AHA: E-cigarettes, vaping products may pose dangerous risks for heart, lungs
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Key takeaways:
- Use of e-cigarettes more than doubled among middle and high schoolers from 2017 to 2019.
- Components of e-cigarettes, including nicotine and flavoring agents, may pose health risks.
Emerging data suggest e-cigarettes and vaping products could increase risk for CV and pulmonary events and are not a “safe” alternative to combustible cigarettes, according to a new scientific statement from the American Heart Association.
“E-cigarettes deliver numerous substances into the body that are potentially harmful, including chemicals and other compounds that are likely not known to or understood by the user,” Jason J. Rose, MD, MBA, associate professor of medicine and dean of innovation and physician science development at University of Maryland School of Medicine, said in a press release. “There is research indicating that nicotine-containing e-cigarettes are associated with acute changes in several hemodynamic measures, including increases in BP and heart rate. There has been research showing that even when nicotine is not present, ingredients in e-cigarettes, particularly flavoring agents, independently carry risks associated with heart and lung disease in animals. Negative effects of e-cigarettes have been shown through in vitro studies and in studies of individuals exposed to chemicals in commercially available products.”
Use of vaping products among youths growing
In the statement, published in Circulation, researchers noted that e-cigarettes and vaping products are the most commonly used tobacco products among youths — with very little data available to assess the impact of these products on a vulnerable age group.
“Data from Monitoring the Future Survey showed that current e-cigarette use more than doubled from 2017 to 2019 among middle and high school students,” the researchers wrote. “In 2019, 25.5% of 12th graders reported current e-cigarette use compared with 11% in 2017.”
Additionally, data show that almost three of four young people using e-cigarettes exclusively reported using flavored tobacco products.
E-cigarettes and vaping products are often touted as a “safer” alternative and even as potential tobacco-cessation products because of their more limited ingredients and the absence of combustion, the researchers wrote, and more research is needed on e-cigarette products before determining whether they pose fewer risks than combustible cigarettes.
“The outbreak of e-cigarette or vaping product use-associated lung injury in the United States in 2019, which led to more than 2,800 hospitalizations, highlighted the risks of e-cigarettes and vaping products,” the researchers wrote. “Currently, all e-cigarettes are regulated as tobacco products and thus do not undergo the premarket animal and human safety studies required of a drug product or medical device.”
Acute CV, pulmonary effects unclear
There are limited clinical studies assessing the impact of e-cigarettes and vaping products on acute CV and pulmonary events, according to the scientific statement; however, researchers stated that prospective, long-term studies that assess CV events and symptoms such as chest pain and heart palpitations for people of all ages are needed. More research is also needed on people who report smoking traditional cigarettes along with e-cigarettes, or so-called dual users, compared with e-cigarette users and nonsmokers, according to researchers.
Data do show known health effects of specific components of vaping aerosols; nicotine also affects the vasculature by inducing vasoconstriction, resulting in elevated BP and impaired wound healing in the microvasculature, the researchers wrote. Emerging evidence suggests that the nicotine solvents propylene glycol and glycerol have cardiopulmonary effects, whereas animal models suggest that flavoring additives in e-cigarettes have “differing toxicities” but are likely an important source of cardiopulmonary toxicity.
The statement notes that any long-term effects of e-cigarettes may take decades to emerge.
“Because e-cigarettes and other vaping systems have only been in the U.S. for about 15 years, we do not yet have enough information on their long-term health effects, so we must rely on shorter-term studies, molecular experiments and research in animals to try to assess the true risk of using e-cigarettes,” Rose said in the release. “It is necessary for us to expand this type of research since the adoption of e-cigarettes has grown exponentially, especially in young people, many of whom may have never used combustible cigarettes.”
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