Vaping as a risk factor for stroke

Electronic cigarettes, known as e-cigarettes or vapes, are battery-operated devices that delivers nicotine to users by turning a nicotine containing solution into a vapour that is inhaled.

It is widely used to help smokers give up tobacco but has also become increasingly popular among people who did not previously smoke, especially young people. Vapes often come in a variety of sweet and fruity flavours.

According to recent study in England, over a three-year period, the rate of vaping by those who were not regular smokers grew substantially – from one in 200 to one in 28. This increase was largely driven by young adults  among individuals aged 18 years1.

Vaping and cardiovascular disease

Vapes usually contain nicotine. Long-term nicotine exposure, even without the other harmful components of traditional cigarettes, can contribute to cardiovascular problems such as high blood pressure and an increased risk of heart disease and stroke. Some studies suggest that vaping may trigger inflammation in the body, including within the cardiovascular system, which is associated with  cardiovascular diseases including stroke2,3.

Vaping and stroke risk: Key points

Research on the cardiovascular effects of electronic nicotine delivery systems (ENDS), or vaping, is still relatively limited compared to traditional smoking. Early evidence suggests that vaping can have negative impacts on cardiovascular health but is an important tool in helping people give up smoking tobacco which is much riskier4.

A scientific statement in the American Heart Association Journal Circulation states: “From a population health perspective, any potential benefits of ENDS products as effective cigarette-cessation products, and the benefits to current smokers stopping cigarettes, must be balanced with the risks that non-smokers start using ENDS products exclusively or as a gateway to further tobacco product use”5

There is evidence indicating that younger adults who vape may be at increased risk for cardiovascular events, including stroke, especially if they have additional risk factors like obesity, hypertension, or a family history of cardiovascular disease6.

 

References

  1. Sarah E Jackson, Lion Shahab, Harry Tattan-Birch, Jamie Brown. Vaping among adults in England who have never regularly smoked: a population-based study, 2016-24. Lancet Public Health. 2024. Oct;9(10):e755-e765. https://doi.org/10.1016/S2468-2667(24)00183-X 
  2. Jonathan B. Berlowitz, Wubin Xie, Alyssa F. Harlow, Naomi M. Hamburg, Michael J. Blaha, Aruni Bhatnagar, Emelia J. Benjamin, Andrew C. Stokes. E-cigarette use and risk of cardiovascular disease: A longitudinal analysis of the PATH study (2013-2019). Circulation. 2022. May 17;145:1557–1559. https://doi.org/10.1161/circulationaha.1 21.057369
  3. Kai Zhao, Jing Li, Ping Zhou, Ling Xu, Mingfei Yang. Is electronic cigarette use a risk factor for stroke? A systematic review and meta-analysis. Tobacco Induced Diseases. 2022. November 14:20:101. https://doi.org/10.18332/tid/154364
  4. Adam P Klein, Karen Yarbrough, John W Cole. Stroke, Smoking and Vaping: The No-Good, the Bad and the Ugly. Ann Public Health Res. 2021. 8(1):1104. https://pubmed.ncbi.nlm.nih.gov/34322688
  5. Jason J. Rose, Suchitra Krishnan-Sarin, Vernat J. Exil, Naomi M. Hamburg, Jessica L. Fetterman, Fumito Ichinose, Miguel A. Perez-Pinzon, Mary Rezk-Hanna, Eric Williamson. Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products: A Scientific Statement From the American Heart Association. Circulation. 2023. Aug22;148:703–728. https://doi.org/10.1161/CIR.0000000000001160
  6. Mohinder R. Vindhyal, Paul M Ndunda, Cyrus M Munguti, Shravani R Vindhyal,  Hayrettin Okut. Impact on cardiovascular outcomes among e-cigarette users: a review from national health interview surveys. Journal of the American College of Cardiology. 2019. https://api.semanticscholar.org/CorpusID:87589736

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