JAHA editors retract study linking e-cigarette use to MIs

The editors of the Journal of the American Heart Association have retracted a study that linked some-day and everyday e-cigarette use to an increased risk of having had a heart attack. The same study alleged the effect of e-cigarettes was comparable to those of conventional cigarettes.

JAHA editors said they “reviewed the peer review process” after finding that study authors Dharma N. Bhatta, PhD, MPH, and Stanton A. Glantz, PhD, didn’t fully account for certain information in the Population Assessment of Tobacco and Health (PATH) Wave 1 survey. Bhatta and Glantz, both of the Center for Tobacco Control Research and Education at the University of California, San Francisco, conducted a longitudinal analysis of PATH Wave 1 and 2 data to establish a link between e-cigarette initiation and MI.

The study’s authors said they adjusted for cigarette smoking, demographic variables and clinical variables and found that everyday e-cigarette use was tied to a 2.25-fold increased likelihood of having had an MI. Some-day e-cig use was linked to a 1.99-fold increased likelihood of previous MI, with a “significant” dose-response. 

According to Bhatta and Glantz, the odds ratio for daily use of both e-cigarettes and traditional combustible cigarettes was 6.64 compared with never-cigarette smokers who had never used e-cigarettes. They said the effects of e-cigarettes were similar to those of conventional cigarettes, noting dual use was riskier than using either product alone.

“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-cigarette use) to address this concern,” the JAHA editors wrote in their retraction notice. “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.”

The editors said that, after publication, they requested Bhatta and Glantz conduct their analysis based on when specific respondents said they started using e-cigarettes. But that would require ongoing access to the PATH Wave 1 survey—a restricted-use dataset—and, despite complying with the editors’ request, Bhatta and Glantz have been unable to access that database.

“Given these issues, the editors are concerned that the study conclusion is unreliable,” the editors wrote.