One e-cigarette can hold as much nicotine as a pack of cigarettes, or more. That detail sits near the center of a new statement from the American Heart Association, which says the evidence is now strong enough to answer a question people keep asking: is vaping bad for my health? Its answer is yes.
The association says several chemicals found in e-cigarettes, and produced when the devices are used as intended, may harm the heart. It issued the statement as policymakers weigh how to handle a fast-changing market for tobacco and nicotine products.
More than water vapor
E-cigarette aerosol is often written off as harmless water vapor. According to the U.S. Food and Drug Administration, it usually carries a mix of chemicals, additives, sweeteners and flavoring agents, some of which the agency classes as harmful or potentially harmful.
Studies have found that e-cigarettes expose users to toxic substances such as formaldehyde and heavy metals, which are tied to cardiovascular, respiratory and cancer-related risks. A study published earlier this month in Circulation: Arrhythmia and Electrophysiology found that synthetic cooling chemicals used in some e-cigarettes may disrupt heart rhythm. The researchers pointed to possible risks including irregular heartbeat and cardiac arrest.
“We’ve long known about the health threats of cigarettes and other traditional tobacco products, but as increasing numbers of e-cigarettes and other newer nicotine products are introduced into the market, we are learning more about the health threats of these products,” said Jason J. Rose, M.D., an association volunteer and chief of pulmonary, critical care and sleep medicine at the University of Maryland School of Medicine. Rose chaired the writing group for the association’s 2023 scientific statement on e-cigarettes. “A growing body of research shows that people who use e-cigarettes can be exposed to chemicals that can harm the heart and blood vessels.”
Nicotine and the heart
Research suggests that breathing in the aerosol may feed oxidative stress and inflammation, along with changes in the body that lead to atherosclerosis, the buildup of fatty plaque in the arteries.
Nicotine adds its own load. It can raise blood pressure and heart rate, narrow blood vessels and make the heart work harder. Over time, the association says, that can lead to heart attack, stroke and heart failure. Nicotine can also increase clotting and contribute to peripheral artery disease, which cuts blood flow and raises the risk of serious events, lower limb amputation among them.
The addiction cycle is a problem in itself. A person feels calm for a while, then irritability, anxiety, trouble concentrating and strong cravings arrive as nicotine levels fall. Using nicotine again relieves the symptoms for a time, which keeps people using.
Focus claims and young users
Some products are marketed as sharpening focus and memory. The association says the evidence does not back lasting cognitive benefits. Nicotine may produce small, inconsistent short-term changes in attention, and in regular users those often reflect relief from withdrawal. The Centers for Disease Control and Prevention says nicotine exposure in young people can harm brain development and is linked to changes in attention, learning and impulse control.
Young people are the main worry. Most youth who use e-cigarettes report flavored products, which appeal to them and can make continued use, and use of other tobacco products, more likely. The association adds that adolescents are more prone to addiction even at lower levels of exposure.
What the association wants
The group has long backed policies to ban the sale of all flavored commercial tobacco and nicotine products, menthol included. It also supports access to proven cessation tools. FDA-approved nicotine replacement therapies, plus counseling, are safe and effective ways to ease withdrawal and improve the odds of quitting, it says.
Nancy Brown, the association’s chief executive officer, was blunt. “The tobacco industry relentlessly targets kids and communities with fruit-, candy- and menthol-flavored tobacco products that encourage use, facilitate addiction and increase profits,” she said. “No tobacco or nicotine product can be considered safe.”
Anyone trying to quit vaping or smoking should talk to a doctor about the options.
Sources
- Growing scientific evidence links e-cigarette chemicals to heart health risks
- Health effects of electronic cigarettes
