Dual use of electronic and regular cigarettes increases heart attack risk more than either smoking or “vaping” alone, according to a new study.
Electronic cigarettes (e-cigarettes) are presumed to be safer than regular cigarettes, though the risks are largely unknown because research on them, especially long term, is lacking. As a result, e-cigarettes are being promoted as a way of quitting smoking and reducing tobacco-related illness. But e-cigarettes keep people addicted to nicotine, and many people who vape continue to smoke cigarettes, at least sometimes.
It’s well known that smoking tobacco greatly increases the risk of heart attacks and strokes. But e-cigarettes pose cardiovascular risks as well. They produce ultra-fine particles and various compounds that can increase inflammation, free radicals, and blood clotting; stimulate the sympathetic (fight-or-flight) nervous system; and impair the flexibility of blood vessels—all of which increase cardiovascular risk.
The study in question, in the American Journal of Preventive Medicine in October 2018, has found that people who both smoke and vape are at higher coronary risk than those who just smoke or just vape. Using data about almost 70,000 people from the U.S. Census Bureau’s National Health Interview Survey, researchers at the University of California, San Francisco, found that daily vaping by itself nearly doubled the risk of having a heart attack, while daily smoking nearly tripled it. But daily dual users of both electronic and regular cigarettes had a nearly quadrupled risk of heart attack compared to people who used neither product.
Some seemingly good news: While former smokers continued to be at elevated risk for heart attacks, former vapers did not. As the researchers noted, “It may be that the risks of e-cigarette use dissipate rapidly when someone stops using them, that some people briefly experiment with e-cigarettes and stop using them before any lasting damage is done, or that e-cigarettes have not been available long enough to cause permanent damage to the cardiovascular system.” But former vapers, as defined by the study, included people who used as little as one e-cigarette in the past, so this may have led to an underestimation of the risk former vapers face.
More bad vaping news: a gateway to smoking
One big concern about e-cigarettes is that they can get kids hooked on nicotine, increasing the likelihood that they will end up smoking tobacco. Until now, this has been hard to quantify. In a study in JAMA Network Open in January 2019, researchers analyzed 2013-14 data from a national sampling of 6,123 children ages 12 to 15 who had never used regular or electronic cigarettes or other tobacco products. Over the next two years, the 9 percent of children who reported that they had tried vaping were four times more likely to go on to smoke as those who never vaped.
Based on these results, the researchers estimated that prior e-cigarette use was a “catalyst” for 22 percent of children who started smoking, which they extrapolated would work out to nearly 180,000 new young smokers nationwide over this two-year period. This raises “concerns that e-cigarettes may renormalize smoking behaviors and erode decades of progress in reducing smoking among youths,” the researchers warned.