More evidence that ecigs increase heart attack risk

Michelle Manderski, Binu Singh, and Cristine Delnevo wrote a letter to American Journal of Preventive Medicine criticizing the paper that Talal Alzahrani and I published using the 2014 and 2016 National Health Interview Survey to demonstrate a cross-sectional association between using e-cigarettes and having had a heart attack on the grounds that we did not include the 2015 data.

As we pointed out in our response, “Adding Data From 2015 Strengthens the Association Between E-Cigarette Use and Myocardial Infarction.”   The reason that we did not include 2015 in the original paper is that we did not realize that the 2015 survey asked about e-cigarettes because the question was in a supplement not the main survey.  In any event, adding the new data made the association between nondaily e-cig user and MI significant, something that we did not find in our original study.  Daily e-cig use was statistically significant in both the original study and with the 2015 data added.

In addition, the evidence on how e-cigs increase heart disease risk is also growing.  Recently, my colleague Matt Springer and his postdocs reported a head-to-head comparison of how Juul and Marlboro Red cigarettes affect blood vessel function.  Both clobbered the ability of blood vessels to dilate (expand) by similar amounts compared to clean air.  The effect was the same as for a third generation e-cig as well.