Mispresenting results and missing the opportunity to discuss their implications

Letter to a medical journal accepted for publication

 

By Dr Farsalinos

            Some of you may remember the comment I posted in early July 2013. It referred to a study published in April 2013 in “Journal of Chromatography”. Researchers evaluated the nitrosamine content of 105 e-liquids available to the South Korean market and found an average of 13 nanograms nitrosamines per ml of e-liquid. I criticized the paper not because of the results or the methodology but because in the discussion section they failed to report the true implications of their research by omitting the obvious comparison of nitrosamine levels with those present in tobacco cigarettes (such a comparison was very elegantly presented in the paper by Cahn and Siegel). Instead, they mentioned that the sample with the highest level of nitrosamines was 10 times higher than the sample tested in 2008 by Laugesen. Moreover, they mispresented the results of the study by Schripp et al (once again, this study must have the record of most false and misleading referencing ever) by saying that nitrosamines may be formed because the temperature of an e-cigarette may go over 350oC. Obviously this is not true since Schripp et al specifically mentioned that such a temperature was measured when the e-cigarette was activated without the presence of liquid. Therefore, this Korean study was the perfect example of how positive for e-cigarette results are presented in a way that the reader makes false conclusions.

            At the time when I uploaded my comment, I decided to send a letter to the editor of “Journal of Chromatography A” about that paper. In this letter, titled “Authors miss the opportunity to discuss important public health implications”, I criticized the lack of comparison of nitrosamine levels between e-liquids and cigarettes, I mentioned that similar levels were found in pharmaceutical nicotine products and of course I rejected the reference to Schripp's findings about the temperature during e-cigarette activation. In fact, i calculated and presented that, according to their results, the daily intake of nitrosamines by using an e-cigarette was 76 to 142-fold lower compared to one tobacco cigarette. After 7 weeks of peer-reviewing, the editor of the journal informed me yesterday that the letter was accepted and will be published shortly.

I will come back with a comment once the letter is officially published.

 

Dr Farsalinos is a researcher at Onassis Cardiac Surgery Center in Athens-Greece and at Medical Imaging Research Center, University Hospital Gathuisberg in Leuven-Belgium. He is actively involved in research on e-cigarettes’ safety and risk profile.           

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