Presented at the American College of Cardiology’s 68th Annual Scientific Session, research shows using e-cigarettes significantly increases chances of heart attack, coronary artery disease and depression.
Concerns about the addictive nature of e-cigarettes, now used by an estimated 1 out of 20 Americans, may only be part of the evolving public health story surrounding their use. New research shows that adults who report puffing e-cigarettes, or vaping, are significantly more likely to have a heart attack, coronary artery disease and depression compared with those who don’t use them or any tobacco products.
Little was known about cardiovascular events and e-cigarette use, until now
E-cigarettes are battery-operated, handheld devices that mimic the experience of smoking a cigarette. They work by heating the e-liquid, which may contain a combination of nicotine, solvent carriers (glycerol, propylene and/or ethylene glycol) and any number of flavours and other chemicals, to a high enough temperature to create an aerosol, or “vapor,” that is inhaled and exhaled.
Mohinder Vindhyal, MD, assistant professor at the University of Kansas School of Medicine Wichita, USA, and the study’s lead author, explains: “Until now, little has been known about cardiovascular events relative to e-cigarette use. These data are a real wake-up call and should prompt more action and awareness about the dangers of e-cigarettes.”
The popularity of e-cigarettes
According to Vindhyal, there are now more than 460 brands of e-cigarettes and over 7,700 flavours.
E-cigarettes have been gaining in popularity since being introduced in 2007, according to researchers’ sales have increased nearly 14-fold in the last decade.
But they are also heavily debated— advertised by some as a safer alternative to smoking tobacco, while others are raising concerns about the explosion of vaping among teens and young adults.
Details of the study
This study found that compared with nonusers, e-cigarette users were 56% more likely to have a heart attack and 30% more likely to suffer a stroke. Coronary artery disease and circulatory problems, including blood clots, were also much higher among those who vape—10% and 44% higher, respectively.
This group was also twice as likely to suffer from depression, anxiety and other emotional problems.
Most, but not all, of these associations held true when controlling for other known cardiovascular risk factors, such as age, sex, body mass index, high cholesterol, high blood pressure and smoking.
After adjusting for these variables, e-cigarette users were 34% more likely to have a heart attack, 25% more likely to have coronary artery disease and 55% more likely to suffer from depression or anxiety. Stroke, high blood pressure and circulatory problems were no longer statistically different between the two groups.
Cigarette smoking is dangerous, but that doesn’t mean e-cigarettes are safe either
“Cigarette smoking carries a much higher probability of heart attack and stroke than e-cigarettes, but that doesn’t mean that vaping is safe,” Vindhyal said, adding that some e-cigarettes contain nicotine and release very similar toxic compounds to tobacco smoking. Nicotine can quicken heart rate and raise blood pressure.
However, there are some limitations to the research.
The study design doesn’t allow researchers to establish causation, but Vindhyal said it does show a clear association between any kind of smoking and negative health outcomes.
He added that self-reported data is also subject to recall bias. The researchers were also unable to determine whether these outcomes may have occurred prior to using e-cigarettes. Further longitudinal data is needed.