Another Glantz Debunking

Posted 4th August 2021 by Dave Cross
“Cross-sectional analyses have suggested that e-cigarette use, independent of combustible cigarette use, elevates the risk of myocardial infarction” write a pair of researchers. Clayton Critcher and Michael Siegel take another look at the subject and conclude that there is no reliable evidence to support the claim.

First evidence of long-term health damage from ecigs: Smoking e-cigarettes daily doubles risk of heart attacks,” wrote Stanton Glantz in his blog.

In a press release, Glantz went on to say, “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. Using both products at the same time is worse than using either one separately. Someone who continues to smoke daily while using e-cigarettes daily increases the odds of a heart attack by a factor of five.”

Then, in 2019, he attempted to claim there was “more evidence that e-cigs cause heart attacks”. If you weren’t paying attention, it might be possible to believe there is an issue.

The pair looked at the same data Glantz and Dharma have used for their ridiculous claims and found: “Among those without a history of smoking, the use of e-cigarettes—past or present—was not associated with MI incidence. Daily e-cigarette use was associated with higher MI incidence only among every-day and former combustible cigarette users.” (1)

Furthermore, the association between every-day e-cigarette use and ever having had an MI is declining.”


Critcher and Siegel slammed Glantz’s outpourings: “The scientific community is well aware that press releases, blog posts, and public activism are not subject to peer review. That same community should be wary of its members who speak with one voice when accountable to peer review but then use the legitimising power of peer review as a credential that assists with the misbroadcasting of their published findings.”

Pointing to Glantz’s most fundamental flaw, Critcher and Siegel reiterate that correlation is not causation. “The present results, which cast doubt on the interpretation that e-cigarette use has led to [heart attacks], raise a second issue with much broader implications. When researchers report cross-sectional analyses, it is common to acknowledge that such designs do not permit causal conclusions.”

In relation to this, they call Glantz’s comments on his work “suspect”.

First, when A is said to be a risk factor for B, it need not mean that A causes B, but without clarification, it does not imply that B may cause A. After all, malnutrition is a risk factor for premature death. Premature death is not a risk factor for malnutrition. Second, (non-peer-reviewed) public communication of the authors’ cross-sectional findings actively promoted the causal interpretation that e-cigarette use causes [heart attacks].”


  1. Re-examining the Association Between E-Cigarette Use and Myocardial Infarction: A Cautionary Tale -

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