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Vaping and Your Heart: What We Know So Far

Young Woman Vaping

Vaping is more than a passing fad: 3,500 adolescents start vaping every day, and one in 20 Americans use e-cigarettes today.

It's popular for a few reasons. First, e-cigarettes don't produce smelly tobacco smoke. And the devices are often more affordable than cigarettes and come in a wide variety of designs and flavors.

In fact, when e-cigarettes first came on the market more than a decade ago, they were touted as a healthier alternative to regular tobacco products, especially for those trying to quit. But research has caught up over the last ten years, painting a grim picture of vaping's so-called health benefits, even compared to cigarettes.

In fact, some researchers posit that they're worse than cigarettes because they carry many of the same health risks but are more easily marketed to young people. Let's break down four major health risks associated with vaping.

Problem One: E-Cigarettes Contain Toxic Chemicals

Regular cigarettes contain about 7,000 chemicals, many of which are toxic. Researchers are still trying to determine exactly what chemicals are in e-cigarettes, but one thing is for sure: e-cigarettes don't contain fewer toxic chemicals than cigarettes.

One chemical in particular has made headlines in recent months. Vitamin E acetate is a thickening agent often used in modified vaping products or black-market e-liquids that contain THC, the main psychoactive ingredient in marijuana.

This chemical is believed to be behind the recent outbreak of lung injuries and deaths dubbed EVALI (E-cigarette or Vaping product use-Associated Lung Injury). That's why the Centers for Disease Control and Prevention recommends avoiding e-cigarette products that contain THC or purchasing e-cigarette devices from friends or online sellers.

Although many e-cigarettes don't contain Vitamin E acetate, vaping exposes the body to thousands of chemicals that are known to be toxic or not yet fully understood by researchers.

Problem Two: Your Heart and Blood Vessels Dislike Aerosol

Decades of research prove that smoking contributes to heart and lung problems. While research into vaping is still ongoing, recent studies have found that it's probably no better than traditional tobacco products. E-cigarettes emit an aerosol that consists of ultrafine particles in higher concentration than cigarette smoke. Exposure to these particles could exacerbate asthma and constrict arteries which could cause a heart attack.

Most e-cigarettes provide nicotine, which is highly addictive and harmful to the cardiovascular system. It raises blood pressure and spikes your adrenaline, which increases your heart rate and the chance of having a heart attack. In fact, a 2017 survey found that the odds of a heart attack increase by 42 percent among e-cigarette users compared to non-smokers. That's the same risk level as having diabetes.

What's more, vaping could damage important blood vessels. A 2019 study of twenty otherwise healthy smokers found that a single vaping episode caused the subjects' brachial artery (located in the upper arm) to stiffen. The inner lining of the artery — the endothelium, which helps vessels contract and regulates inflammation — stopped working correctly, too.

Endothelial cells appeared in another study. Stanford researchers reported in 2019 that e-cigarette flavorings damaged lab-grown endothelial cells, even in the absence of nicotine. The damage varied by flavor, with cinnamon and menthol among the worst offenders.

One matter still up for debate is how these effects compare with traditional tobacco products. While there's more work to be done, researchers found in 2019 that compared to tobacco smokers, e-cigarette users saw no increase in blood flow during mild exercise. Tobacco smokers saw a modest increase, and non-smokers saw the greatest increase.

Problem Three: Vaping Isn't Good for Your Lungs, Either

E-cigarette vapor and secondhand vapor contain a number of chemicals that have been linked to serious lung problems:

  • Diacetyl: A butter-flavored chemical that's been linked to lung disease
  • Formaldehyde: A chemical used in building materials and household products that could cause cancer
  • Acrolein: A herbicide linked to lung injury and COPD that could cause lung cancer
  • Benzene: A carcinogenic chemical used to create other chemicals including plastics, dyes, and pesticides
  • Heavy metals like nickel, tin and lead

Not surprisingly, researchers have linked e-cigarette use to lung problems. Researchers found in 2019 that vaping increases a person's likelihood of developing asthma and chronic obstructive pulmonary disease (COPD). If that sounds familiar, it's because these conditions are also more common among smokers than non-smokers.

Problem Four: Vaping Doesn't Make It Easier to Quit Smoking

Although individual reports suggest vaping makes it easier to quit smoking cigarettes, this isn't true for everyone. E-cigarettes have not received FDA approval as a smoking cessation device, and recent research found that people who tried to switch to vaping instead of cigarettes ended up using both.

Fortunately, there are many healthier ways to kick the nicotine habit.

The Bottom Line: Vaping Isn't Part of a Heart-Healthy Lifestyle

It's possible that once more research has been carried out, we'll find that e-cigarettes carry fewer health risks compared to cigarettes. But the opposite could be true, too, and initial findings seem to point that way.

Researchers still need to determine many things, like:

  • Does vaping increase COVID-19 complications?
  • What are the exact chemicals present in e-cigarettes?
  • The hazards to specific groups, like teens, older people, and those with heart and lung problems
  • What are the effects of vaping during pregnancy?
  • How to treat and prevent EVALI
  • The health risks associated with e-liquid flavorings, marijuana, and other drugs
  • The safety of various e-cigarette devices, which have different coils, power outputs, and compositions of e-liquids

That's a lot of unknowns — especially for a habit that's supposedly better than regular cigarettes.

When it comes to your heart, the healthiest approach is to never begin smoking or vaping in the first place. And if you already smoke or vape, work with your doctor and find a smoking cessation treatment that works for you.

Fact or Fiction on Vaping

  • Fiction: E-cigarettes produce harmless, scentless water vapor.
    • Fact: E-cigarettes produce an aerosol — not water vapor — that contains toxic chemicals that have been linked to heart and lung diseases and cancer.
  • Fiction: It's no big deal to try an e-cigarette once.
    • Fact: 20 percent of people who try an e-cigarette once become regular users.
  • Fiction: Most people start using tobacco around age 20.
    • Fact: Most people start using tobacco between the ages of 10 and 19.
  • Fiction: One JUUL e-cigarette pod contains less nicotine than two regular cigarettes.
    • Fact: One JUUL e-cigarette pod has as much nicotine as a pack of 20 regular cigarettes.
  • Fiction: E-cigarettes are a good way to quit smoking regular cigarettes.
    • Fact: Many adults who use e-cigarettes to help them quit smoking end up using both regular cigarettes and e-cigarettes.

About this Blog

The Penn Heart and Vascular blog provides the latest information on heart disease prevention, nutrition and breakthroughs in cardiovascular care.


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