Having Health Insurance Increases Your Risk of a Heart Attack, and Other Cross-Sectional Study Foibles

Later this week, a research study will be presented at the International Stroke Conference in Hawaii that purports to show that vaping increases the risk of heart attacks. In a recent post, I showed that this research is fatally flawed because it violates the basic principle in epidemiology that correlation does not equal causation. The study found a correlation between using e-cigarettes and ever having had a heart attack. The authors conclude that vaping must therefore increase heart attack risk. However, the more likely explanation is the opposite: smokers who experience a heart attack are more likely to try to quit smoking and therefore more likely to use e-cigarettes.

As an exercise, I used the same data (the 2016 Behavioral Risk Factor Surveillance Survey) to show that by the same reasoning, making a quit attempt increases your risk of a heart attack.

Here are some other factors that increase your risk for a heart attack, based on the 2016 BRFSS:

• Having health care insurance (67% increase in heart attack risk)
• Having a health care provider (174% increase)
• Going to the doctor annually for a routine physical exam (150% increase in risk)
• Having ever received the pneumonia vaccine (253% increase in risk)
• Ever having had a mammogram (52% increase in risk)

So according to anti-vaping researcher logic, obtaining health care insurance, obtaining a health care provider, going to the doctor for routine exams, getting vaccinated for pneumonia, and having a mammogram all increase your risk of a heart attack.

By the way, the same analysis reveals that compared to vaping only occasionally, you reduce your risk of a heart attack substantially if you vape every single day.

In fact, daily vapers are at lower risk of having reported a heart attack than people who never vaped!