Anti-vape campaigners fail to recognise retraction of misinformed studies

Organizations and activists campaigning against vaping products in Bangladesh and elsewhere often refer to studies that allegedly found links between cancer and heart disease to vaping. However, the campaigners have been conveniently ignoring the news of these studies being retracted by international journals due to their questionable methodology and inconclusive analysis, said a press release.

Despite the proven efficacy of vaping products as quit smoking tools, anti-vape groups have been opposing its use in smoking cessation citing various reasons, including claims that vape can potentially cause cancer and myocardial infarction or more commonly known as heart attack. But the two main studies that were the sources of these claims have been retracted by the publishing journals for serious errors, something anti-vape campaigners evidently do not want to draw attention to.

The study titled ‘Electronic Cigarette Use and Myocardial Infarction Among Adults in the US Population Assessment of Tobacco and Health’, published in 2020 in the Journal of the American Heart Association was officially retracted by the journal’s editors as they raised concerns regarding the conclusion being unreliable.

The official retraction notice states that, “During peer review, the reviewers identified the important question of whether the myocardial infarctions occurred before or after the respondents initiated the use of e‐cigarettes.”

Clarification was requested during the peer review process, but “the reviewers and editors did not confirm that the authors had both understood and complied with the request prior to acceptance of the article for publication,” the retraction notes.

The authors of the study could not comply with the requests of the peer reviewers to provide further analysis that answered the crucial question, leading the journal to formally retract the article. The Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA), which is an alliance between the Tobacco Harm Reduction Advocates from various Asia-Pacific countries including New Zealand, Indonesia, Australia, Philippines and South Korea, and their respective organizations in the region stated, “In the Journal of the American Heart Association, which reported an association between vaping and heart attacks was also retracted.”

The advocates further noted, “Astoundingly, this article is still used as a reference in the FCTC guidelines around e-cigarettes.” This means that despite the retraction, interest-driven anti-vape groups are still using this study.

The 2022 study that linked cancer to e-cigarettes or vaping, titled ‘Cancer Prevalence in E-Cigarette Users: A Retrospective Cross-Sectional NHANES Study’, which was published in the World Journal of Oncology, was similarly retracted for serious errors in research methodology.

Chris Snowdon, a well-renowned tobacco harm reduction advocate, pointed out in his blog the statistical errors made in this publication and wrote, “This is a classic case of immortal time bias. You need to wait until these people are very old, or preferably dead before you can draw any conclusions from data like this.”

His review played a crucial role in calling the authorities to review this research. “It’s an easy mistake to make, I guess, but the authors of the vaping study should have been aware of it. Their research tells us absolutely nothing.” wrote Snowdon in his blog.

Based upon Chris Snowdon’s review the World Journal of Oncology raised concerns regarding the methodology of the study and stated in the official retraction notice, “Concerns have been raised

regarding the article’s methodology, source data processing including statistical analysis, and reliability of conclusion, the authors failed to provide justified explanations and evidence for the inquires, subsequently this article has been retracted at the request of Editor-in-Chief.”

However, conclusions from these studies continue to be used by anti-vape advocates, raising concerns about the reliability of these advocates and misleading vape policies in the country.