensions

Readers on

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36 Mendeley
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Title
Appropriate and inappropriate methods for investigating the “gateway” hypothesis, with a review of the evidence linking prior snus use to later cigarette smoking
Published in
Harm Reduction Journal, January 2015
DOI 10.1186/s12954-015-0040-7
Pubmed ID
Authors

Peter N Lee

Abstract

The "gateway hypothesis" usually refers to the possibility that the taking up of habit A, which is considered harmless (or less harmful), may lead to the subsequent taking up of another habit, B, which is considered harmful (or more harmful). Possible approaches to designing and analysing studies to test the hypothesis are discussed. Evidence relating to the use of snus (A) as a gateway for smoking (B) is then evaluated in detail. The importance of having appropriate data available on the sequence of use of A and B and on other potential confounding factors that may lead to the taking up of B is emphasised. Where randomised trials are impractical, the preferred designs include the prospective cohort study in which ever use of A and of B is recorded at regular intervals, and the cross-sectional survey in which time of starting to use A and B is recorded. Both approaches allow time-stratified analytical methods to be used, in which, in each time period, risk of initiating B among never users of B at the start of the interval is compared according to prior use of A. Adjustment in analysis for the potential confounding factors is essential. Of 11 studies of possible relevance conducted in Sweden, Finland or Norway, only one seriously addresses potential confounding by those other factors involved in the initiation of smoking. Furthermore, 5 of the 11 studies are of a design that does not allow proper testing of the gateway hypothesis for various reasons, and the analysis is unsatisfactory, sometimes seriously, in all the remaining six. While better analyses could be attempted for some of the six studies identified as having appropriate design, the issues of confounding remain, and more studies are clearly needed. To obtain a rapid answer, a properly designed cross-sectional survey is recommended.

Twitter Demographics

The data shown below were collected from the profiles of 21 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 36 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 19%
Researcher 6 17%
Student > Bachelor 3 8%
Student > Doctoral Student 3 8%
Other 3 8%
Other 10 28%
Unknown 4 11%
Readers by discipline Count As %
Psychology 10 28%
Medicine and Dentistry 7 19%
Environmental Science 5 14%
Social Sciences 5 14%
Biochemistry, Genetics and Molecular Biology 1 3%
Other 1 3%
Unknown 7 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 26. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 July 2019.
All research outputs
#781,285
of 15,465,366 outputs
Outputs from Harm Reduction Journal
#118
of 595 outputs
Outputs of similar age
#14,952
of 225,287 outputs
Outputs of similar age from Harm Reduction Journal
#1
of 1 outputs
Altmetric has tracked 15,465,366 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 595 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 23.4. This one has done well, scoring higher than 80% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 225,287 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them