E-cigarettes don’t produce the same mix of toxic chemicals as conventional cigarettes, but US research shows that the battery-powered devices are far from harmless for your heart, writes Sandra Gordon for Everyday Health.
The notion that e-cigs are better for your health than conventional cigarettes may have gone up in smoke.
In the largest cross-sectional study to date examining e-cigarettes and stroke presented at the American Stroke Association’s 2019 International Stroke Conference in Hawaii, researchers found that the odds of having a stroke were 71 percent higher in e-cigarette users compared with nonusers. Similarly, the odds of a heart attack or angina (chest pain) were 59 and 40 percent higher, respectively, in e-cigarette users compared with nonusers.
Paul Ndunda, MD, the study’s lead researcher and an assistant professor in the school of medicine at the University of Kansas in Wichita, says that the results could mean one of two things: e-cigarettes may directly cause stroke, heart attack, and angina; or, e-cigarette users are different from nonusers (they may have a higher risk of stroke to begin with compared with nonusers, for example).
“We can’t draw an exact conclusion from these findings because this study doesn’t follow participants over time,” says Dr. Ndunda. “We need a long-term study that’s designed to parse those out.”
Ndunda and his team evaluated a database of 400,000 respondents from the 2016 behavioral risk factor surveillance system study, which included 66,795 respondents who reported regularly using e-cigarettes and 343,856 reporting never having used e-cigarettes.
Recognizing that e-cigarette users in the study may have also been current or former cigarette smokers, Ndunda and his team further analyzed the data to remove the effect of cigarette smoking – and found that e-cigarettes still fared poorly.
“In e-cigarette users who have never smoked, we found 29 percent higher odds of stroke, 25 percent higher odds of heart attack and 18 percent higher odds of angina, or coronary heart disease, compared with nonusers,” Ndunda says.
Can e-cigarettes help you quit?
Some e-cigarette users may use vaping to quit smoking as a kind of step-down process. A study published in January 2019 in the New England Journal of Medicine found that e-cigarettes were more effective in smoking cessation than nicotine replacement therapy, when combined with behavioral support.
But in its first policy statement on e-cigarettes 2014, the American Heart Association recommended using e-cigarettes for smoking cessation only as a last resort, after you’ve tried approved and tested quitting methods, which may include:
The nicotine patch, with or without a prescription medication such as buproprion (brand names Wellbutrin and Zyban) or varenicline (Chantix) to help you cope with nicotine cravings
Behavioral support, such as calling a quit line like 1-800-QUIT-NOW to speak with a trained quit coach.
Enlisting your doctor’s help. When you’re trying to be a quitter, especially if you’re considering using nicotine replacement products, “a conversation with your doctor is important,” Ndunda says.
- The nicotine patch, with or without a prescription medication such as buproprion (brand names Wellbutrin and Zyban) or varenicline (Chantix) to help you cope with nicotine cravings
- Behavioral support, such as calling a quit line like 1-800-QUIT-NOW to speak with a trained quit coach.
- Enlisting your doctor’s help. When you’re trying to be a quitter, especially if you’re considering using nicotine replacement products, “a conversation with your doctor is important,” Ndunda says.
E-cigarettes, which heat a liquid typically containing nicotine, flavorings, and other chemicals known to be toxic to humans (ethylene glycol, formaldehyde, and heavy metals) into an aerosol that users inhale, or vape, have been around in their current form for about 12 years. And very little research has been done on the devices, which can resemble traditional cigarettes, cigars, or pipes, or a USB flash drive.
This study points to the fact that vaping may not be safe for your cardiovascular system.
“If you don’t use e-cigarettes, don’t start,” Ndunda says.
Abstract 9: Electronic Cigarette Use is Associated With a Higher Risk of Stroke
Paul M Ndunda and Tabitha M Muutu
Introduction: In 2016, 3.2% of US adults and 11.3% of high school students reported using electronic cigarettes (e-cigarettes) in the preceding 30 days. Its use among young people increased by 900% between 2011 and 2015.
Stroke occurs in 795,000 people and causes 133,000 deaths annually in the US. The association between e-cigarette use and stroke is unknown. The purpose of this study was to determine the association between e-cigarette use and stroke.
The study is an analysis of the 2016 Behavioral Risk Factor Surveillance System (BRFSS) an annual chronic disease and behavioral risk factor survey conducted by the CDC. The sample included 66,795 respondents that reported ever regularly using e-cigarettes. The control group was the 343,856 respondents that reported never using e-cigarettes. Odds ratios were calculated using logistic regression analysis. Among the covariates tested, age, sex, smoking status, diabetes, exercise and Body Mass Index (BMI) categories showed significant effects on the model and were adjusted for in the outcomes.
Results: Overall 21% of BRFSS respondents reported ever using e-cigarettes, with 48.5% of them being female (P <0.0001). Compared with non-users, e-cigarette users had a lower mean age (44 vs 57 years [P <0.0001]), lower mean BMI (27.7 vs 28.1 [P <0.0001]) and a lower rate of diabetes (9.8% vs 12.1% [P <0.0001]). They however had higher rates of cigarette smoking (78.7% vs 37.4% [P <0.0001]). Compared with non-users, e-cigarette users had higher adjusted odds of stroke (OR 1.71 [1.64 – 1.8]), myocardial infarction (OR 1.59 [1.53 – 1.66]), angina or coronary heart disease (OR 1.4 [1.35 – 1.46]).
E-cigarette use is associated with higher odds of stroke, myocardial infarction and angina/coronary heart disease.