Glantz Debunked Yet Again

Posted 11th October 2019 by Dave Cross
Stanton Glantz foisted a deeply flawed association between vaping and myocardial infarctions (heart attacks) on the world with a poster at a conference in 2018. It immediately drew criticism for the glaring errors but he didn’t change anything in the subsequent published paper. Since then, the work has drawn further denunciation; this week, the American Journal of Preventative Medicine has published another letter highlighting its erroneous nature.

When the poster was shown, Carl Phillips predicted in the Daily Caller: "It has not yet appeared in a peer-reviewed journal, but it will, and the peer-review process will do nothing to correct the errors noted here." [link]

When the research was finally published, Glantz was quoted as saying: “While people may think they are reducing their health risks, we found that the heart attack risk of e-cigarettes adds to the risk of smoking cigarettes.”

The paper concluded: “Daily e-cigarette use, adjusted for smoking conventional cigarettes as well as other risk factors, is associated with increased risk of myocardial infarction.”

The fact that a number of the vapers self-reporting myocardial infarctions had them when they were smoking, sometimes up to a couple of decades before vaping, mattered little to California’s foremost anti-vaping charlatan.

Doctors Konstantinos Farsalinos and Raymond Niaura pointed out that his selection of data sets was bizarre to say the least, and indicated a clear intention to massage them for a desired outcome. “The NCHS guidance clearly states that the different sample design periods should be treated as statistically independent,” they wrote; but Glantz didn’t.

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“Our findings show the well-established limitations of cross-sectional studies, which cannot justify any claims about causal inference, as mentioned in the conclusion by Alzahrani and colleagues. Therefore, the conclusion of their study is incorrect and should be revised.”

Pointing out what should have been obvious to any intelligent researcher, Doctors Middlekauff and Gornbein commented: “Of concern, however, is the fact that 95% of EC users were also former or current tobacco cigarette smokers, and the timing of the MI relative to onset of EC use is unknown.”

Middlekauff and Gornbein went on to highlight that Glantz’ figures (if accepted as valid, which they aren’t) actually show vaping is safer than smoking and reduces the risk of myocardial infarctions.

Michelle Bover Manderski, Binu Singh and Cristine Delnevo from the Centre for Tobacco Studies, Rutgers School of Public Health, New Jersey, are the latest to pull his work to pieces.

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“We echo the concerns raised by Middlekauff and Gornbein and note several additional limitations and methodological discrepancies that undermine the conclusions of this study,” they write.

“Contrary to what the authors described in their methods, the published tables may present unweighted results. If this is the case, then the results are not nationally representative, do not account for the complex sampling design, and underestimate variance. In addition, the authors examined data from the 2014 and 2016 National Health Interview Surveys, omitting 2015 without mention or explanation despite it being readily available in the cancer control supplement.”

“As the debate on the risks−benefits of electronic-cigarettes continues, a rigorous evidence base is critical,” they continue, pointing out that Glantz’ study can never be used to make a claim related to “excess risk for future MI”.

“It is not possible through the analysis of cross-sectional data.”

“Equally important, we were unable to replicate the authors’ findings. Given the importance of this topic to public health, we request that the authors provide a full and comprehensive explanation for the discrepancies noted and temper their conclusions about ‘increased risk of myocardial infarction’ to reflect the limitations of cross-sectional data.”

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  • “E-Cigarette Use and Myocardial Infarction: Importance of a Sound Evidence Base in the E-Cigarette Risks–Benefits Debate”, Bover Manderski, Singh and Delnevo – [link]

 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker
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