The American Heart Association is sounding an alarm as mounting scientific evidence links e-cigarette chemicals to potentially serious cardiovascular harms. In a statement drawing on recent studies and its own 2023 scientific statement, the association warns that many users and policymakers may underestimate the risks of vaping.
Contrary to common misconceptions that e-cigarette aerosol is harmless water vapor, the U.S. Food and Drug Administration notes that it typically contains a mix of chemicals, additives, sweeteners and flavoring agents, including substances classified as harmful or potentially harmful. A study published earlier this month in Circulation: Arrhythmia and Electrophysiology found that synthetic cooling chemicals used in some e-cigarettes may disrupt heart rhythm, raising concerns about irregular heartbeat and cardiac arrest.
“We’ve long known about the health threats of cigarettes and other traditional tobacco products, but as increasing numbers of e-cigarettes and other newer nicotine products are introduced into the market, we are learning more about the health threats of these products,” said Jason J. Rose, M.D., M.B.A., American Heart Association volunteer and associate professor at the University of Maryland School of Medicine. “A growing body of research shows that people who use e-cigarettes can be exposed to chemicals that can harm the heart and blood vessels.”
Multiple studies show that e-cigarettes expose users to toxic substances such as formaldehyde and heavy metals, which are linked to cardiovascular, respiratory and cancer-related risks. Nicotine, in addition to being highly addictive, can damage the heart and other vital organs. Researchers are increasingly able to quantify the levels of these chemicals in users.
Inhaling e-cigarette aerosol may contribute to oxidative stress, inflammation, damage to blood vessel function, and changes that can lead to atherosclerosis. Nicotine itself raises blood pressure and heart rate, narrows blood vessels, and forces the heart to work harder, potentially leading to heart attack, stroke and heart failure, according to the American Heart Association. One e-cigarette can contain as much or more nicotine as a pack of cigarettes, fueling addiction.
Claims that nicotine improves focus or memory are not supported by evidence. The Centers for Disease Control and Prevention notes that nicotine exposure, especially among young people, can harm brain development and affect attention, learning and impulse control. Most youth who use e-cigarettes report using flavored products, which increase the likelihood of continued use and transition to other tobacco products.
The American Heart Association supports policies to prohibit the sale of all flavored commercial tobacco and nicotine products, including menthol, and to expand access to proven cessation tools. “The tobacco industry relentlessly targets kids and communities with fruit-, candy- and menthol-flavored tobacco products,” said Nancy Brown, CEO of the American Heart Association. “No tobacco or nicotine product can be considered safe.”
