E-cigarettes not a “healthy” cigarette

To a middle-aged smoker struggling to quit, e-cigarettes seem a healthier bet. The electronic version delivers nicotine to your body via water vapor instead of tobacco smoke. That’s got to be better.

But mounting evidence shows e-cigarettes are far from safe.

A recent study published in the Journal of the American College of Cardiology found several of the flavorings used in e-cigarettes caused damage to the cells that line the blood vessels. This type of cell damage is a known precursor to heart disease and strokes.

“The preliminary data is disconcerting,” said Andre Macedo Dias, MD, a cardiologist with Baptist Heart Specialists. “It raises awareness that we should not just use e-cigarettes as if they were completely harmless”

In the study, researchers exposed endothelial cells in a lab-grown setting to six e-liquids with different flavorings. The endothelium is a thin membrane lining the inside of the heart and blood vessels. The endothelial cells exposed to e-liquids showed signs of damage and death.

Killing endothelial cells is not a good thing. The blood vessels are supposed to be wide open pipes, Dr. Dias said. When the vessels become damaged, they sometimes regenerate with scar tissue. That’s how blockages begin.

“Anything that stretches the inner part of the arteries starts the progression of arterial sclerosis [a hardening or narrowing of the arteries],” he said. “It’s why we think vaping is going to lead to serious cardiovascular conditions.”

The findings matter, not just for smokers trying to quit, but also, for non-smoking teens, who are picking up e-cigarettes at an alarming rate.

A two-decade drop in teen tobacco smoking—from 28% in 1997 to 5% in 2018—has now been reversed by an epidemic of e-cigarette use. In 2018, 27.6% of teens said they had vaped at least once over the last month, according to a report by the U.S. Department of Health and Human Services’ Office of Adolescent Health.

“They want to smoke and they know regular cigarettes are dangerous,” Dr. Dias said. They think this is cool, and they believe it’s harmless. The consequences are still unknown, but this is the group that is going to become addicted to e-cigarettes and face those consequences.”

E-cigarettes came on the scene about a decade ago. Marketed as a smoking cessation device, the flavor and feel of e-cigs mimic regular cigarettes and allow users to progress over time to formulas that deliver lower and lower doses of nicotine.

Today E-cigarettes come in thousands of flavors. But critics say some, like bubblegum and tutti frutti, are targeting non-smoking teens. In 2016 the FDA outlawed the sale of e-cigs to anyone under 18. Federal policymakers have also made moves to regulate e-cig flavors.  

Even though e-cigarettes eliminate the tobacco smoke that irritates and inflames lung tissue, they still contain waste chemicals that could have long-term effects, Dr. Dias said. Several waste chemicals in tobacco cigarettes, for example, are known to cause cancer.

“It’s not like people are just vaping water,” Dr. Dias said. “We don’t have enough studies yet. But e-cigarettes should be used with caution and probably only as a last resort by a person who is really trying to quit smoking.”

Are you wondering how common habits affect your heart health? Speak to your Baptist Health primary care physician. Or visit baptistjax.com/heart to find a cardiologist near you.