Junk science

American Heart Association Journal Finally Retracts Study Implying That E-Cigarettes Cause Heart Attacks Before People Use Them

The journal's editors recognized the problem before publication, but the authors failed to address it.

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Eight months after the Journal of the American Heart Association published a study implying that e-cigarettes magically cause heart attacks before people even try them, it has retracted the article. "The editors are concerned that the study conclusion is unreliable," JAHA says in a notice posted today.

Based on data from the Population Assessment of Tobacco and Health (PATH), Dharma Bhatta and Stanton Glantz claimed to find that "e-cigarette use is an independent risk factor for having had a myocardial infarction." Glantz, a longtime anti-smoking activist and e-cigarette opponent who directs the Center for Tobacco Research Control and Education at the University of California, San Francisco, said the results provided "more evidence that e-cigs cause heart attacks." Notwithstanding the evidence that vaping is much less hazardous than smoking, Glantz and Bhatta, an epidemiologist at the center, concluded that "e‐cigarettes should not be promoted or prescribed as a less risky alternative to combustible cigarettes and should not be recommended for smoking cessation among people with or at risk of myocardial infarction."

But as University of Louisville tobacco researcher Brad Rodu pointed out last July, the analysis that Bhatta and Glantz ran included former smokers who had heart attacks before they started vaping. Once those subjects were excluded, Rodu and University of Louisville economist Nantaporn Plurphanswat found, the association described by Bhatta and Glantz disappeared. "The main findings from the Bhatta-Glantz study are false and invalid," Rodu and Plurphanswat wrote in a July 11 letter to JAHA. "Their analysis was an indefensible breach of any reasonable standard for research on association or causation." In another letter a week later, Rodu and Plurphanswat urged the journal's editors to "take appropriate action on this article, including retraction."

Eleven days ago, I noted that JAHA had not responded to Rodu's criticism, which was recently amplified by 16 prominent tobacco researchers, except to say that "the American Heart Association is steadfastly committed to ensuring an objective and thorough evaluation of any and all inquiries received about studies published in any of our journals." I asked JAHA for comment while writing that post, and today I received a reply from AHA spokeswoman Michelle Kirkwood. "Bhatta et al.'s manuscript underwent a thorough and comprehensive review during the past 7 months," she says in her email, "and the process is now complete. As of 2/18/20, JAHA has retracted the paper."

Why did it take the journal so long to acknowledge the glaring error highlighted by Rodu and other critics of the study? Here is how the AHA describes what happened (emphasis added):

After becoming aware that the study…did not fully account for certain information in the Population Assessment of Tobacco and Health [PATH] Wave 1 survey, the editors of Journal of the American Heart Association reviewed the peer review process.

During peer review, the reviewers identified the important question of whether the myocardial infarctions occurred before or after the respondents initiated e‐cigarette use, and requested that the authors use additional data in the PATH codebook (age of first MI and age of first e‐cigarettes use) to address this concern. While the authors did provide some additional analysis, 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.

Post publication, the editors requested Dr. Bhatta et al conduct the analysis based on when specific respondents started using e‐cigarettes, which required ongoing access to the restricted use dataset from the PATH Wave 1 survey. The authors agreed to comply with the editors' request. The deadline set by the editors for completion of the revised analysis was not met because the authors are currently unable to access the PATH database. Given these issues, the editors are concerned that the study conclusion is unreliable.

Even before publication, in other words, JAHA's editors and reviewers recognized that there was a logical problem with asserting a causal link between e-cigarette use and heart attacks based on cases that predated e-cigarette use. They asked Bhatta and Glantz to address that crucial issue, and the authors failed to do so, even though the PATH database included the necessary information. JAHA published the study anyway, and Bhatta and Glantz say they can't do a corrective analysis now because they no longer have access to the PATH database.

That seems like a pretty slipshod peer review and editorial process, doesn't it? I suspect JAHA would have been a bit more careful with a study that found vaping prevents heart attacks by helping smokers quit.

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  1. I was prompted by a CASAA newsletter to write a shittygram to the journal. Glad to see they have come around on this.

    1. They haven’t ‘come around’, they’ve been backed into a corner. The entire Anti-Smoking Crusade went off the rails sometime in the 1980’s, and hasn’t gotten back on. They are incensed that so many people keep smoking, or chose to give up cigarettes in ways not approved by the Crusade. The links between cigarette smoking and various ills are pretty solid, but the entire ‘secondhand smoke’ argument is dung, and I question whether the various arms of the Crusade are even TRYING to do honest research anymore.

    1. Interesting article but not sure the MSA is the main reason for the current anti-vape hysteria. The MSA only has a few years left but lots of states get even more money from cigarette taxes to fund various programs such as children’s health insurance and balance budgets. The states with high taxes like NY NJ and CA stand to lose the most as vaping replaces smoking, so it’s not a coincidence that they are the most hostile to it. You also have big pharma whose nicotine patches, gum, and drugs are taking a hit because of e-cigs, and they sponsor lots of health organizations and research, so of course they will be anti-vaping too.

  2. What they meant to say is that e-cigarettes magically cause baldness before people even try them. Yeah, that’s the ticket!

  3. JAHA’s editors and reviewers recognized that there was a logical problem with asserting a causal link between e-cigarette use and heart attacks based on cases that predated e-cigarette use. They asked Bhatta and Glantz to address that crucial issue, and the authors failed to do so. … JAHA published the study anyway

    Therefore JAHA is not, um, a journal of integrity.

    1. But they have FEELINGS!

    2. Yup. Journal of the American Heart Association got caught with their pants around their ankles!

  4. They were trying to figure out how to retract retroactively, and finally gave up. Physicists they are not.

  5. OT –

    Serious (if true) hate crime allegations: “A Cedar Rapids [Iowa] man who was arrested Monday is accused of holding a woman captive and forcing her to watch “Roots”…“so she could better understand her racism,” according to a criminal complaint.

    “When she tried to move, Noye told her to “remain seated and watch the movie with him or he would kill her and spread her body parts across Interstate 380 on the way to Chicago,” the complaint said.”

    https://www.thegazette.com/subject/news/public-safety/woman-forced-to-watch-roots-to-understand-her-racism-cedar-rapids-police-said-20200217

    1. “remain seated and watch the movie with him or he would kill her and spread her body parts across Interstate 380 on the way to Chicago,”

      Wow, your mind gets all ready to make a joke after just reading the first part and then it gets really dark fast. He’s psychotic. Then you see his creepy smiling mugshot and that confirms it.

    2. Let’s not get too much. The man is obviously psychotic. If he hadn’t grabbed onto one political agenda, he would have grabbed onto another.

      1. Sure…..

        But Roots? Where ya gonna find a copy of Roots in the middle of a psychotic break?

        1. I forget who, but somebody’s got it streaming for free all through February.

  6. I think this news great

  7. I am blown away by those Truth.org ads where they have this magician turning vapes into cigarettes to teach the kids the truth that vaping is exactly the same as smoking. You have an honest-to-God illusionist using a trick – i.e. something that is totally not the truth to try to get you to believe that it is in fact the truth – to try and sell the idea that they’re telling you the truth and totally not tricking you. I can’t even wrap my head around how fucked up this is. But I guess that’s how we science these days. Make up some bullshit that furthers the narrative and what does it matter if it’s bullshit? If it ain’t true, it’s at least truthy.

    I see this same thing with the WHO and the CDC who keep pushing the idea that this coronavirus thing is nothing to worry about because, look, the regular flu is much worse and so far the coronavirus hasn’t killed that many people. With no mention of the idea that they don’t know that much about the coronavirus and they have no idea how many people it’s going to affect and how many people it’s going to kill. It’s just “all is well, we’ve got this thing under control, no need to worry, we’ll tell you all you need to know” and they’re already telling you you’re an idiot if you go out and buy masks – a dangerous idiot even because you’re just contributing to the needless worry.

    1. People get coronavirus every day. And rhinovirus and adenovirus, too. Achoo.

    2. Better still is the Truth FUD ad, Fear, Uncertainty, and Doubt.

      “Fact: No one knows the long-term effects of vaping!”

      Juul is owned by tobacco. Its purpose is to fall on its sword, dragging crushing regulation doen on itself and the rest of the vaping industry. It is responsible for the hysteria, putting up large ads in stores of warnings and bragging on removing sales from 97,000 “traditional retailers”.

      It isn’t trying to pre-respond to stave off regulation. It is trying to bring it on to destroy itself…and the rest of the industry.

      Get with the 4D chess, people.

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  9. This is huge news but doubt it will be mentioned in any of the media outlets of record. Glantz has built an entire career on prevarication over the “risks” of secondhand smoke and even third hand smoke-sure it hurts to get a retraction, but he will move on

    1. It is small news but good.

      This is not a major journal in the medical community.

      Anyone who knows how to read this kind of article could see the gaps in basic analysis. You could dress it up with confidence intervals but it meant nothing.

      Good job in getting a retraction.

      AHA has done some good things. This time they screwed up. Go on and do better.

      1. It isn’t about the medical community though.

        It is about getting quoted on “Good Morning America” so that we can move on with banning all vaping.

        So more people will smoke.

        So more Tobacco settlement money will keep flowing.

        1. Which is just terrible.

          I remember getting a little grant from the AHA as an undergrad to be a grunt assistant in the summer in a lab at my school. Can’t even remember what it was about. Hardly understood it. Just did what the prof and grad students needed. Cleaned a lot of equipment . I think I got to do some basic DNA preps and making gels.

          Got a little income and was good for my education.

          Then you get to something this obviously wrong.

  10. Very Good Article Sir. Keep it up. Sarkari TET

  11. Hi….
    They will not have to. The people paying for his studies will be the ones shutting him down. Why give him more money when you can fund someone else who can agree with you to do the research.

    Retractions for mistakes like this are the worst thing you can get caught doing as a researcher outside of generating the data yourself. And some will say this is the same as if he made up the data himself because there is no way a reasonable researcher would have done the design of this experiment the way he did unless the intention was to deceive.

    A review will likely be started to determine if that was the case or not, and if they find it is, he will be barred from future research altogether.

    This was a very serious mistake he got caught doing. I am in psychology and education and I could face losing my right to do research for this for a mistake like this, despite my findings having little impact on overall public health. In medicine, when the issue directly affects public health the ethics are even tighter. He fucked up big time and will get hit hard for it.

    Edit: Shit just read retraction watch. He was already locked out of his research as he sexually harassed a student and thus could not even defend himself because he does not have the right to access his own data. Yeah I do not see a bright future here at all.
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  13. So far the journal has a better record of retracting lies than the journals pushing global cooling/warming/change/disruption/apocalypse (or whatever the trending term for it is this week.

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  15. We are today better equipped and staffed than native witch doctors were/are, but insofar as knowing what we’re doing, little better than they were – and we lie and deceive quite as much as they did/do.

    1. The native witch doctors relied on empirical evidence much as we do today. This works that doesn’t. The medieval doctors did the same. They often failed because the scientific evidence was unknown.

      We know far much more now. That is fact. We can do things unimagined even decades ago.

      There are always unknowns. The further you push the boundaries the more you know that.

      Really the whole point is to explore until you do not know.

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  17. “I suspect JAHA would have been a bit more careful with a study that found vaping PREVENTS heart attacks by helping smokers quit.”

    Indeed.

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