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ASH responds predictably

ASH England, among the world's greatest cheerleaders for e-cigarettes, posted the following report in its news feed:

USA: Study finds vapers who use e-cigarettes every day are at higher risk of heart attack

Researchers analysed the 2014 and 2016 results of The National Health Interview Survey, which includes interviews from adults living in the US. Some 69,452 participants were asked: 'Have you ever been told by a doctor or other health professional that you had a heart attack (also called myocardial infarction)?'. The analysis of the increased risk of heart attacks was based on answers to this question.  

The researchers found that people who smoke tobacco and use e-cigarettes were most likely to have had a heart attack. 

Editorial note: This study does not establish a causal relationship between heart attacks and the use of e-cigarettes. Rather it shows that at the point they were surveyed people who smoked and/or vaped were more likely to have had a heart attack in their lifetime. The study was not able to determine when the heart attack took place, whether it followed or preceded use of an e-cigarette. It is therefore inaccurate to say this research shows that vaping leads to an increased risk of a heart attack. The link between tobacco smoking and heart attacks is well established. See our fact sheet for more information. ASH fact sheet: Smoking, the Heart and Circulation.

Source: Daily Mail, 23 August 2018

Interestingly, ASH England spent 88 words summing up the study and 111 words trying to dismiss the findings.  Like all e-cig cheerleaders, they make the point that you cannot use the "cause" word based on a cross-sectional study (which is why we didn't say "cause").  They also recite all the usual concerns with cross-sectional studies.

They ignore the fact that well-done cross-sectional studies are the first step to identifying relationships worthy of exploring in longitudinal studies.  Longitudinal studies, because they involve following the same people for years, take years to do.

So, ignoring or downplaying cross-sectional studies is a standard strategy for ignoring evidence you don't like.  ASH England did this when the first cross-sectional studies were published suggesting that e-cigs are a gateway to cigarettes.  Even though there are a ton of longitudinal studies showing the gateway effect, ASH England keeps trying to downplay them, too.

ASH England also ignores the fact that the association we found is exactly  what one would expect based on the known adverse biological effects of e-cigs on blood vessels and the cardiovascular system.

But they have lots of friends in England. 

The question is how many people will e-cigs have to kill before they start looking at what the evidence shows rather than trying to explain it away.

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