A study claimed vaping doubles risk for heart attacks. It's been retracted for being 'unreliable'

Jayne O'Donnell, USA TODAY

One of the country's best-known tobacco researchers is under fire this week after one of his federally funded vaping studies was retracted and other academics are calling for federal review of some of his other influential anti-vaping research. 

The retracted study, by University of California, San Francisco medical school professor Stanton Glantz and published in Journal of the American Heart Association, said vaping doubled the risk of heart attacks. It was paid for primarily by the second of two $20 million grants awarded to Glantz and UCSF in 2018 from the National Institutes of Health and the Food and Drug Administration to research tobacco and e-cigarettes.

In July, USA TODAY reported on questions about the study and another researcher's conclusion that the majority of the heart attacks happened before people vaped.

The timing of Glantz's recent work is of particular importance as it came as the Trump administration considered restricting the sale of flavored electronic cigarettes. Glantz's work is often used by anti-vaping advocates in and outside of government to argue for stricter regulations. 

In January, the Food and Drug Administration banned flavors other than menthol and tobacco in the smaller vape pens popular with teens and restricted the sale of other youth-friendly flavors to vape shops and smoking bars restricted to adults. 

Is vaping safer than smoking? Depends who you ask, and what scientific study they point to

New York University professor David Abrams, who called for the retraction with a group of 16 academics, scientists and other public health experts, is now drafting letters to NIH's Office of Research Integrity and UCSF's president to request investigations of other Glantz research. Abrams said he hopes others who signed the letter, including fellow NYU professor and tobacco researcher Ray Niaura, University of Michigan economics professor Ken Warner and Marcus Munafo, editor in chief of the journal Nicotine and Tobacco Research, will support the inquiry. 

In a statement, NIH's Office of Extramural Research said it "does not confirm or discuss any reviews, whether they are being considered, planned, on-going, or completed, regarding specific individual investigators supported by NIH."

Glantz and his co-author, Dharma Bhatta, told JAHA during the review process that they addressed the discrepancy by only including heart attacks that occurred after 2007, when vaping started in the U.S. The journal asked them to prove their finding again but the researchers said they could no longer access the data. 

"Given these issues, the editors are concerned that the study conclusion is unreliable," JAHA said Tuesday when it retracted the study

Glantz defended himself in a lengthy blog post Tuesday, accusing JAHA of caving "to pressure from e-cig interests" and not following the usual protocol when journal articles are questioned. He also stood by the study and threatened to sue the journal. 

When contacted by USA TODAY for comment, Glantz referenced his blog post and pointed to Abrams' connection to the Phillip Morris Foundation for a Smokefree America and what he said were industry connections of the other academics. 

Abrams said he offered the nonprofit free advice on reviewing grants on how to get people to quit smoking and that he and the other 15 signatories are senior scientists not funded in any way by industry. 

"This is his typical modus operandi, blaming everyone but himself, doubling down on supporting the paper, and smearing his critics as ‘e-cig interests,'" Abrams said. "I would say professor Glantz has not taken the retraction with good grace."

University of Louisville professor Brad Rodu brought the Glantz study to USA TODAY's attention and sent a letter urging retraction to JAHA last summer. Glantz, who learned of the criticism when contacted by the newspaper, criticized the journal in his blog post for failing to publish Rodu's letter and allowing him to respond.

Rodu is not among those who signed the letter seeking the study be recalled. While he supports the move, the University of Louisville receives unrestricted funding from tobacco and vaping companies, so was not included.

Brad Rodu is a professor of medicine at University of Louisville and holds an endowed chair in Tobacco Harm Reduction Research.

Ivan Oransky, a physician and medical journalist who runs the website Retraction Watch, said Glantz's study shows the positions and funding sources of authors don't assure accuracy. There are far more retractions from academic laboratories without pharmaceutical industry funding than from the industry-backed ones. Oransky said industry researchers know they are under scrutiny, while advocates seldom evoke the same skepticism. 

"No matter how you feel about vaping, correcting the scientific record is critical (or) you can’t trust anything you read," Oransky said. "There is this presumption if it isn’t industry funded, it's somehow more legitimate." 

The dataset Glantz and Rodu used is often utilized by researchers to replicate others' findings, which is encouraged in science. In its statement, NIH said it "relies heavily upon rigorous and transparent research." 

"When journals make the decision to retract one of their published articles, such as what JAHA did in this case when the data were found to be unreliable, it can help avoid potential harm to a scientific field, wasted resources, lost time, and in some cases, harm to patient populations, if done in a timely manner," said NIH, which along with the FDA funded Glantz's research.

Stanton Glantz is a professor of medicine and director of the Center for Tobacco Research Control & Education at the University of California, San Francisco.

Abrams, a former head of NIH's office of behavioral and social science research, said additional Glantz studies deserving of the most scrutiny include two major publications in 2018: A meta analysis of other vaping studies published in the British journal Lancet Respiratory Medicine and one in the journal Pediatrics about teen vaping and smoking.

The Lancet analysis of several studies was based on a "misleading negative correlation between e-cigarettes and smoking cessation" and used studies that had nothing to do with quitting smoking, Abrams said. This violated the basic tenets of medical research review, he added. 

"It has had a massive misleading influence in the field to this day because it is cited as the main reference" to show vaping makes it harder to quit smoking, Abrams said.  

The other study concluded the "use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents." Rodu, who analyzed the claim, found only 11 of 9,000 teens studied vaped before they started smoking and 80% of the kids who smoked hadn't used tobacco product previously. 

Using that data, Abrams said the "effect of vaping is not just diminished, it disappears."

Abrams said the teens were as likely to drink alcohol or use marijuana as cigarettes because they were risk takers to start. A "massive exaggeration" of Glantz's flawed work, he added, convinced the public the biggest risk of teen vaping is they will turn to cigarettes and reverse decades of progress in lowering the smoking rate. 

Oransky said the retraction is evidence of a larger problem with medical journal research, which can take years or even decades to disprove. He called the retraction of Glantz's paper eight months after publication "lightning fast," and noted, "It can take heroics to get a paper corrected."

"This seems to illustrate how porous the peer review system is," said Oransky. "Journals like us to think it's the Good Housekeeping Seal of approval and it just isn’t." 

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This article originally appeared on USA TODAY: Vaping study retracted: Scientists want probe of UCSF tobacco research