Vaping Health Risks: Study Links E-cigs to Heart Attack and Stroke—but There's More to It

People who smoke e-cigarettes are more likely to suffer from conditions including heart disease and stroke, research has suggested.

A preliminary study presented at the American Stroke Association's International Stroke Conference 2019, Honolulu, which has not yet been peer reviewed, linked vaping to cardiovascular disease. However, experts not involved in the work explained the association may come down to the past habits of vape users.

Between 2011 and 2015, the use of e-cigarettes in the U.S. has spiked by 900 percent, the authors of the research pointed out. The team at the University of Kansas wanted to provide an insight into the potential health implications of this habit, and specifically the potential risk of stroke.

The researchers studied 2016 data from the Behavioral Risk Factor Surveillance System survey, carried out each year by the Centers for Disease Control and Prevention. 66,795 respondents used e-cigarettes regularly, while 343,856 had never used the devices. They also took into account information on the age and sex of participants, whether they smoked, had diabetes, how much they exercised and their BMI.

The fifth of respondents who used e-cigarettes were younger on average compared with non-users, at 44 years old compared with 57 years old; had a lower BMI score; and were less likely to have diabetes.

But vape users were also more likely to smoke cigarettes, and had higher chance of suffering from a stroke, angina and coronary heart disease, according to the study.

Dr. Paul Ndunda, study author and assistant professor in the School of Medicine at the University of Kansas in Wichita, told Newsweek this study is the first to show an association between e-cigarette use and stroke. It is also one of the largest studies to show an association between e-cigarette use and heart disease, he said.

However, he acknowledged his study was limited in several ways. It was cross-sectional, meaning it does not prove causation but only association between disease and vaping. And e-cigarette and smoking were not quantified in the data, only if the participants were smokers or non-smokers.

"This research calls for well designed, large, long-term population studies to assess whether e-cigarettes cause stroke and cardiovascular disease," he said.

Dr. Aaron Scott of the Institute of Inflammation and Ageing at the University of Birmingham, U.K., who was not involved in the study, explained to Newsweek: "This abstract doesn't tell us much more than what is already known.

"Most of the people using e-cigarettes are going to be ex-smokers and, as such, they will have a history of tobacco use and a higher risk of heart disease. The effects of nicotine on atherosclerosis [where plaque builds up inside your arteries] are also already well investigated.

"In terms of cardiovascular damage, the nicotine in e-cigarettes may, in the long run, prove to have similar effects to smoking traditional cigarettes but until long term sequential data is obtained it remains speculation."

His colleague, Professor David Thickett, also of the Institute of Inflammation and Ageing, agreed that observational studies such as this need to be "backed up by cohort studies that are followed over time."

Addressing the potential harms of vaping more generally, Ndunda said there is still a lot that we don't know about health effects of e-cigarettes.

"In addition to other known risks of e-cigarettes, there may be risks to brain and heart health. Therefore; those who haven't started vaping and don't smoke combustible cigarettes are probably better off not starting vaping. Those that are vaping, for purposes other than quitting smoking are probably better off stopping. Those that vape as a smoking cessation aid need to have a discussion with their doctors. There may be other effective methods suitable for them."

He pointed out the FDA has not approved e-cigarettes in the U.S. for smoking cessation.

However, Ndunda stressed research suggests regular cigarettes "present more health risks than e-cigarettes and e-cigarettes may have a role in quitting for some smokers but there is need for more research in this area and the public health implications of recommending e-cigarettes for smoking cessation is complicated."