February 5, 2019

Stanton A. Glantz, PhD

Another study ties e-cigs to strokes and confirms association with heart attacks

Paul M Ndunda and Tabitha M Muutu just presented their paper “Electronic Cigarette Use is Associated With a Higher Risk of Stroke” at the International Stroke Conference.  They conducted a cross-sectional analysis using the CDC’s Behavorial Risk Factor Surveillance System data from 2016 to assess the risks of stroke and myocardial infarction in e-cigarette users, controlling for cigarette smoking.  They found compared with non-users, e-cigarette users had higher adjusted odds of stroke (OR 1.71 [1.64 - 1.8]), myocardial infarction (OR 1.59 [1.53 - 1.66]), angina or coronary heart disease (OR 1.4 [1.35 - 1.46]).

These risks are similar to what we reported based on the National Health Interview Survey.

The fact that two independent data sources yielded such similar results is strong evidence that the association is real.

Farsalinos has already criticized the paper, mostly with linguistic challenges of what the word “risk factor” means.  Had he checked Wikipedia he would have seen that the term “risk factor” is meant to be used when describing associations in cross-sectional studies.

Here is an NPR story on the study that has a good description and puts it into context.

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