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AHA study is bogus; vaping is NOT as bad for the heart as smoking, says Siegel

The American Heart Association (AHA) is at it again, this time falsely claiming that vaping is no better than smoking when it comes to heart health.  As nonsensical as this may sound, the organization’s anti-vaping pontifications are gaining massive coverage in the mainstream media.  This dangerous misrepresentation is just another example of the medical community’s obvious bias against electronic cigarettes, says Dr. Michael Siegel of Boston University.

Siegel is a Professor of Community Health Sciences and a physician specializing in preventative medicine.  Immediately after completing his residency, Siegel also completed a two-year stint as a researcher in tobacco analysis at the U.S. Centers for Disease Control and Prevention.   Consequently, when the AHA issued a press release on Monday with the alarming headline, "E-cigarettes take serious toll on heart health, not safer than traditional cigarettes," Dr. Siegel was understandably outraged.

Siegel debunks two AHA studies, calling them ‘deceptive’

On his website Tobacco Analysis, Dr. Siegel takes great pains to summarize the basis of the AHA research and associated conclusions, misguided as they may be.  In short, the findings are based purely on comparative levels of various cholesterols in vapers and non-smokers.  The fact that the AHA researchers specifically ignored comparisons between vapers and smokers is, in itself, highly suspect.

The investigators collected biomarker data from a cross-sectional group of 476 participants ages 21-45.  Only 94 were non-smokers.  The remainder were e-cigarette “smokers” of varying degrees.

The intentional use of the term “smokers” by the AHA is also highly suspect.  Any so-called scientist worth a grain of salt knows full well that vaping is not synonymous with smoking.  The AHA appears to be intentionally misleading by using this terminology. 

Related Article:   Seigel: 44% of state vaping warnings on verge of committing ‘public health malpractice’

Siegel points out that the AHA analysis of cholesterol levels – both good and bad – in smokers-turned-vapers and non-smokers means absolutely nothing.  In general, he counters, smokers almost always have worse cholesterol levels than non-smokers, and most vapers are former smokers.

This discrepancy can occur for a multitude of reasons, but the most prominent are poor diet and lack of exercise.  In short, persons with lengthy histories of smoking tend to have taken lesser care of themselves overall compared to non-smokers.  Siegel states the following. 

In a cross-sectional study, you have to be very careful in extrapolating from correlation to causation because this type of study design is very susceptible to confounding -- that is, a third variable that is associated with both smoking/vaping status and cholesterol levels and makes it look like they are related but the relationship is actually driven by this third variable.
 
In this example, there is a very strong potential confounder: diet. It is very likely that smokers and former smokers have significantly less healthy diets than nonsmokers and therefore, worse cholesterol profiles. There may be differences in physical activity as well, which would lead to a finding of worse cholesterol profiles in current and former smokers than in nonsmokers. 

These intentional inaccuracies and flaws in the AHA research techniques were not the only target of Dr. Siegel’s ire.  One very specific paragraph within the organization’s press release caught his attention due to its “unfounded scientific conclusions, deceptive communications to the public about the health effects of e-cigarettes, and misguided medical advice.”

Related Article:   Ex-FDA Chief Gottlieb: JUUL is the problem, not adult vape shops

Appearing about midway through the document, the AHA study author Sana Majid makes some rather startling statements.  Majid, coincidentally, hails from the very same academic institution as Dr. Siegel – Boston University. 

"Although primary care providers and patients may think that the use of e-cigarettes by cigarette smokers makes heart health sense, our study shows e-cigarette use is also related to differences in cholesterol levels. The best option is to use FDA-approved methods to aid in smoking cessation, along with behavioral counseling."

The AHA is once again only endorsing the use of FDA-approved nicotine replacement therapies like lozenges, patches, and gums to help smokers quit.   However, their anti-vaping stance has grown even more diabolical because the agency is now explicitly warning all American smokers to never even consider using a vaporizer or e-cigarette as a more effective alternative.

Siegel notes that approximately 90 percent of smokers trying to quit through FDA-approved patches, gums, and lozenges fail miserably.  These statistics are supported by several reputable and peer-reviewed research studies.  One of the more recent is entitled, A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy published in February 2019 in the New England Journal of Medicine.

The AHA is now falsely claiming that vaping is just as bad for the heart as smoking.   But to a smoker’s ears, the true and intended underlying message is crystal clear.  “If given a choice between vaping and smoking, you might as well smoke because FDA-approved nicotine replacement therapies rarely work.”  This, says Dr. Siegel, is deceptive, misguided, and simply unacceptable.   

Related Article:   Vaping is twice as effective than NRTs for smoking cessation, says new study

(image courtesy of Boston University)

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