Position Paper: E-Cigarettes, Vaping are Associated With Heart Problems

A new position paper published by the European Society of Cardiology takes aim at vaping and e-cigarettes for their deleterious effects on the heart.

The authors began by noting that tobacco use is the single largest preventable risk factor for premature death, as well as the second leading cause of cardiovascular disease.

“In response to the harmful effects of tobacco smoking, the use of electronic cigarettes (e-cigarettes) has emerged and gained significant popularity over the past 15 years,” they wrote. “E-cigarettes are promoted as safe alternatives for traditional tobacco smoking and are often suggested as a way to reduce or quit smoking. However, evidence suggests they are not harmless.”

The paper goes on to say that one of the problems of the rapid adoption of e-cigarettes as an alternative to traditional tobacco products is that it has outrun regulators, which has resulted in mixed and weakened regulations overall. Another concern they cited was the widespread use of the products among adolescents and young people.

“While the long-term direct cardiovascular effects of e-cigarettes remain largely unknown, the existing evidence suggests that the e-cigarette should not be regarded as a cardiovascular safe product,” they emphasized. They pointed to a lack of robust clinical trial data and long-term cohort studies that would be able to examine use and outcomes over longer periods of time, creating uncertainty for chronic users.

While e-cigarettes have also been promoted for the purposes of smoking cessation for tobacco users, the authors noted that there are also no comprehensive data to suggest that e-cigarettes impact smoking cessation. Some observational studies suggested e-cigarettes are more effective than nicotine replacement therapies, other studies were inconclusive or showed no effect.

To this end, the authors urged practitioners to use caution when recommending the use of e-cigarettes to patients and the general public. They noted that there is mounting evidence suggesting they are at least indirectly harmful to health (and the heart), and also that there remains a risk that e-smokers may replace tobacco consumption with e-cigarette consumption rather than quitting altogether.

“Currently, there is a lack of robust longitudinal data on the impact of e-cigarettes on smoking cessation, and more research is warranted,” they concluded. “Nonetheless, health professionals should inform their patients and the general public of the possible cardiovascular and other risks of e-cigarette smoking. Continued monitoring and legislation to limit use is important.”