Cameron English, director of the Life Sciences Division of the American Council on Science and Health (ACSH), published an article to refute the unreliable e-cigarette research conclusions in the past year. The article listed seven unreliable studies and refuted them one by one.


Recently, Cameron English once again published an article refuting a new study on e-cigarettes, which said that the use of e-cigarettes may increase the risk of pre-diabetes Thorough criticism.


Here is the full text:


Certain recent studies have linked e-cigarette use with increased risk of bone damage, erectile dysfunction, smoking relapse, depression, and stroke. However, these studies related to e-cigarettes are not supported by convincing data, so we have previously published a paper to refute them.


As more research results related to e-cigarettes come out, another unreliable study is in front of us, and many media still cite the study out of context or without thinking, in order to amplify the harmful theory of e-cigarettes.


A new study published March 2 in the American Journal of Preventive Medicine links e-cigarettes to an increased risk of prediabetes.


The researchers analyzed data from 600,046 people who reported their vaping and cigarette smoking experiences between 2016 and 2018 to the Behavioral Risk Factor Surveillance System (BRFSS), a CDC-sponsored telephone survey project to monitor relationships with the Behavioral Risk Factor Surveillance System (BRFSS). Health-related risk behaviors, chronic diseases, and use of preventive services across the United States.


The data show that the prevalence of prediabetes is 9% among e-cigarette users and 13.4% among cigarette smokers; the prevalence of prediabetes among single e-cigarette users (people who have never smoked cigarettes) was 5.9%, and the prevalence of dual cigarette and e-cigarette users was 10.2%


The study concluded: “In this representative sample of U.S. adults, e-cigarette use was associated with increased odds of prediabetes.”


However, like other unreliable studies, this study is based on incomplete data and its conclusions are severely limited. Currently, there is little reason to believe that e-cigarettes increase the risk of prediabetes.


  1. Unstable exposure data


The first issue, which I have to sound like a record breaking point that keeps pointing this out, is the failure of researchers to collect meaningful exposure data:


“Respondents were first asked: Have you ever used an e-cigarette or other vaping product in your lifetime, or even only once? Those who answered no were classified as never vaping.”


Those who answered yes were classified as e-cigarette users and then asked: Do you currently use e-cigarettes or other vaping products every day, some days, or not at all? E-cigarette users who used to answer every day or day were classified as current e-cigarette users, and e-cigarette users who did not answer at all were classified as former e-cigarette users.


As we pointed out in response to a recent study linking e-cigarettes to bone damage, answers to these questions do not provide an adequate assessment of e-cigarette use. Replace vaping with any other behavior and you’ll see why. Classifying someone as a former chocolate user because they report eating a Snickers bar once in their life is definitely not indicative of their eating habits. Asking if they eat chocolate every day or days is equally unhelpful. In this case, you need to be more specific about how much someone vapes and what kind of equipment and vaping oil they use.


  1. Serious limitations


It gets worse when we investigate the limitations of the study:


“Limitations of this study include self-reported tobacco use and lack of medical confirmation of prediabetes and other dietary information. The BRFSS is a cross-sectional survey, so a causal relationship between e-cigarette use and prediabetes cannot be inferred. Another A potential limitation is recall bias. Furthermore, the authors have no information on weight gain in former e-cigarette users, which could lead to misinformation bias.”


Combined with the aforementioned inaccurate exposure data, these limitations are enough to undermine the credibility of the study. The study authors also acknowledged that the correlations they found were based solely on self-reported data. Additionally, they found that only a small percentage of the participants had prediabetes and vaped during the study period. There is no way to know if vaping caused these people to become prediabetic.


  1. What about the mechanism?


This key detail is also buried deep in the paper: The mechanisms underlying the causal link between e-cigarette use and prediabetes are not fully understood. Stripped of its academic language, what the phrase really means is that we don’t know how vaping causes prediabetes.


The authors cite a study that showed that smokers had higher blood sugar levels than non-smokers after an oral glucose tolerance test, and suggested that nicotine may be the culprit in this study. But that may just be due to a few other variables, smokers have poorer blood sugar control; studies have found that smokers tend to eat fewer fruits and vegetables and exercise less than non-smokers. Conversely, some studies also show that smoking is associated with weight loss, which tends to lower the risk of diabetes.


We still have a lot to learn about the effects of e-cigarettes on metabolism. Unfortunately, their research doesn’t improve our understanding of this.


Used appropriately, e-cigarettes may be a good transitional choice to help you quit smoking. Although the practice of using e-cigarettes as a stop-smoking tool is not an official guideline, preliminary studies suggest this approach may be effective. For example, a study published in April 2015 in the International Journal of Environmental Research and Public Health found that after 12 months, about 41 percent of smokers who had switched to vaping to help them kick their cigarette habit had managed to quit, and an additional 25.4 percent had reduced the number of cigarettes used.

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