Comparing smoking-related disease rates from e-cigarette use with those from tobacco cigarette use: a reanalysis of a recently-published study
Abstract
A recent meta-analysis by Glantz et al. combined odds ratios (ORs) relating e-cigarette use (vaping) to cardiovascular disease, stroke, chronic obstructive pulmonary disease (COPD) and other endpoints. They assessed all included studies as having a low risk of bias, and concluded that vaping and smoking have a “comparable” disease odds, with dual use associated with more risk than smoking. To examine the accuracy of these conclusions, giving particular attention to myocardial infarction (MI), stroke and COPD. We determined (1) whether the pooled random-effect estimates were correctly calculated from the ORs included, (2) whether the detailed outcomes were correctly described and appropriate and whether additional OR estimates could have been included from the studies considered, (3) whether the data were correctly extracted from the source papers, (4) whether some studies should definitely or possibly have been excluded, (5) what the pooled OR estimates were for MI, stroke and COPD after excluding definitely invalid results and restricting attention to data based on appropriate disease definitions, (6) how estimates of the excess risk (ER = OR − 1) for vaping compare to those we estimate for quitting, (7) whether various sources of bias were adequately accounted for, and (8) whether conclusions were confirmed in studies where reverse causation was not an issue, i.e. where disease onset could not have preceded uptake of vaping. We found no major issues regarding pooled…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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