Insignificant Impact of E-Cigarettes on Cardiovascular Disease Risk

Study Overview

A recent study published in the journal Circulation by the American Heart & Stroke Foundation indicates an insignificant impact of e-cigarette use on the risk of cardiovascular disease (CVD). The research specifically focuses on individuals who engage in “dual use,” meaning they complement their conventional cigarette consumption with e-cigarettes. Findings suggest that their risk of developing CVD is comparable to that of those who smoke only combustible cigarettes.

Are E-Cigarettes Harmful?

E-cigarettes have surged in popularity, often marketed as a “healthier” alternative to traditional smoking. However, existing research does not validate this assertion. E-cigarettes can contain various potentially harmful substances, including nicotine, metals, fine particulate matter, and other organic compounds. One study revealed that e-cigarette use can induce inflammation and oxidative stress, leading to tissue damage.

Long-Term Data on CVD Risk

A critical question remains: do e-cigarettes, similar to conventional cigarettes, elevate the risk of CVD? While short-term studies have compared CVD risk across different user groups, long-term data is limited.

Study Methodology

Participant Data Collection

Researchers from Boston University analyzed data from the Population Assessment of Tobacco and Health (PATH) study, which surveyed participants annually from 2013 to 2019. A total of 324,027 individuals aged 18 or older were eligible for the study, with 51% being women and 50% under the age of 35. Participants were categorized into groups: sole conventional cigarette users, sole e-cigarette users, dual users, and non-users.

Classification Criteria

Participants were classified based on their smoking habits: conventional cigarette smokers had smoked more than 100 combustible cigarettes in their lifetime and continued to smoke at the time of the study, while e-cigarette users also reported current use.

Study Findings

CVD Risk Comparison

Throughout the study, participants were screened for cardiovascular disease during annual check-ups. A total of 1,487 CVD cases were identified. The analysis revealed that e-cigarette users did not exhibit a higher likelihood of developing CVD compared to non-users. Additionally, dual users did not show a significant difference in CVD risk when compared to those who solely smoked conventional cigarettes. Co-author Andrew C. Stokes from Boston University noted, “Many smokers who attempt to use e-cigarettes for traditional cigarette smoking cessation actually continue using both products, becoming dual users, where we saw no reduction in cardiovascular risk.”

Need for Larger and Longer Studies

While the overall participant sample reached 324,027, researchers believe a larger sample could enhance the reliability of the findings. Within the sole e-cigarette and dual user groups, only 41 and 113 cases of CVD were recorded, respectively. Longer monitoring periods may yield more reliable results, as the “progressive development of CVD” suggests that individuals may require years of observation before CVD becomes evident.

References

Berlowitz, J.B. et al. (2022). E-cigarette Use and Risk of Cardiovascular Disease: A Longitudinal Analysis of the PATH Study, 2013-2019. Circulation; 145: 00-00. Doi: 10.1161/CIRCULATIONAHA.121.057369.
Tarran, R. et al. (2021). E-cigarettes and cardiopulmonary health. Function; 11: zqab004. doi: 10.1093/FUNCTION/ZQAB004.
National Addiction & HIV Data Archive Program. (2021). Population Assessment of Tobacco and Health (PATH) Study [United States] Public-Use Files. University of Michigan. Doi: 10.3886/ICPSR36498.v16.
Lewis, C. (2022). No health benefits among adults who used both e-cigarettes and traditional cigarettes. EurekAlert! Accessed May 9, 2022. Retrieved from https://www.eurekalert.org/news-releases/951601.