- Researchers say that e-cigarettes and tobacco cigarettes have similar negative effects on the human cardiovascular system.
- They add that smoking and vaping at the same time have even serious consequences for heart health.
- Both cigarettes and smoking are said to irritate the respiratory tract.
Two studies published today — one in humans, the other in rats — show similar cardiovascular effects of cigarettes and e-cigarettes.
The findings also show that smoking and cigarettes together lead to even more serious heart health problems.
The researchers report that the effects on blood vessel function are likely caused by airway irritation from inhalation of a foreign substance, rather than specific components of cigarette smoke or e-cigarette vapor.
The studies were published in the peer-reviewed Journal of the American Heart Association
“The goal of this project was to determine why a growing number of inhaled tobacco products, including combustible cigarettes, heatable tobacco products, and e-cigarettes, all impair endothelial function despite fundamental differences in these products,” said Matthew L. Springer, PhD. lead investigator on both studies and professor of medicine in the Division of Cardiology at the University of California, San Francisco, in
“Thousands of chemicals have been identified in tobacco smoke, some of which are also present in e-cigarette aerosols, either as an original ingredient or as a chemical reaction product of the heating process,” Dr Springer said. “We sought to discover which particular component of e-cigarette smoke or vapor might be responsible for interfering with the ability of blood vessels to function effectively.”
Both cigarettes and e-cigarettes cause endothelial dysfunction, the inability of large blood vessels to open up enough to supply enough blood to the heart and other tissues. This condition can be an early predictor of cardiovascular disease.
The Springer team
In the rat
Menthol is added to many tobacco products and can reduce the irritation caused by smoking and can play a major role in facilitating nicotine addiction.
The study found that blood vessel dilation was reduced by all four types of cigarettes, ranging from 20% to 46%. Higher levels of nicotine were associated with a greater reduction in FMD, and menthol was associated with a lower reduction in FMD.
Springer said menthol should not be assumed to be a beneficial additive in smoking and vaping products because the harm is still significant and menthol has other harmful effects.
“This study reaffirms what we doctors have known for years: that cigarette smoking is harmful to the lungs and heart,” Dr. Robert Goldberg, a pulmonologist at Providence Mission Hospital in Southern California, told Healthline. “While vaping was initially considered a safer option for helping people quit smoking, aerosol ingredients have not been evaluated by the US Food and Drug Administration.
“And e-liquid, when heated, is a powerful vasoconstrictor or blood pressure drug and delivers nicotine extremely quickly into your body. This poses a serious health risk to both your lungs and your heart,” he added.
Goldberg said the initial thinking was that vaping was safer because someone wasn’t inhaling harmful fumes.
“But we don’t know the exact chemical composition of the vaporizing liquid,” he explained. “What we do know is that other ingredients and chemical compounds found in the liquid have their own health risks. We are just beginning to understand the toxic side effects that inhaling e-cigarette vapor can have on our lungs and heart.
Rats were also exposed to two major gases found in smoke and aerosol, as well as pure carbon nanoparticles, to assess the effects on blood vessel dilation.
Gases and carbon particles show similar damage to all tobacco smoke, although they represent completely different chemical and physical components of smoke.
“We were surprised to find that this is not a specific foreign material that is inhaled and causes harmful cardiovascular effects. It’s the fact that some kind of irritant is inhaled in the first place, regardless of what it was,” Springer said. “All inhaled products are likely to have similar deleterious effects on vascular function.”
That may mean there’s less of a difference in harm between cigarettes and smoking, Patricia Folan, RN, clinical program director at Northwell Health Center for Tobacco Control, told Healthline.
“Many adults are documented to be dual users of combustible and e-cigarettes,” she said. “According to the study, this poses an even greater health hazard than using either alone.”
“This information is important to share with the public who may think they are helping themselves by cutting down on regular cigarettes and switching to a vape product by using both at the same time,” Follan said.
Dr. Thomas Yadegar, a pulmonologist and medical director of the intensive care unit at Providence Cedars-Sinai Tarzana Medical Center in California, told Healthline that “every type of inhaled agent, regardless of origin, has an effect on the blood vessels in the airways. This is the main prerequisite for the use of inhaled drugs.
“While inhalers and nebulizers seek to dilate airways via blood vessels, inhalation of smoke, fumes, dust or other environmental factors can start a cascade of inflammation,” Yadegar said.
Springer said the lack of a specific toxin accounting for vascular damage means regulatory agencies cannot rely on banning specific ingredients to avoid the adverse effects of inhaled products.
The second study found that long-term vaping and cigarette smoking cause changes in the blood that affect endothelial function, albeit in different ways.
“Our findings suggest that vaping, despite not smoking combustible cigarettes, causes changes in the blood that increase the potential for leakage in blood vessels, and that both smoking and vaping cause changes in the blood that lead to endothelial dysfunction and increased risk of future heart attacks.” -vascular events in otherwise healthy people,” Springer said.
“It is important that regulators, clinicians and the public realize that vaping is not harmless,” he added. “Smoking and vaping can have similar harmful cardiovascular effects, but each condition causes some potentially harmful effects that the other does not. These differences suggest that dual product use, meaning smoking combustible cigarettes and also using e-cigarette products, may actually be worse for vascular health than either smoking or the cigarette alone.
Doctors say that however you interpret the studies, quitting smoking and smoking cigarettes is the best way to deal with the danger.
We know that the evidence-based way to quit smoking is through consultation with a ‘quit coach’ in combination with nicotine replacement therapy (eg patches, gum, lozenges etc.) sold in local pharmacies over the counter prescription,” Mary Martinasek, a respiratory therapist and associate professor of public health at the University of Tampa in Florida, told Healthline.
“This method is the only evidence-based approach to quitting,” Martinasek said. “Smokefree.gov outlines this information. Many states, such as Florida, offer these products for free and free ‘coach exit’ consultations.”
“If it’s for a teenager, the American Academy of Pediatrics advises doctors to prescribe nicotine replacement therapies to those under the age of 18,” she added.