In adolescents the use of e-cigarettes doubles the risk of starting to smoke traditional cigarettes, states a position paper from the European Society of Cardiology, published on 30 July 2020 in the European Journal of Preventive Cardiology.
"Vaping is marketed towards teenagers and the tobacco industry uses celebrities to promote it as being healthier than smoking," said senior author Professor Maja-Lisa Løchen of UiT, the Arctic University of Norway, Tromsø, in a news release from the European Society of Cardiology or ESC.
The release continues:
"Legislation on the marketing and sales of e-cigarettes varies enormously between countries,” says Løchen. “Action is urgently needed to halt the growing use in young people. The World Health Organization states that e-cigarettes are harmful to health."
Studies have reported that e-cigarette use in young people has increased from 5% in 2013 to nearly 25% in 2018. Up to 5% of adults use e-cigarettes, with wide variation between countries.
The position paper of the European Association of Preventive Cardiology (EAPC), a branch of the European Society of Cardiology, focusses on the cardiovascular effects of e-cigarettes – including devices that look like cigarettes and refillable vaporisers that do not look like cigarettes.
It calls on regulators to protect young people by limiting sales and advertising and banning sweet flavours which teens believe are less harmful.
Health risks
Research has shown that e-cigarettes raise blood pressure and heart rate, change the artery walls so that they become stiffer and less elastic, and inhibit the function of blood vessels by damaging their lining. Each of these four effects are risk factors for blood clots and fatty build-up inside artery walls which can cause heart attacks. A study last year found a link between e-cigarettes and heart attacks.
On top of the heart effects, evidence is accumulating that vaping has negative effects on the lungs and is detrimental to the developing foetus during pregnancy. Preliminary research indicates that e-cigarettes could cause cancer.
The release continues further:
It's not clear whether e-cigarettes can help people quit smoking, since studies have produced conflicting results. "When these studies are pooled together it does not show that e-cigarettes are more effective than conventional, well-tested stop smoking methods," said Løchen.
"In addition, people who use e-cigarettes for smoking cessation often end up being double consumers of both traditional tobacco cigarettes and e-cigarettes."
"E-cigarettes should only be used for smoking cessation if nothing else has worked and the individual is carefully monitored for adverse effects.”
According to the ESC release, Løchen concluded: "E-cigarettes are a relatively new product and the long-term health effects are unknown. Now is the time for politicians and regulators to act – with public health campaigns to increase awareness and legislation to halt uptake in young people."
Recommendations
Heart doctors and researchers recommend:
- Regulate advertising of e-cigarettes the same as tobacco to protect young people.
- Age verification procedures to prevent adolescents from accessing e-cigarette websites.
- Schools to educate children about the negative effects of e-cigarettes.
- Public campaigns to raise awareness of adverse effects and prevent initiation of vaping.
- Consider for smoking cessation only if conventional methods have failed and individuals are monitored for adverse effects.
- Avoid e-cigarettes during pregnancy.
Electronic cigarettes and health with special focus on cardiovascular effects: Position paper of the European Association of Preventive Cardiology (EAPC)
European Journal of Preventive Cardiology. Published on 29 July 2020.
Authors
Maryam Kayousi, Charlotta Pisinger, Jean-Claude Barthelemy Delphine De Smedt, Konstantinos Koskinas, Pedro Marques-Vidal, Demosthenes Panagiotakos, Eva Bossano Prescott, Monica Tiberi, Vassilios S Vassiliou and Maja-Lisa Lochen.
Abstract
Tobacco use is the single largest preventable risk factor for premature death of non-communicable diseases and the second leading cause of cardiovascular disease. In response to the harmful effects of tobacco smoking, the use of electronic cigarettes (e-cigarettes) has emerged and gained significant popularity over the past 15 years. E-cigarettes are promoted as safe alternatives for traditional tobacco smoking and are often suggested as a way to reduce or quit smoking. However, evidence suggests they are not harmless.
Discussion
The rapid evolution of the e-cigarette market has outpaced the legislator’s regulatory capacity, leading to mixed regulations. The increasing use of e-cigarettes in adolescents and young individuals is of concern. While the long-term direct cardiovascular effects of e-cigarettes remain largely unknown, the existing evidence suggests that the e-cigarette should not be regarded as a cardiovascular safe product. The contribution of e-cigarette use to reducing conventional cigarette use and smoking cessation is complex, and the impact of e-cigarette use on long-term cessation lacks sufficient evidence.
Conclusion
This position paper describes the evidence regarding the prevalence of e-cigarette smoking, uptake of e-cigarettes in the young, related legislations, cardiovascular effects of e-cigarettes and the impact of e-cigarettes on smoking cessation. Knowledge gaps in the field are also highlighted. The recommendations from the population science and public health section of the European Association of Preventive Cardiology are presented.
[link url="https://www.eurekalert.org/pub_releases/2020-07/esoc-vlw072820.php"]Vaping linked with heart problems[/link]
[link url="https://journals.sagepub.com/doi/10.1177/2047487320941993"]Electronic cigarettes and health with special focus on cardiovascular effects: Position paper of the European Association of Preventive Cardiology (EAPC)[/link]