Imagine if there were a very low-alcohol drink that could help wean some heavy drinkers off alcohol. A researcher conducts a clinical trial among pregnant women who are heavy drinkers, in which half are randomized to receive a supply of very low-alcohol beverages, and the other half are asked what they like to drink and then provided with a three-month supply of, say, vodka.

This would obviously be an unethical research design because the standard care for pregnant women who drink alcohol is not to supply them with a trimester’s supply of vodka.

If that scenario troubles you, then you should be equally troubled by an actual clinical trial that was carried out using a similar protocol. Just substitute cigarettes for alcohol.

In a National Institutes of Health-funded clinical trial la

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