In this article, Markham Heid attempts to explain why vaping is worse for your heart health than cigarette smoking but does so in a biased and unsupported way. He uses one research study conducted by the Cedars-Sinai Medical Centre in Los Angeles to defend his bias, rather than using the source as impartial information source. This article is more of an educated opinion piece rather than factual reporting on vape use and heart health.
Heid’s only source of significant research was conducted by the Cedars-Sinai Medical Centre in Los Angeles that tested the rates of blood flow to the heart in e-cigarette smokers, tobacco smokers and non-smokers. The study was done on a very small scale, Heid reports the sample size as 10 non-smokers, 10 e-cigarette smokers, and 10 tobacco smokers, which is incorrect as there were only 9 cigarette smokers included in the study. All sample subjects were generally healthy and aged between 18 to 38. The test results showed that e-cigarette users blood flow to the heart decreased, while traditional cigarette smokers had a slight increase of blood flow followed by a decrease. From the results it can be inferred that e-cigarettes can be associated with the risk of coronary vascular dysfunction, as reported by Dr. Florian Rader, a member of the Cedars-Sinai research team, but this fact is not proven. The conclusions reported by the Cedars-Sinai study provide grounds for needing more research regarding the subject.
Heid uses the study’s conclusions to his advantage, not reporting on all the results but rather using the results of the vape users to support the idea that vaping causes abnormalities of blood flow to the heart. The results of the cigarette users and e-cigarette users were very similar, and the study also did not account for any external factors, such as the use of marijuana in association with cigarettes or e-cigarettes. Heid uses the statistics of heart related deaths and lung cancer deaths in his favour, stating that heart related deaths are higher than lung cancer related deaths, and the health implications of vaping may have a tremendous effect on the already high numbers of heart related deaths.
Heid redeems himself near the end of the article by reporting that Dr. Rader believes the study was not at a large enough scale to provide concrete evidence of e-cigarette use being worse for the heart than tobacco use. There are risks associated with using e-cigarettes, but the study does not have any concrete evidence that e-cigarette use is worse for heart health than traditional tobacco. In this article, Heid is using the research conducted as a way of looking at the possible effects of vaping rather than the effects of vaping versus the effects of cigarette smoking on heart health. The research shows that vaping can cause health risks, but not that the harm from vaping is worse than the harm from smoking.
To conclude, Heid is inferring that the concerning heart health implications from vaping are worse than the implications from cigarette smoking. The article is more of a warning about possible health complications caused by e-cigarette use because they have not yet been studied enough to know all the risks.
Markham Heid’s November 11th news article in Time severely falls short of being an unbiased and informational account for the recent “Vaping Crisis” that has found its way into North American news headlines. Heid’s article details experiments done by Dr. Florian Rader that were presented at the American Heart Association’s 2019 conference that investigated changes in myocardial blood flow, or the amount of blood that is passed through the heart, in non-smokers, smokers, and e-cigarette users after being subjected to a mild stress test. The mild stress test that was used is called a post-handgrip cuff ischemia and is similar to a common hand gripper. The subject’s blood flow was measured before and after the stress test before and after use of either a cigarette or an e-cigarette and the change in blood flow as a result of the stress test was determined. Dr. Rader and his group found that the non-smokers had the largest change in blood flow, the smokers had less of a change in blood flow and the e-cigarette users had no change in blood flow. The reported results were from a sample size of 10 non-smokers, 10 e-cigarette users, and 9 smokers (although the news article incorrectly states this as 10 smokers).
Heid misses the mark with this article in many aspects of scientific reporting. One of the first oversights in this article is the complete lack of references to the studies that the article is about. No links are provided and the best that one can do is to go the AHA website, search for “Florian Rader” (senior author), find that he and his collogues had presented three, very similar, abstracts at the 2019 AHA conference and assume that Heid is referring to Abstract 15018 based on the sample sizes reported (although Heid incorrectly stated one of the sample sizes). This will lead one to the submitted abstract by Rader’s group, but the full report is not documented anywhere. Because of the small amount of data provided as well as the fact that these investigations were centered around a single blood flow test, the author of the news article seems to be over exaggerating the results by claiming that e-cigarettes are worse for heart health than traditional cigarettes. Heart health is comprised of many different factors and many more tests and larger sample sizes are necessary before anyone can make a remarkable claim like that.
Heid does report Rader’s statement saying that the sample size is too small to make any conclusions and that the results are only apparent when averages are taken, but Heid seems to innocuously slip in this important fact and focuses more on including over exaggerations of previous studies or completely unrelated studies regarding e-cigarette use. Heid makes sure to reference previous survey-based analysis that could show a (very) weak correlation between e-cigarette use and stroke or heart attack. Heid does not mention the possibility that these weak correlations could be because many users of e-cigarettes are former smokers and could have increased risk of health problems form their previous years of smoking. Heid also feels the need to include a seemingly unrelated account of an isolated case of a teenager having an allergic reaction to an e-cigarette and the two paragraphs on the subject in the article were clearly aimed at enticing fear towards e-cigarettes.
At the end of the article, there was almost a glimpse of hope as Heid mentions the CDC’s evidence that the “Vaping Crisis” could be caused by vitamin E acetate in illegal, black market THC (active ingredient in marijuana) pod vaping devices. This claim seems to be effortlessly brushed off though and Heid ends the article with his claim of “all the evidence is piling up” against e-cigarettes. The author seems to have missed the report from the CDC that was released on November 8th that states that 100% of the “Vaping Crisis” victim’s lung fluid samples tested positive for vitamin E acetate while the control group tested at 0%. Heid also seems to have left out any one of the numerous United Kingdom-based research articles and experts who have, for many years now, been stating the opposite of what United States-based researchers have been claiming on the dangers of e-cigarettes. Many health professionals in the UK see e-cigarettes as a less harmful alternative to traditional cigarettes and Public Health England (PHE) still stands by their claim that “vaping is 95% less harmful than tobacco”.
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