Smoking is implicated in various cancers, including lung cancer, but its effect on the cardiovascular system is somewhat less discussed. However, smoking profoundly affects our blood vessels and, ultimately, our long-term heart health. Smoking traditional cigarettes can worsen atherosclerosis (the narrowing of the arteries) both in the heart and peripheral extremities, causing problems with limb health and even dramatically increasing the risk of a heart attack. Traditional smoking also constricts blood vessels around the body, meaning that the heart must work harder to pump blood. For example, the body will have a more challenging time fighting off infection after an injury or surgery. Healing is often compromised too. With the advent of E-cigarettes and so-called vaping, many believe it is an appropriate and significantly lower-risk alternative to traditional tobacco products. But is this the case? Should vaping be considered a suitable option for those trying to quit smoking? There is a lot we know and even more that we don’t.
The Safety of Vaping Compared to Traditional Smoking
Theoretically, by containing fewer toxic compounds, vaping compares favorably to traditional cigarettes, which these days are not pure tobacco but an amalgam of thousands of chemicals. That said, there is a much greater grey market in vaping products, which means some users will expose themselves to potentially toxic chemicals. This was highlighted by the outbreak of lung injury in early 2020. Sixty-eight people died, and hundreds more were injured, seemingly due to vitamin E acetate added to vape products. Vitamin E acetate is commonly used as a thickener for THC so it can be smoked in a vape. Sadly, it was also highly toxic for those injured or killed during this time.
We know that traditional smoking is terrible for virtually every part of the body, not least of which is the heart. Many people also use E-cigarettes and traditional cigarettes concurrently, creating a “worst of both worlds” situation. This concept of dual-use to curb traditional smoking is harmful and negates any benefit of vaping over a conventional cigarette.
With that said, preliminary data, which lacks any long-term follow-up, suggest that E-cigarette smoking is slightly less risky than traditional smoking despite being worse, of course, compared to complete abstinence.
As a Smoking Cessation Tool
Vaping has been touted as an alternative to smoking and a potentially effective smoking cessation tool. But is this true? And if not, why do we believe this misconception? The answer is complex but generally revolves around the additives in tobacco used for traditional cigarettes. It’s no secret that we inhale thousands of chemicals when smoking a conventional cigarette. However, E-cigarettes have their concerns, and impurities have even caused respiratory issues in some users. Furthermore, the long-term effects of vaping and E-cigarettes indeed are not known. While it may seem like vaping offers a low-risk smoking experience, the evidence suggests otherwise.
The Direct Effects on the Heart
As more research comes out on the effects of vaping, we have seen that many vape products can increase blood pressure and the secretion of adrenaline around the body. This increases the user’s heart rate and, likewise, the risk of a heart attack, especially in those more susceptible to heart disease.
Vaping has also been linked to increased cholesterol buildup in the arteries, hardening of the arteries, and improper blood clotting, which can all contribute to cardiovascular problems.
Ultimately, the answer is to avoid both vaping and traditional tobacco smoking. Neither offers any benefits to the heart but represents a series of significant risks. This is particularly true of patients who require an interventional or invasive heart procedure. We encourage all our patients to pursue a smoking cessation program and begin reversing the effects of vaping or tobacco smoking on their cardiovascular health. In the meantime, tell your cardiologist if you are vaping to ensure we understand your complete risk profile.