Irresponsibility exposed

A public health expert in the US has said that according to a study, making a serious attempt to quit smoking is associated with a significant (41 percent) increase in heart attack risk.

Dr. Michael Siegel, a Professor in the Department of Community Health Sciences, Boston University School of Public Health, wasn’t attempting to discourage smokers from attempting to quit their habit – far from it; he was pointing out how it was possible for studies to arrive at perverse findings.

Siegel’s focus was on a recent study that, according to news coverage, had used cross-sectional data from the 2016 Behavioral Risk Factor Surveillance Survey (BRFSS) and found that ever use of e-cigarettes increased the risk of reporting ever having had a heart attack, while controlling for age, gender, body mass index, history of diabetes, and smoking status. The news articles had reported that the study found a 59 percent increase in heart attack risk associated with the use of e-cigarettes.

On his blog, The Rest of the Story, Siegel points out that it is irresponsible to use the results of this cross-sectional study to conclude (or even suggest) that e-cigarette use increases heart attack or stroke risk because the study assessed only the relationship between ‘ever’ having used e-cigarettes and ‘ever’ having had a heart attack. The study had no information on whether the heart attacks or the e-cigarette use had come first.

Referring to his own take on quit attempts being associated with a 41 percent increase in heart attack risk, Siegel said that he had used the 2016 BRFSS and modeled the risk of having had a heart attack as a function of having tried to quit smoking (and succeeding for at least one day). He had controlled for age, gender, body mass index, diabetes, and smoking status.

‘Obviously, what is going on here is not that quitting smoking increases your risk of having a heart attack,’ he said. ‘Instead, what is happening is that smokers who experience a heart attack are more likely to try to quit smoking.

‘But the same reasoning used by researchers to conclude that vaping increases heart attack risk supports the conclusion that trying to quit smoking increases heart attack risk.’