ArticleAmerican journal of preventive medicine2021
Re-examining the Association Between E-Cigarette Use and Myocardial Infarction: A Cautionary Tale.
Article in American journal of preventive medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Electronic cigarettes and cardiovascular outcomes: a systematic review and meta-analysis of Major Adverse Cardiovascular Events (MACE).BMC public health · 2026Pooled it
- Health impacts of electronic nicotine delivery systems: an umbrella review of systematic reviews.BMJ open · 2025Pooled it
- Risk Modulation by Electronic Cigarette Consumption in Cardiovascular Disease and Its Relevance in Cardiac Surgery-A Narrative Review.Journal of cardiovascular development and disease · 2026Review
- A Narrative Review of the Potential Impact of Next-Generation Tobacco and Nicotine Products on Cardiovascular Health.Cureus · 2026Review
- E-cigarette Duration and Incident COPD Among Adults Aged 40 Years and Older with a Smoking History.medRxiv : the preprint server for health sciences · 2026Article
- Electronic cigarettes and cardiovascular diseases: An updated systematic review and network meta-analysis.Tobacco induced diseases · 2025Review
- Adult Electronic Nicotine Delivery System Use in the USA: a Scoping Review Through a Health Equity Lens.Current addiction reports · 2023Article
- Association between e-cigarette use and myocardial infarction: a systematic review and meta-analysis.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2023Article
- Review
- Examining Disparities in Current E-Cigarette Use among U.S. Adults before and after the WHO Declaration of the COVID-19 Pandemic in March 2020.International journal of environmental research and public health · 2023Article
- Longitudinal Associations Between Exclusive and Dual Use of Electronic Nicotine Delivery Systems and Cigarettes and Self-Reported Incident Diagnosed Cardiovascular Disease Among Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Article
- The association between electronic cigarettes, sleep duration, and the adverse cardiovascular outcomes: Findings from behavioral risk factor surveillance system, 2020.Frontiers in cardiovascular medicine · 2022Article
- E-Cigarettes-a review of the evidence-harm versus harm reduction.Tobacco use insights · 2022Review
- Investigating the effect of e-cigarette use on quitting smoking in adults aged 25 years or more using the PATH study.F1000Research · 2020Article
Corrections and comments
- Commented on by
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCross-sectional analyses have suggested that e-cigarette use, independent of combustible cigarette use, elevates the risk of myocardial infarction. Previous researchers confused their own models' assumptions that these risks were independent with the idea that their analyses validated the presence of independent risks. This study avoids this pitfall.
methodsCross-sectional analyses of the 2014-2019 National Health Interview Surveys (N=175,546) were conducted in 2020.
resultsLogistic regressions found that e-cigarette use was associated with having had a myocardial infarction, but this association significantly varied on the basis of one's smoking history. With a host of demographic and clinical variables controlled, e-cigarette use was associated with lifetime myocardial infarction occurrence only among current smokers. A counterfactual analysis first removed all (current or former) e-cigarette‒using respondents who had suffered a myocardial infarction without a history of smoking. The independent-effects model used in previous research misleadingly indicated that daily vaping increases never smokers' odds of having had a myocardial infarction by 1.55 (95% CI=1.11, 2.15), even though no such myocardial infarction sufferers remained in the analyzed data. The association between myocardial infarction and vaping daily has shown a significant annual decline (AOR=0.81, 95% CI=0.67, 0.98).
conclusionsThere is no reliable evidence that e-cigarette use is associated with ever having had a myocardial infarction among never smokers. Contrary to concerns that the harms associated with e-cigarettes are only now emerging after more years of possible product use, the only evidence of time-dependent variation in the association between e-cigarette use and myocardial infarction ran counter to this possibility. The scientific community must insist that researchers engage in accurate public communication of peer-reviewed findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.