A study conducted by the peer-reviewed journal Gastroenterology Research linking vaping to liver diseases was retracted by the publication recently as the authors of the study were unable to address the concerns and questions raised on the authenticity and reliability of the findings. While the letter-to-the-editor that questioned the report was not made public, the journal carried a short notice regarding the retraction. It said, “Concerns have been raised regarding the article’s methodology, source data processing including statistical analysis, and reliability of conclusions.”
The paper titled "Association of Smoking and E-Cigarette in Chronic Liver Disease: An NHANES Study," was retracted on June 11, almost a year after being published in June 2022. As reported by Filter magazine, critics feel that such retractions reiterate the fact that public health researchers are overstating the harms of vaping in their academic literature.
According to Gregory Conley, Director of legislative and external affairs for the American Vapor Manufacturers Association, a similar incident was noted in the year 2020 when a study by the Journal of the American Heart Association (JAHA) linking vaping as a cause for heart attacks, was retracted by the publication for being flawed on several parameters. As pointed out by researchers, the JAHA study had lacked credibility and failed to include survey data on nicotine use. During the JAHA paper retraction, the letter-to-the-editor with the queries was published that provided more clarity to the readers on the reasons for the retraction.
However, in the case of the recently retracted study by Gastroenterology Research, there is a lot of opacity on the issue as the letter-to-the-editor has not been made public and remains under wraps. When talking to Filter magazine on the shortcomings of the report, Ray Niaura, a psychologist and epidemiology professor at New York University’s School of Global Public Health, said, “The only survey question on vaping was a broad one. It said, “Have you ever used an e-cigarette?” On the contrary, questions involving combustible tobacco included “Do you now smoke cigarettes?” and whether someone has smoked “at least 100 cigarettes” in their life.” Niaura reckons that the question on vaping was rather weak and unclear to be able to draw any conclusion.
The study was conducted based on a publicly available database from the National Health and Nutrition Examination Survey (NHANES). The participant responses were then linked to liver diseases. Post receiving the letter that asked for clarification, authors were asked to file their response or rebuttal but they failed to respond. Niaura, who also studies tobacco dependence and treatment, stated to the Filter magazine that such flawed studies result in a ripple effect that later gets difficult to control.The erroneous findings continue to repeat in other papers, in media or websites that aggregate multiple articles. It was, therefore, gratifying to see the journal retract the paper.
The debate on whether vaping saves conventional smokers or creates new addicts have been around for a long time. While vaping is promoted as a safer alternative to regular smokers trying to quit their nicotine addiction, the facts are debated by various groups and forums. Hence, vaping requires more authentic studies, science-based research and campaigns to bring the required levels of awareness regarding its consumption. Countries like Japan have seen a successful reduction in cigarette sales, and according to the American Cancer Society, the decline resulted from the introduction of heated tobacco products in the country. WHO data states that there are more than one billion smokers in the world today, and the number is expected to stay steady until 2025. It is also estimated that around eight million deaths happen each year globally and is about to be a massive health crisis that requires immediate attention and control measures.
As Niaura sees it, many public health researchers have been quick to frame vaping as a threat to be avoided while other scientists are now “playing catch up” to balance the debate. He feels, while it was a right decision to retract the paper, the letter-to-the editor with the questions, if published, can bring better clarity and spread awareness among readers.