How Do E-cigarettes Affect Heart Health?
I see a fair number of individuals in my office who have switched from traditional cigarettes to vaping, thinking it’s safer and less damaging to their health. I’ve written about the dangers of vaping, especially among younger adults and teens. E-cigarettes can contain nicotine and other chemicals that are harmful to one’s health. A July 2018 study published in the SAGE journal, Vascular Medicine highlights a new danger associated with vaping e-cigarettes that contain nicotine. And vaper beware – the damage to your heart may be the same, or even worse, than a traditional smokers’ experience.
The usage of e-cigarettes may limit the inhalation of smoke, but it does not avoid the absorption of nicotine. Nicotine is the element that provides pleasure in the brain.
Cigarettes, vapor, and nicotine
The research study was a randomized trial that looked at use of three tobacco products – cigarettes, electronic cigarette with nicotine, and electronic cigarette without nicotine. The control group smoked a nicotine-free liquid. Fifteen active smokers who were blinded to the content of the vaping device, were studied before and two hours after smoking a cigarette and one of the two vaping devices. The researchers were interested in seeing the impact on peripheral and central blood pressures and arterial stiffness. In varying levels of import and precision, these are variables that measure heart and vascular function.
Central blood pressure is the pressure in the aorta, which is the large artery that receives blood pumped by the heart. It’s considered a good indicator of the pressure that the heart and other vital organs experience. Central blood pressure is considered an optimal predictor of vascular disease when compared to traditional peripheral blood pressure (taken with a cuff placed on your upper arm and a sphygmomanometer).
The subjects were all traditional smokers without a history of vaping or dual use. The subjects smoked one cigarette for at least five minutes, inhaling into their lungs, and then used one of the vaping options for five minutes (one puff every 30 seconds for ten puffs, with a single puff lasting four seconds). Using flavorings, subjects did not know if the vaping device contained nicotine in the fluid or not. Vital signs were monitored for two hours from the time smoking with each device commenced.
Effects on blood pressure and heart rate
The general findings were that cigarettes and nicotine-containing vaping devices had the same impact on participant blood pressure and heart rate, compared to nicotine-free vaping devices. Peripheral systolic blood pressure was elevated for 45 minutes after using a nicotine containing e-cigarette and for 15 minutes after smoking a traditional cigarette. Heart rate was also elevated for a full 45 minutes after vaping with nicotine, with the largest rate increase (more than 8 percent) in the first 30 minutes. Traditional cigarette smoking raised heart rate only for a duration of 30 minutes. No changes were noted in the nicotine-free vaping group.
Heart dangers are well associated with traditional cigarette smoking (nicotine). This research clearly identifies the immediate dangers of vaping with a nicotine-containing solution. Since this is one of the early studies on acute impact of vaping with nicotine-based solutions, there is clearly a need for more research to identify the impact of chronic use of nicotine-based e cigarettes.
E-cigarettes have been around for a relatively short time and their usage has increased widely especially among teenagers; patterns of use have been variable. There was at one point the thought that e-cigarettes were useful in helping to facilitate smoking cessation. The U.S. Family Smoking Prevention and Tobacco Control Act passed in 2009 mandated the need to publish the nicotine content of all cigarettes including e-cigarettes. This spurred the production of very low nicotine content (VLNC) cigarettes, which were hypothesized to be non-addictive. Studies, however, have shown that simply reducing the content of nicotine in the e-cigarettes does not reduce smoking dependence.
The vapor of e-cigarettes contains more nicotine than the smoke emanated from a regular cigarette being smoked.
Health risks remain in e-cigarettes
To emphasize the findings of this particular, though, it’s important to note that the average consumer assumes vaping and using e-cigarettes is “much safer” than using traditional cigarettes. E-cigarettes are also discussed as a tool for smoking cessation, though it appears that beginning a vaping habit because it’s perceived as safer than smoking cigarettes is also occurring among teens and young adults. If you look at advertising campaigns, vaping is the new cool. E-cigarettes have themes, flavorings, and are cornering the smoking market. Nicotine, whether delivered in a regular cigarette or e-cigarette is clearly associated with health risks. And when individuals vape, they may take more puffs or deeper puffs than a traditional smoker.
If I have a patient who is a smoker, I might be comfortable weaning them off cigarettes using a vaping tool with clearly planned decreasing levels of nicotine, and then having them switch to a nicotine-free liquid for a while. But the ultimate goal would be to get them off all smoking devices. I don’t think there is a “safe smoke” out there. Clearly, we need to elevate the discussion about all vaping devices and the known and newly discovered dangers associated with them, even as advertisers attempt to sell a “they’re safer” message about them to consumers.
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