Statistics and data-gathering can be a sensitive undertaking. Whoever physically conducts the study wields tremendous influence over how said data is collected and organized, which in turn dramatically influences the studies’ conclusions.
Recently, a new cross-sectional analysis of three studies published between 2014 and 2019 claims to have found inconsistencies and assumptions within the researcher’s methodology. According to the author, these issues resulted in the researchers mistakenly finding correlations between e-cigarette use and heart attacks where none existed.
This type of retrospective critical review highlights the imperfect nature of academic studies. It also vitally reaffirms that readers shouldn’t take every published piece at face value.
Problems with the Data
The authors titled the critical study, Re-examining the Association Between E-Cigarette Use and Myocardial Infarction: A Cautionary Tale. The team published it in The American Journal of Preventive Medicine in July of 2021.
It claims that users who smoke e-cigarettes are not associated with increased heart attack risk, as long as they did not previously smoke traditional combustible cigarettes.
The study also critiques the three previous contradictory studies, all of which relied on five years of data from National Health Interview Surveys. This new study re-examined that dataset under a more accurate model. Here, the authors distinguished between e-cigarette users who had never smoked combustible cigarettes, and those who had.
Written by Boston University Professor Dr. Michael Siegel and University of California, Berkeley, professor Dr. Clayton Critcher, the research analyzed all 175,546 responses from the National Health Surveys. They discovered a separate variable connected to a higher risks of heart attacks. In fact, these attacks were only linked to smokers who were also currently smoking cigarettes at the time. There was no association among vapers who had never smoked cigarettes.
This suggests the initial round of studies, two of which referenced the findings of the first, failed to factor smoking as an independent variable. They had mistakenly drawn conclusions without first making that crucial distinction.
Additionally, all three papers omitted any reference to the 2015 National Survey dataset. This omission occurred despite that data being “readily available,” according to Siegal.
New Analysis
Upon reanalyzing the data, Siegel and Critcher found an important distinction in the result. They saw that any correlation between e-cigarettes and heart attacks was entirely dependent on the participant’s history of smoking combustible cigarettes.
Both doctors clearly stated the previous researchers fell into the trap of thinking correlation equals causation. And in fact, the authors of the second study later retracted the work by demand, due to mischaracterizing results.
“By analogy, if one models height as a function of weight, one cannot then use that output to play out counterfactual scenarios to learn how much shorter a person will become upon losing weight,” Critcher and Siegel wrote about the prior work in their study.
The pair went on to acknowledge that e-cigarettes are still relatively new as a vaping product. As a result, researchers cannot fully gauge the long-term health implications. They both hoped to see more studies conducted that explore this very relationship.
However, that does not take away from the fact that previous research mischaracterized this link between vaping and heart attacks. And ultimately scientists must always correct misinformation when possible.
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