“Research on tobacco harm reduction (THR), and particularly on electronic cigarettes (e-cigarettes), remains a highly controversial topic in the scientific community. The controversy is also sustained by research, which is often poorly designed, conducted, and interpreted,” say Doctors Konstantinos Farsalinos and Riccardo Polosa.
“Dissemination of inaccurate information on smoke-free alternatives in the media contributes to public scepticism and uncertainty, particularly among smokers, who as a result are discouraged from adopting reduced-risk lifestyles.”
Vapers will probably be well aware of the pair of experts, who have both been working diligently to research the truth about electronic cigarettes since the early days of vaping.
During their time uncovering facts about ecigs, Farsalinos and Polosa have both spoken out about research protocols and frequently debunked poor quality research that attracted large scale media attention.
“Due to the limited evidence on the health impact of e-cigarettes from longitudinal cohorts, several cross-sectional studies have been published instead, mostly showing that e-cigarette use may be associated with diseases of the respiratory and the cardiovascular system.”
They give the example of a study by Parekh et al., which claimed that switching to vaping did not give any stroke prevention benefits and even claimed it increased the likelihood of ex-smokers having a stroke. Typically, the study neglected to include a number of key points such as the timing of a stroke in relation to vape initiation.
“This is not an isolated case. Cross-sectional data such as BRFSS and National Health Interview Survey (NHIS) do not contain any information on exposure initiation or diagnosis. Therefore, they should not be used to make causal inferences, unless questions that would generate information about the age of disease diagnosis and of tobacco and nicotine use initiation were introduced.
“Despite these unacknowledged limitations, BRFSS and NHIS data have been used to show relationships between e-cigarette use and smoking-related diseases in multiple papers, which have been often accompanied by press statements communicating messages that could be interpreted as causal inferences. Consequently, these studies on e-cigarettes are reiterating the same potential mistake confusing associations with causation, leading to unreliable conclusions.”
They go on to highlight that such information can be gleaned from the Population Assessment of Tobacco and Health Survey, and has been used by researchers such as Brad Rodu, but as they do not provide shock negative headlines, “these have been overlooked.”
- Internal and Emergency Medicine - https://www.springer.com/journal/11739