The Heart of the Problem

Posted 6th February 2019 by Dave Cross
“E-cigarette use increases the risk of stroke and heart attack”, blared the American Stroke Association in the lead up to its International Stroke Conference in Honolulu. Experts without an axe to grind had shredded the research conclusions before the day was out.

“Using e-cigarettes increases your odds of having a stroke, heart attack and coronary heart disease, according to preliminary research,” claimed the press release.

“In the largest study to date”, it claims, “examining e-cigarettes and stroke, researchers tapped a database of 400,000 respondents. That database, the 2016 behavioural risk factor surveillance system (BRFSS) survey, collected data from residents in all 50 states about their health-related risk behaviours, chronic health conditions and use of preventive services.”

Paul Ndunda, lead author, said: “Compared with non-users, e-cigarette users were younger, had a lower body mass index and a lower rate of diabetes.”

The study claims to have discovered:

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  • 71 percent higher risk of stroke;
  • 59 percent higher risk of heart attack or angina;
  • 40 percent higher risk of coronary heart disease; and
  • Double the rate of cigarette smoking.

Yes, vaping makes you smoke twice as much. This is how good this study is.

The Daily Mail found Dr Larry Goldstein was willing to spout off: “'It's obviously quite concerning. This is a potential chip of the spear, of a wave of cardio-vascular disease that may be coming in the future, especially since this has been so attractive to young users. 'This is the first real data that we're seeing associating e-cigarette use with hard cardiovascular events. But it's quite a concern, especially since nationwide now we've seen a levelling off in, and in many instances an increase in the risk of stroke-related mortality in the country. It's hard to know what contribution this has to that, but it doesn't appear to be safer, or safe right now from the data that's available.”

We’ve corrected the Mail’s spelling and grammatical errors; it’s not like they do this for a living. It is probably why they failed to balance the article with statements from qualified experts.

Dr Konstantinos Farsalinos said: “Both these conclusions are simply wrong and constitute epidemiological malpractice and misinformation.”

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“‘Increasing the risk’ means that someone is first exposed to a condition (in this case, exposed to e-cigarette use) and then, because of this exposure, he/she develops disease. Both studies cannot provide any of this information to substantiate an increased risk.”

“Both are cross-sectional surveys, meaning that they asked participants if they have heart disease and if they use e-cigarettes. The studies provide no information on whether e-cigarette use was initiated before (and how long before) or after the development of disease.”

“They know that the statements about ‘increased risk’ are wrong. So, why do they use these statements? Perhaps we should ask them…”

Dr. Michael Siegel called the claims “irresponsible”. He continued: “The study has no information on which came first. In other words, it is entirely possible (and in fact quite likely) that the majority of respondents who reported having used e-cigarettes and having had a heart attack actually suffered the heart attack first and then subsequently started using electronic cigarettes because they were desperate to quit smoking after experiencing this life-threatening event.”

“The same reasoning used by researchers to conclude that vaping increases heart attack risk supports the conclusion that trying to quit smoking increases heart attack risk.”


“For that matter, one could show that use of asthma inhalers is associated with an increased risk of having asthma, that use of insulin is associated with an increased risk of diabetes, or that the consumption of gluten-free food increases your risk for Celiac disease (caused by gluten allergy).”



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