Vaping more harmful to heart health than regular cigarettes

E-cigarette use, or vaping, could be more harmful to heart health than traditional cigarettes.

That’s according to preliminary results of two studies scheduled to be presented this week at the American Heart Association’s Scientific Sessions 2019.

The findings come at a time when vaping has caused more than two thousand cases of severe lung illness, known as e-cigarette, or vaping, product use associated lung injury (EVALI), across the nation and nearly 40 deaths. The exact cause of the EVALI is still unknown, though the CDC and states are investigating and have identified vitamin E acetate as a possible harmful additive linked in all the cases.

The preliminary findings are significant, as e-cigarettes were marketed as a safer alternative than smoking and some studies focused on their helpfulness of traditional smoking cessation. New data reveals the products may be just as––or more––harmful than traditional cigarettes.

"There is no long-term safety data on e-cigarettes,” Rose Marie Robertson, MD, FAHA, the American Heart Association's deputy chief science and medical officer, said in a statement. “However, there are decades of data for the safety of other nicotine replacement therapies."

Study findings

One of the studies found vaping can worsen cholesterol, triglycerides and glucose levels––factors for heart disease––on par with the effects of cigarettes. In this study, which measured 476 health adults, the e-cigarette users had higher LDL cholesterol, considered to be the bad type of cholesterol, and lower overall cholesterol compared to nonsmokers. HDL, or good, cholesterol was lower among people who both vaped and smoked traditional cigarettes. Of the group of participants, 94 were non-smokers, 45 smoked e-cigarettes, 52 smoked both traditional and e-cigarettes, and 285 smoked traditional cigarettes.

"Although primary care providers and patients may think that the use of e-cigarettes by cigarette smokers makes heart health sense, our study shows e-cigarette use is also related to differences in cholesterol levels,” study author Sana Majid, MD, a postdoctoral fellow in vascular biology at the Boston University School of Medicine, said in a statement. “The best option is to use FDA-approved methods to aid in smoking cessation, along with behavioral counseling.”

The second study further found vaping decreases blood flow to the heart more than cigarettes and is associated with coronary vascular dysfunction. The study analyzed the heart blood flow of 19 young adults between 24 and 32 immediately before and after smoking e-cigarettes or traditional cigarettes. The participants were examined at rest and after performing a grip exercise that simulates physiologic stress.

Researchers were surprised that blood flow decreased even at rest after participants smoked e-cigarettes.

"In smokers who use traditional cigarettes, blood flow increased modestly after traditional cigarette inhalation and then decreased with subsequent stress. However, in smokers who use e-cigs, blood flow decreased after both inhalation at rest and after handgrip stress," study author Florian Rader, MD, MS, medical director of the Human Physiology Laboratory and assistant director of the Non-Invasive Laboratory at Smidt Heart Institute at Cedars-Sinai Medical Center, said in a statement. "These results indicate that e-cig use is associated with persistent coronary vascular dysfunction at rest, even in the absence of physiologic stress."

Policy backlash

The epidemic of the EVALI cases has loomed so large, capturing national headlines, that the Trump administration recently announced it would move to ban all non-tobacco flavored e-cigarette products. Preemptively, Juul, one of the biggest vaping manufacturers, opted to stop selling mint flavored pods––the company’s most popular flavor.

President Trump also said he would meet with representatives from the vaping industry.

“Will be meeting with representatives of the Vaping industry, together with medical professionals and individual state representatives, to come up with an acceptable solution to the Vaping and E-cigarette dilemma,” Trump tweeted Nov. 11. “Children’s health & safety, together with jobs, will be a focus!”

The Trump administration’s notice to ban flavored vaping products has created a backlash among a certain sect of supporters, however. The future ban has turned into a single-issue vote for some who vape, NBC News reported.