A conflict of interest is strongly associated with tobacco industry-favourable results, indicating no harm of e-cigarettes

Prev Med. 2019 Feb:119:124-131. doi: 10.1016/j.ypmed.2018.12.011. Epub 2018 Dec 18.


Researchers reach contradictory results when trying to assess the potential harm of e-cigarettes. This study investigated whether the findings and conclusions in papers published on e-cigarettes and health differ depending on whether the authors had a financial conflict of interest (COI) or not. A total of 94 studies (identified in a previous systematic review) that investigated the content of fluid/vapor of e-cigarettes or in vitro experiments were included. The type, level and direction of the financial COI were coded. Abstracts were blinded and evaluated by two assessors. Fischer's Test and Logistic regression analyses were used to investigate the associations between findings of harm/conclusions and COI. All three dimensions of COI showed the same tendency: studies with industry-related COI found potential harm significantly less often than studies without a COI. 95.1% of papers without and 39.4% of papers with a COI found potential harmful effects/substances. Only 7.7% of tobacco industry-related studies found potential harm. The odds of finding of no harm were significantly higher in studies with an industry-related COI (OR 66.92 (95% CI 8.1-552.9)) than in studies without a COI. A strong/moderate COI was associated with very high odds (OR 91.50 (95% CI 10.9-771.4)) of finding of no harm compared with studies with no/weak COI. This blinded assessment showed that almost all papers without a COI found potentially harmful effects of e-cigarettes. There was a strong association between industry-related COI and tobacco- and e-cigarette industry-favourable results, indicating that e-cigarettes are harmless.

Keywords: Bias; Conflict of interest; E-cigarette; Industry; Smoking.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Conflict of Interest / economics*
  • Electronic Nicotine Delivery Systems*
  • Humans
  • Smoking / adverse effects*
  • Tobacco Industry / economics
  • Tobacco Industry / organization & administration*
  • Vaping / adverse effects*