- This Is Your Heart on E-Cigarettes
- E-Cigarettes Aggravate Heart Diseases
- Dangerous Chemicals Are in the E-Cigarette Mix
- How to Kick the Nicotine Habit
- Heart Palpitations, Causes, Symptoms, And Treatments
- Heart Palpitations: Stress
- Heart Palpitations: Caffeine
- Heart Palpitations: Nicotine
- Heart Palpitations: Fever
- Heart Palpitations: Medicines
- Heart Palpitations: Low Blood Sugar
- Heart Palpitations: Overactive Thyroid Gland
- Heart Palpitations: Heart Rhythm Problems
- Heart Palpitations: Alcohol
- Heart Palpitations: See A Doctor
- Mysterious vaping-related lung illnesses are spreading across the US. Doctors say these are the symptoms to watch out for.
- Let’s talk about wet lung…
- Can anything else cause wet lung?
- What wet lung symptoms should I look out for?
- Vaping appears to be making hundreds of people sick. Doctors have no idea why.
- Doctors are treating a disease of unknown origin
- The illness caused the first known vaping death in America — and that’s scary given what we know about who is vaping
- A crackdown on e-cigarettes is underway
- While the respiratory illnesses may be new, we already know breathing vapor into lungs can irritate them
- Vaping has been tied to other serious health problems
- Listen to Today, Explained
- E-cigarettes may slow down your heart rate
- Studying e-cigarettes’ effects in mice
- E-cigarette aerosols slow down heart rate
- Relevance for human use
- E-cigarettes containing nicotine linked to increased risk of heart attacks and stroke, study finds
- Finding ways to quit
- The effects e-cigarettes have on the heart
- The dangers of nicotine found in e-cigs
- A final note
- Why should you quit?
- What makes cigarettes so toxic and dangerous?
- Carbon monoxide & nicotine: A dangerous duo
- Secondhand Smoke
- The bottom line
- E-cigarettes linked to heart attacks, coronary artery disease and depression
- Heart palpitations from vaping
- Vaping every day could double your risk of a heart attack, new research suggests
- ‘We’re the first people to show a long term impact of e-cigarettes’
- People who vape and smoke are most at risk
- Snowballing evidence of health concerns tied to vaping
This Is Your Heart on E-Cigarettes
E-Cigarettes Aggravate Heart Diseases
“An e-cigarette is a nicotine delivery system,” says Elliott Antman, MD, professor of cardiovascular medicine at Harvard Medical School in Boston. “Nicotine is known to increase heart rate and increase blood pressure.” This is risky business for people who already have an irregular heartbeat or dangerously high blood pressure.
“People with coronary artery blockages and people with congestive heart failure could be made worse by exposure to nicotine. They might develop chest pain or increased symptoms of heart failure,” says Dr. Antman. And a person with an arrhythmia — atrial fibrillation, for example — could have an episode provoked by nicotine, cautions Antman. “In a confined space, secondhand vapor could also expose people to nicotine, something they would not want to be exposed to.”
The precise way that nicotine changes heart function is a mystery. William T. Abraham, MD, director of the division of cardiovascular medicine and professor of internal medicine at Ohio State University in Columbus, says, “Nicotine causes sympathetic neural stimulation which, in turn, may raise blood pressure and heart rate.”
“Controversial evidence suggests that nicotine may disrupt the lining of blood vessels,” Dr. Abraham adds, “which may predispose users to the development of atherosclerotic plaques — hardening of the arteries — in blood vessels.”
RELATED: E-Cigarette-iquette: To Puff or Not to Puff?
Dangerous Chemicals Are in the E-Cigarette Mix
Consumers can choose from a dizzying array of possibilities among hundreds of brands and thousands of different flavors of e-cigarettes, and it’s impossible to know what exactly you are about to inhale into your lungs.
Antman says that because e-cigarettes haven’t been regulated, we don’t know what is in the product.
In addition to nicotine, other, sometimes undisclosed chemicals in e-cigarettes have health experts concerned. The artificial flavors and chemicals in these products are not yet FDA regulated or controlled in any way — but some are linked to disease. One known ingredient is propylene glycol, a dangerous chemical.
“Propylene glycol is particularly a risky substance to take into the body,” cautions Day. He notes that propylene glycol is broken down to a toxin called propionaldehyde, which is known to cause liver damage. “Propionaldehyde is also used in the manufacturing process of plastics,” says Day. “This is definitely not something someone would want to willingly consume.”
Further clinical studies on e-cigarettes are sorely needed. “The problem is that the research is incomplete. The explosion of marketing has outpaced the science about what we know,” says Antman. “Some disturbing reports show that formaldehyde can be produced. Formaldehyde is known to be a carcinogen, or to cause cancer.” New analysis has shown that the amount of formaldehyde exposure from e-cigs is particularly high when they’re vaped at high voltage using a variable-voltage battery.
“Until more is known about the potential health risks of e-cigarettes, it’s probably best to avoid them unless your alternative is tobacco cigarettes that have well-known health risks,” notes Abraham.
How to Kick the Nicotine Habit
Getting the United States to the American Heart Association’s goal of a tobacco-free society will be harder as e-cigarettes gain hold in the marketplace. Leading health groups are weighing in on the scope of the problem and possible solutions.
A Centers for Disease Control and Prevention study published in August 2014 in the journal Nicotine and Tobacco Research found that the numbers of middle school and high school kids on e-cigarettes tripled from 2011 to 2013. A recent policy statement of the American Heart Association published in August 2014 in the journal Circulation calls for strong, swift steps to regulate e-cigarette products in order to prevent sales to young people not yet hooked on nicotine.
As of August 2016, it’s illegal in the United States to sell e-cigarettes to those younger than 19, due to new FDA regulations.
“This is a very important policy statement for the American Heart Association to make. A whole new generation of Americans could become addicted. In the past 50 years, 20 million died because of tobacco — all preventable,” says Antman.
The World Health Organization also reported a need for regulating e-cigarettes to minimize potential health risks around the world, due to chemicals considered to be toxins.
In some cases at the personal level, using e-cigarettes to quit smoking regular cigarettes could be a net gain for a smoker who has heart disease. “If an e-cigarette is used as part of a smoking cessation program, it could have benefit as a short-term bridge to abstinence,” says Day. “My worry is that e-cigarettes have been glamorized, and with this glamour we will soon see many more cases of heart disease in younger people.”
“For individuals who are smokers, our recommendation is to try the cessation aids that have been approved and regulated by the FDA — gum, patches, etc.” says Antman. If these don’t work, then it’s time to talk to your doctor about quitting and possibly considering e-cigarettes.
Antman stresses two important cautionary notes. First, we don’t know about e-cigarette safety in the long term. Second, e-cigarettes are not well regulated, and so we don’t actually know what’s in the products. Because of this, he recommends, “Avoid dual use of both cigarettes and e-cigarettes. Set a quick date to get off all forms of tobacco.”
March 15, 2005 — Smokeless tobacco boosts heart rate, blood pressure, and adrenalin.
The results have “potential implications” for heart risk, the study notes. The study was small and short, so it’s not the final word on smokeless tobacco. But the findings indicate cigarettes may not be the only tobacco product that affects the heart.
Smokeless tobacco, also called snuff or “spit” tobacco, is used by more than 5 million adults and more than 750,000 adolescents, say researchers. With more young men — especially athletes — using smokeless tobacco, the researchers were curious about its impact.
Experts have already tied smokeless tobacco to oral cancer and dental problems such as receding gums, bone loss, and bad breath. In 1986, the U.S. Surgeon General concluded that smokeless tobacco isn’t a safe alternative for cigarettes or cigars, according to the American Cancer Society (ACS). Smokeless tobacco may also lead to nicotine addiction, says the ACS.
Not as much is known about how smokeless tobacco affects the heart. But doctors do know that cigarettes are a heart hazard. Quitting smoking is widely regarded as one of the best things a smoker can do for his heart.
Heart Palpitations, Causes, Symptoms, And Treatments
Heart palpitations can cause light pounding, flutters, or skipped beats and they may or may not signal a serious disease. Knowing the symptoms and your health history will help you decide whether or not to call your doctor.
Heart Palpitations: Stress
Stress is the catalyst for many illnesses and heart problems is one of them. Intense emotions can trigger the release of hormones that speed up your heartbeat. Your body gets ready to face a threat, even if you’re not in danger. Panic attacks are intense bouts of fear that can last a few minutes. Symptoms include a racing heart, sweating, chills, trouble breathing, and chest pain. A panic attack can feel like a heart attack. If you’re not sure which one you’re having, get medical help.
Heart Palpitations: Caffeine
Caffeine has many positive health benefits but can also cause health trouble. For example, too many cups during the day, or very string coffee can lead to heart issues. Caffeine is a stimulant that raises your heart rate. One study found that caffeine from coffee, tea, might trigger palpitationsthem in people with heart rhythm problems.
Heart Palpitations: Nicotine
The addictive chemical in cigarettes and other tobacco products, nicotine raises your blood pressure and speeds up your heart rate. Quitting smoking is one of the best things you can do for your heart. Also, patches and other nicotine replacement products can make your heart race. Palpitations can also be a symptom of nicotine withdrawal, but they should stop within 3 to 4 weeks after you quit.
Heart Palpitations: Fever
When you have a fever during an illness, your body uses energy at a faster pace than usual. This can set off palpitations. Usually your temperature needs to be above 100.4 F to affect your heart rate.
Heart Palpitations: Medicines
Some prescription and over-the-counter medicines cause palpitations as a side effect, including:
- Antifungal medicines
- Antipsychotic drugs
- Asthma inhalers
- Cough and cold medicines
- Diet pills
- High blood pressure medicines
- Thyroid pills
Heart Palpitations: Low Blood Sugar
Skipped a meal can also lead to palpitations. When your blood sugar level drops, your body releases stress hormones like adrenaline to prepare for an emergency food shortage. Adrenaline speeds up your heart rate.
Heart Palpitations: Overactive Thyroid Gland
An overactive thyroid (called hyperthyroidism) can make too much thyroid hormone. This speeds up your heart so much that you feel it beating in your chest. Taking too much thyroid hormone to treat an underactive thyroid gland (called hypothyroidism) will also rev up your heartbeat.
Heart Palpitations: Heart Rhythm Problems
Atrial fibrillation (AFib) happens when the heart’s upper chambers, called the atria, flutter instead of beating normally. This can signal serious heart issues that can eventually lead to a stroke or heart attack. Get it checked out fast.
Heart Palpitations: Alcohol
Alcohol can affect your heart. If you drink a lot, or just have more than usual, you might feel your heart beating faster or fluttering. Small amounts of alcohol may also trigger heart flutters even when they only drink a little bit.
Heart Palpitations: See A Doctor
Make a doctor’s appointment if they come more often or you also have symptoms like these:
- Chest pain or pressure
- Shortness of breath
- As of September 17, the CDC reported 530 cases of vaping-related illnesses in 38 states and confirmed seven deaths in six states.
- On September 11, the Trump administration announced it’s pushing forward a ban on all flavored e-cigarettes, including mint and menthol flavors, across the US.
- Health experts have been unable to pinpoint a root cause since the vape device industry is expansive and unregulated.
- So far, experts believe chemicals like formaldehyde and acrolein could be to blame, as well as vitamin E acetate.
- Here are vape-related illness symptoms to look out for if you’ve ever used a cannabis or nicotine vape.
- Visit Insider’s homepage for more.
On September 11, the Trump administration announced it’s pushing forward a ban on all flavored e-cigarettes, including mint and menthol flavors, across the U.S.
“The Trump Administration is making it clear that we intend to clear the market of flavored e-cigarettes to reverse the deeply concerning epidemic of youth e-cigarette use that is impacting children, families, schools and communities,” Health and Human Services Secretary Alex Azar said in a statement.
As vaping-related lung illnesses continue to lead to hospitalizations, medically induced comas, and even deaths across the United States, the Centers for Disease Control and Prevention is warning people about the risks of using e-cigarette devices, both with tobacco and cannabis products.
As of September 17, the CDC reported over 530 cases of vaping-related illnesses in 38 states and confirmed seven deaths in six states. The CDC, Food and Drug Administration, and doctors are telling anyone who uses e-cigarettes to vape to abstain while the two agencies work with local health departments to investigate the causes of the illnesses.
“It is at this point very clear that vaping is not only unhealthy, but it is very dangerous. This is not anymore a debate. I urge everyone to refrain from vaping anything,” Dr. Melodi Pirzada, a pediatric pulmonologist at NYU Winthrop, told Insider.
Health experts have been unable to pinpoint a root cause since the vape device industry is expansive and unregulated. So far, experts believe chemicals like formaldehyde and acrolein could be to blame, as well as vitamin E acetate, a component of vegetable oil that is often used to turn nicotine or THC into the aerosol users then inhale.
It’s possible that some of these ingredients don’t completely vaporize so when users inhale them, fluid enters the lungs and builds up, causing rare forms of pneumonia reported in many of the recent vape-related hospitalizations.
Here are the signs and symptoms that could be indicative of a serious lung problem if you’ve used any vape products. If they sound like your experience, seek medical care promptly. You can also call your local poison control center at 1-800-222-1222 if you’re concerned about your health after using an e-cigarette product.
- An 18-year-old woman developed hypersensitivity pneumonitis, a.k.a. “wet lung” after just three weeks of vaping.
- This is the first reported case of a teenager developing the condition after using e-cigarettes.
- Wet lung is an immune system disorder that affects the lung, and occurs in some people after breathing in certain substances they’re sensitive to.
Here’s a not-so-friendly reminder that vaping isn’t exactly harmless: An 18-year-old woman recently came down with something called “wet lung” after just three weeks of using e-cigs.
The news comes from a case study, published in the journal Pediatrics, which breaks down the story of formerly healthy woman who started vaping, and then started having trouble breathing, along with a cough and chest pain that got worse when she took deep breaths.
After just three weeks of vaping, her condition was bad enough to warrant an ER visit, where doctors admitted her to the pediatric ICU and started her on antibiotics. When her condition got worse, doctors had to intubate her (meaning, they put a tube into her windpipe to help her breathe) and put tubes in her chest to drain fluid that was building up in there. She was also put on a mechanical ventilator (again, to help her breathe).
The woman was eventually diagnosed with hypersensitivity pneumonitis, aka “wet lung,” a rare immune system disorder that affects the lungs, causing them to become inflamed as an allergic reaction to inhaled dust, fungus, molds, or chemicals, per the American Lung Association.
She was then treated with an IV of methylprednisolone, a drug that treats severe allergic reactions. She was able to stop using the mechanical ventilator within a few days. Hopefully, she tossed her e-cig after all that scariness, too.
The researchers point out that this is the first reported case of a teenager developing wet lung from vaping and should definitely raise some eyebrows with parents and pediatricians.
Let’s talk about wet lung…
Wet lung isn’t something everyone can get—it depends on how your body’s immune system reacts to certain substances, according to the National Heart, Lung, and Blood Institute. Certain factors also increase your risk of developing wet lung, like age, environment, family history and genetics, lifestyle habits, and sex or gender.
If you do come down with wet lung and it’s detected early, you’ll probably be okay. If it goes on long enough without treatment, and you continue to be exposed to whatever is irritating you, it can cause permanent scarring in your lungs—making it hard to breathe in the future, according to the American Lung Association.
Can anything else cause wet lung?
Plenty of things. The condition is also known as bird fancier’s lung, farmer’s lung, hot tub lung, and humidifier lung—you get the idea. You can develop wet lung from being exposed to the following things, according to the National Heart, Lung, and Blood Institute:
- Animal furs
- Air conditioner, humidifier, and ventilation systems
- Bird poop and feathers
- Contaminated foods like cheese, grapes, barley, sugarcane
- Contaminated industry products or materials like sausage casings and corks
- Contaminated metal working fluid
- Hardwood dusts
- Hay or grain animal feed
- Hot tubs
Again, wet lung is dependent on your immune system, so it’s possible to be exposed to these things and have no issues, says Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, Calif.
But with e-cigarettes, it gets tricky. The “juice” used in them usually contains nicotine, along with other solvents and flavors. When you atomize those ingredients (i.e., turn them into a vapor), it can be hard to know what, exactly, will trigger a reaction, says Osita Onugha, M.D., a thoracic surgeon and assistant professor of thoracic surgery at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, Calif.
“In general, this is a cautionary tale for young people who think that vaping isn’t as severe as smoking,” he says.
What wet lung symptoms should I look out for?
The symptoms of wet lung can vary depending on how severe your case is and how sensitive you are to the irritant, but they generally include a flu-like illness that causes a fever, chills, muscle or joint pain, or headaches, a rattling cough, chronic bronchitis, shortness of breath, weight loss, and fatigue, the American Lung Association says. People can even turn blue because they don’t get enough oxygen in, Casciari says.
If you develop any of these symptoms, talk to your doctor ASAP or get to your local ER. “You’re going to be in bad shape,” Casciari says. Wet lung can feel like the flu but, while the flu tends to crop up between October and May, wet lung can happen any time, the American Lung Association points out.
You might also notice that you have a dry cough or shortness of breath when you’re exposed to something in particular—that’s also a tip-off.
If you’re vaping in an attempt to quit cigarettes, don’t panic and assume that this will happen to you—Casciari says this is an “unusual reaction.” But it’s a good reminder that you really shouldn’t just take up a vaping habit for kicks. “This kind of thing is possible,” Casciari points out.
The bottom line: Developing wet lung from vaping is uncommon, but it’s definitely possible—so if you have any unusual reactions while smoking e-cigs, see your doctor ASAP.
Korin Miller Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more.
Vaping appears to be making hundreds of people sick. Doctors have no idea why.
It was the stream of young, otherwise healthy patients landing in the intensive care unit with trouble breathing that made Utah pulmonologist Dr. Dixie Harris suspect something was up.
The first patient presented at the Salt Lake City hospital, where Harris works, on August 6. The man, in his 20s, was vomiting and had aches and pains. He also couldn’t breathe properly. So Harris tried to figure out if an infection may be causing the problems — and found nothing.
“It’s not typical go to the ICU in that much distress without an obvious infection,” she told Vox. Within days, several more cases surfaced — and Harris and her colleagues at the Intermountain Healthcare hospital group started to suspect the cause may be vaping, or THC oils, since that’s the only thing the patients had in common.
In all, 47 cases of the vaping-related respiratory illness have been reported in Utah, part of a growing wave of 805 reported by 46 states and the US Virgin Islands since April, according to a Centers for Disease Control and Prevention (CDC) update on September 26. These cases are either confirmed (tests have shown there’s no infection causing the illness and vaping appears to be the only culprit) or probable (testing is still underway, or the patient has an infection but doctors don’t think it’s what causing their breathing troubles). The only other country to report a vaping-related illness case to date has been Canada.
All US patients used e-cigarette products, and many had vaped THC-containing products and/or nicotine-containing liquids. The CDC also confirmed that the death toll related to the outbreak has risen: There are now 12 deaths in 10 states. “And we do expect others,” said Anne Schuchat, principal deputy director at CDC, in a briefing last week.
Health officials are “working 24/7” to figure out what’s causing the problem, Schuchat said. The Food and Drug Administration’s office of criminal investigations also has “parallel investigative efforts” underway, though they haven’t named any target in the probe.
But again, both CDC and FDA officials have not singled out any particular cause and emphasized that no one product or substance has been linked to the outbreak. “I’d like to stress how challenging this situation is,” Schuchat said. Patients have been exposed to a variety of products and e-liquids, sometimes don’t remember what they used, or are reluctant or too ill to say. “I wish we had more answers,” she added.
For now, the CDC is advising everybody — except smokers who are vaping to quit combustible cigarettes — to avoid using e-cigarette products, particularly those purchased off the street. Health officials are also asking consumers to stop modifying e-cigarettes or adding “substances to these products that are not intended by the manufacturer.”
These cases, officials warned, could wind up being the most severe manifestation of an even broader range of illness. And this disease is not the only alarming health problem recently linked to vaping. That’s why the way we view the safety of these devices is likely to change in the coming weeks and years. Here’s what we know so far.
Doctors are treating a disease of unknown origin
Patients who have come down with the mystery illness started to experience symptoms anywhere from a few days to several weeks after using e-cigarettes. So far, the patients have a few things in common, according to the CDC. They suffered from respiratory symptoms, including coughing, shortness of breath, chest pain, and difficulty breathing. Nausea, vomiting, diarrhea, fatigue, abdominal pain, fever, and weight loss were also common symptoms. (Harris, the Salt Lake City pulmonologist, said that in her patients, the breathing troubles always followed the gastrointestinal issues.)
Last week, the CDC shared details of the groups hardest hit: nearly three-quarters of the cases were male, and two-thirds were aged 18 and 34. Alarmingly, 16 percent were younger than 18 years and more than half were under 25 years of age. Some patients have gotten seriously ill, even winding up in intensive care units on oxygen support through ventilators or intubation.
A New England Journal of Medicine study of 53 cases in Illinois and Wisconsin squares with the CDC’s findings. According to the report authors, patients were mostly male, generally healthy when they became ill, and had a median age of 19. Nearly all had to be hospitalized, and over half required management in the intensive care unit. Every patient reported e-cigarette use in the past 90 days, most reported using THC-based products, and the majority also reported using a nicotine-based product.
In a related editorial, the Harvard T.H. Chan School of Public Health’s David C. Christiani wrote that it might be the interaction of multiple ingredients that’s having toxic side effects. “E-cigarette fluids have been shown to contain at least six groups of potentially toxic compounds. … The effect of adding ingredients such as THC or CBD to this mix needs to be investigated.”
On lung X-rays, the lungs appear to be inflamed, as if a pathogen infected them. But when doctors have tried to find a common bacterial or viral source of the disease, they’ve failed to turn anything up. Again, patients only have vaping in common, but no specific products or substances link all the cases together. That’s why an investigation is underway, and officials are urging doctors and the public to report cases. People who are concerned they’ve been harmed by an e-cigarette product should also contact their health care provider or local poison control center at 1-800-222-1222.
2/ This is important
NO single substance or e-cigarette product has been consistently associated with these illness reports.
— U.S. Surgeon General (@Surgeon_General) August 30, 2019
In the absence of a known cause, treating patients has proven tricky. Doctors have to consider a range of triggers, according to the CDC. Even though some patients who have been treated with steroids have shown improvement, health care providers are advised to only prescribe them on a case-by-case basis.
According to a September 5 statement from the New York State Department of Health, a single chemical — vitamin E acetate — has turned up in the cartridges of marijuana vape products respiratory illness patients from New York had been using.
“At least one vitamin E acetate-containing vape product has been linked to each patient who submitted a product for testing,” the state health department, which is tracking more than 30 cases of vaping-related illness, said. Even though vitamin E acetate is safely used in nutritional supplements, “its oil-like properties could be associated with the observed symptoms,” the statement read.
But CDC and FDA health investigators distanced themselves from New York’s findings, saying they still don’t know exactly what’s making people sick and that some of the products they’ve tested didn’t contain the chemical.
The illness caused the first known vaping death in America — and that’s scary given what we know about who is vaping
In the coming days, there may be more cases. It’s possible the death toll will rise, too.
On August 23, officials reported the first death linked to vaping amid the spate of illnesses. The patient — an adult woman in her 30s based in Illinois — with severe respiratory disease was hospitalized after vaping and died. No other details about the patient, what vaping products she used or her health status, were released to the public. A second death, in Oregon, was reported on September 4. By September 26, the total confirmed death toll rose to 12 across 10 states.
The potential seriousness of the disease is particularly frightening given who it seems to be mostly affecting: young people. This isn’t surprising since we know vaping has surged in this group.
According to preliminary data from a new National Institutes of Health survey, which has tracked substance use among American adolescents, there’s been another year-on-year surge in nicotine e-cigarette use between 2018 and 2019. According to the preliminary survey findings, which were released early this year, 1 in 4 high school seniors reported using nicotine e-cigarettes in the past 30 days, followed by 1 in 5 high school juniors, and 1 in 11 eighth graders. The rates were even higher for kids reporting vaping over the past 12 months.
These numbers topped the 2018 survey findings, when the number of high school seniors who say they vaped nicotine in the past 30 days doubled — the largest increase ever recorded for any substance in the survey’s 43-year history. It was also the same year Juul, a device designed to deliver a mega-dose of nicotine, which was marketed at youth, took over the US e-cigarette market.
A crackdown on e-cigarettes is underway
The new outbreak, together with this youth survey data, prompted the White House to announce that it’s planning to ban flavored e-cigarettes in the coming months. There’s ample evidence that flavors are among the top draws to vaping for adolescents. And that’s why states across the country are also cracking down.
On September 24, Massachusetts’s governor announced a four-month ban on e-cigarette products in the state, also declaring a public health emergency over the vaping-related respiratory epidemic. Michigan became the first state to approve a ban on e-cigarette flavors, and New York enacted a similar ban. Influential public health advocates, including Mike Bloomberg, have come out in favor of banning flavors as a way to curb the youth vaping epidemic.
Juul, the nation’s best-selling e-cigarette, is under severe scrutiny. On September 9, the FDA sent a warning letter to Juul, saying the company violated federal regulations by marketing Juul products as safer than smoking — including to schoolchildren — ahead of winning FDA approval to make those claims. Federal prosecutors in California, meanwhile, are investigating the company, as is the Federal Trade Commission, several state attorneys general, and the FDA.
While the respiratory illnesses may be new, we already know breathing vapor into lungs can irritate them
Even before the appearance of the mystery illness, researchers have been finding that vapor can irritate the lungs.
Researchers recently tracked 28,000 adults to tease out whether e-cigarettes exacerbate wheezing. Some of the people in the study were current vapers who used only e-cigarettes; others were smokers only; still others were dual users (who smoked and vaped); and finally, there were also folks who didn’t smoke or vape at all.
Compared with that last group, the non-users, the risk of wheezing among the vapers nearly doubled.
When the researchers looked at the study participants’ history of vaping or smoking, they came to even more interesting findings: The risk of wheezing was higher in current vapers who were also ex-smokers than in ex-smokers who did not vape. In other words, it wasn’t just a vaper’s potential history of smoking that was driving the uptick in wheezing among vapers. “Therefore,” the authors concluded, “promoting complete cessation of both smoking and vaping will be beneficial to maximize the risk reduction of wheezing and other related respiratory symptoms.”
Other studies have focused on whether e-cigarette users are more likely to develop chronic obstructive pulmonary disease (COPD), a set of lung complications that makes it hard to breathe. Research in mice and human airway cells showed that nicotine-containing e-cigarette vapor seemed to trigger “effects normally associated with the development of COPD.”
In preliminary human studies, researchers also found associations between regular vaping and COPD. But again, this human research was observational, not experimental, so it’s not yet clear that vaping caused COPD. (For example, it’s possible the people who have COPD are more likely to use electronic cigarettes, such as ex-smokers seeking a harm-reduction method.)
Vaping has been tied to other serious health problems
There’s still a lot we don’t know about the short- and long-term effects of using e-cigarette products, mostly because they haven’t been on the market for very long (and diseases related to vaping may take years or even decades to manifest).
Among the myriad health concerns: The FDA has been warning that nicotine-induced seizures could be a rare side effect of vaping.
There are also nicotine’s heart health concerns. “Nicotine does the same thing as cigarettes,” Neal Benowitz, a professor of medicine at the University of California San Francisco who’s been studying the link between e-cigarettes and heart health, told Vox previously. It can increase the adrenaline circulating in our bodies and activate the sympathetic nervous system (our fight-or-flight response), raising blood pressure, speeding up the heart rate, and causing the arteries — the vessels that carry blood — to narrow.
Even when vapor is nicotine-free, it may carry other heart health risks. The heating element in e-cigarettes emits tiny particles, sometimes including metals, which can lodge themselves deep into the lungs and get absorbed into the body’s circulatory system. “That’s where we see the potential cardiovascular toxicity,” Maciej Goniewicz, one of the leading e-cigarette researchers based at Roswell Park Comprehensive Cancer Center in Buffalo, New York, told Vox previously.
Recent studies have shown that puffing on e-cigarettes increases concentration of these microscopic pollutants — in particular, PM2.5 and ultra-fine particles — in indoor environments.
Researchers don’t yet know what risks e-cigarette aerosol particles carry, but these tiny particles have been studied extensively in the context of air pollution and tobacco smoking. In those studies, researchers have linked exposure to small particles with a range of bad cardiovascular outcomes, including heart attacks, high blood pressure, and coronary artery disease.
Long-term health risks aside, a recent New England Journal of Medicine case study described a 17-year-old Nevada teenager who showed up in the emergency room after a VGOD e-cigarette exploded in his mouth. “He had a circular puncture to the chin, extensive lacerations in his mouth, multiple disrupted lower incisors, and bony incongruity of the left mandible,” the doctors who treated the boy wrote in their report.
For now, the spate of illness tied to vaping is a reminder that there are a lot of products out there that haven’t been tested by officials or regulated in any way.
“These cases demonstrate the importance of effective regulation,” said David Liddell Ashley, a former director of the office of science in the Center for Tobacco Products at the FDA. “Without premarket testing, reporting, and review, consumers become the test subjects.”
Listen to Today, Explained
Vox’s Julia Belluz explains what’s going on with the outbreak of a mysterious vaping-related respiratory illness that’s sweeping across the US.
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E-cigarettes may slow down your heart rate
The results of some new research, to be presented at the 2017 American Heart Association’s Scientific Sessions, reveal how electronic cigarettes affect heart rhythm and function in mice.
Share on PinterestE-cigarettes are particularly popular among high school students.
The new research was led by Daniel J. Conklin, Ph.D., an assistant professor at the University of Louisville in Kentucky.
Prof. Conklin and his colleagues set out to examine the effect of two aerosols commonly found in electronic cigarettes (e-cigarettes): propylene glycol and vegetable glycerin.
Although more and more people turn to e-cigarettes because of their perceived diminished health risks when compared with traditional cigarettes, the Centers for Disease Control and Prevention (CDC) warn that aerosols often contain cancer-causing chemicals and heavy metals, among other things.
The CDC also admit that the exact “health effects and potentially harmful doses of heated and aerosolized constituents of e-cigarette liquids are not completely understood.”
The new research — which will be presented at the American Heart Association’s (AHA) Scientific Sessions 2017, held in Anaheim, CA — brings us one step closer to understanding these health effects, with a focus on their impact on the cardiovascular system.
Studying e-cigarettes’ effects in mice
Prof. Conklin and team set out to examine the “acute electrocardiogram (ECG) effects of inhalation exposure” to the aerosols in so-called electronic nicotine delivery systems (ENDS).
ENDS include e-cigarettes and any other product that produces “an aerosolized mixture containing flavored liquids and nicotine that is inhaled by the user.”
The researchers also wanted to see how these effects would fare compared with mainstream cigarette smoke.
To this end, they exposed healthy male mice to ENDS for 9 minutes, a period of time that qualifies as acute exposure. The mice had ECG transmitters implanted in them.
Additionally, the mice were exposed to smoke from traditional cigarettes with and without nicotine, as well as to ENDS constituents. The ECG measurements were compared with “time-matched, filtered-air controls.”
E-cigarette aerosols slow down heart rate
The researchers found that being exposed to both ENDS aerosols and mainstream cigarette smoke quickly slowed down the rodents’ heart rate.
In other words, they induced bradycardia. This is a condition that can sometimes cause problems, especially in older individuals. Doctors say that although not always an issue, bradycardia is something that people should get checked out if they have accompanying symptoms.
The researchers also found that exposure to the two aerosols extended the heart’s electrical cycle.
Similar to mainstream cigarette smoke, the authors conclude, “ENDS aerosols strongly affect cardiovascular function in mice.”
“Heated humectants generate aldehydes,” they add. Aldehydes are toxic and known to contribute to cardiovascular and pulmonary disease.
Acrolein, acetaldehyde, and formaldehyde were also released when the two aerosols were heated. Of these, only acrolein seemed to cause a slow heartbeat in the mice.
Finally, the study also revealed that, before their heart rate dropped, the mice also exhibited an increase in blood pressure.
The evidence “suggests that the use of ENDS may increase risks of arrhythmia and overall ,” conclude the researchers.
Relevance for human use
In their policy statement on the toxicity of e-cigarettes, the AHA write, “Although animal models have obvious limitations, these models could be useful in assessing the pharmacokinetic, pharmacodynamic, and toxicokinetic properties of e-cigarette exposures.”
“The pathophysiological outcomes and biomarkers, identified in animal studies,” they add, “should also be evaluated in controlled human exposure studies to develop validated concordance between animal and human data.”
It is worth mentioning that e-cigarette smoking is becoming more and more prevalent, particularly among young people. In fact, between 2013 and 2014, the number of young adults who said that they had used e-cigarettes at least once in their lives doubled.
In 2016, over 11 percent of high schoolers and more than 4 percent of middle school students admitted to having used e-cigarettes.
Many people consider e-cigarettes a healthier alternative to regular cigarettes.
But according to a new study, they could increase your risk of heart attack and stroke if they contain nicotine.
Researchers from the Karolinska Institute, a medical university in Stockholm, found that vaping devices containing nicotine can result in a stiffening of the arteries, as well as an increase in heart rate and blood pressure.
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Sharing the full story, not just the headlines
Vaping is now a £1billion industry in the UK, and the market is still growing too.
E-cigarettes are commonly considered to be a stepping stone for people trying to quit smoking entirely, but the new study suggests they may be more dangerous than previously thought.
The researchers recruited 15 healthy volunteers who’d never smoked e-cigarettes before for their study.
After running a series of tests, they found that 30 minutes after vaping, the participants had experienced a significant increase in blood pressure, heart rate and arterial stiffness.
These side effects weren’t experienced by the participants who’d smoked e-cigarettes without nicotine though.
Lead researcher Dr Magnus Lundback said: “The number of e-cigarette users has increased dramatically in the last few years. E-cigarettes are regarded by the general public as almost harmless.
“The industry markets their product as a way to reduce harm and to help people to stop smoking tobacco cigarettes. However, the safety of e-cigarettes is debated, and a growing body of evidence is suggesting several adverse health effects.
“The results are preliminary, but in this study we found there was a significant increase in heart rate and blood pressure in the volunteers who were exposed to e-cigarettes containing nicotine. Arterial stiffness increased around three-fold in those who were exposed to nicotine-containing e-cigarettes compared with the nicotine-free group.”
The study size was small and the effects were temporary, but Lundback believes repeated usage of e-cigarettes could have permanent effects.
Some experts, however, have spoken out about the study’s results.
Dr Tim Chico, Reader in Cardiovascular Medicine & consultant cardiologist, University of Sheffield, said:
“Electronic cigarettes are certain to have some health effects, and it is very important that non-smokers do not start using them erroneously thinking that they are harmless. However, the key question is whether they are as harmful as conventional cigarettes, and this seems very unlikely, particularly if they are used as a bridge to quitting all cigarettes completely.
“Although it is important to understand the effects of electronic cigarettes, this should not detract from the fact that smoking conventional cigarettes reduces life expectancy by ten years and causes chronic diseases that devastate quality of life.”
University of Iowa cardiologist Milena A Gebska, M.D., tells her patients that it doesn’t make a difference which kind of cigarette they’re smoking—traditional or electronic—the risks to heart health suggest that her patients stop smoking immediately.
Nicotine, found in traditional and electronic cigarettes, has proven to constrict blood vessels, temporarily raise blood pressure and heart rate, and elevate glucose levels. Blood vessel constriction is never healthy and can be particularly dangerous in patients who already have high blood pressure (hypertension), diabetes, or atherosclerosis.
The increasingly popular electronic cigarettes were introduced in 2008. Commonly known as “e-cigs,” these battery-operated cigarette devices involve the inhalation of vapors from liquid nicotine.
E-cigarettes are a popular alternative to smoking traditional cigarettes. While e-cigarettes do not contain the tar and smoke of traditional cigarettes, they do contain nicotine, which increases the risk of heart and vascular disease.
Finding ways to quit
Dr. Gebska says she takes the time to discuss with her patients different options to help with smoking cessation. She is sure to mention the risks that come with smoking e-cigarettes to those looking to switch from smoking traditional cigarettes to e-cigarettes.
Unfortunately, smoking any form of cigarette has its negative long-term effects on the heart. Therefore, if you have or are at risk of developing heart disease, avoid smoking entirely. Dr. Gebska recommends regular moderate intensity exercise as a wonderful adjunct to a smoking cessation program.
Those dealing with smoking addiction and wish to quit should speak with their doctor.
The effects e-cigarettes have on the heart
The CEO of the American Heart Association worries there will be an increased risk of developing nicotine addiction and heart issues due to the attractive flavors and advertisements of e-cigarettes.
The AHA also recommends the government apply stricter e-cigarette regulation since the long-term effects of e-cigarettes on the heart are unknown.
The dangers of nicotine found in e-cigs
A study done at Brown University found that nicotine in cigarettes (including e-cigs) increases a smoker’s risk of cholesterol plaque build up inside of the arteries and developing atherosclerosis. Clogged vessels limit the flow of blood to and from the vital organs and may lead to pain in legs with walking (claudication), heart attack, and stroke.
According to the American Heart Association, non-smokers are also at risk. Involuntary exposure to nicotine given off by e-cigarettes is harmful in the same sense second-hand smoke given off by traditional cigarettes is harmful.
A final note
While smoking e-cigarettes may reduce the risk of cancer associated with tobacco use, the risk of heart disease remains.
You probably know about the relationship between smoking and lung cancer, but did you know smoking is also linked to heart disease, stroke and other chronic diseases? Smoking can increase your risk for cancer of the bladder, throat, mouth, kidneys, cervix and pancreas. Thinking about quitting? Look at the facts!
Why should you quit?
- Smoking is the most preventable cause of death in the United States.
- Almost one third of deaths from coronary heart disease are due to smoking and secondhand smoke.
- Smoking is linked to about 90% of lung cancer cases in the United States.
- Smoking rates overall are down, but too many adults still smoke, vape and use other forms of tobacco, especially between the ages of 21 and 34.
- About half of U.S. children ages 3-11 are exposed to secondhand smoke.
- On average, smokers die more than 10 years earlier than nonsmokers.
- You can be one of the millions of people who successfully quit every year.
What makes cigarettes so toxic and dangerous?
There are more than 5,000 chemical components found in cigarette smoke and hundreds of them are harmful to human health, according to the Centers for Disease Control and Prevention.
Here are a few examples:
- 1,3-Butadiene is a chemical used to manufacture rubber. It is considered to be a carcinogenic chemical that can cause certain blood cancers.
- Arsenic is used to preserve wood. Some arsenic compounds have been linked to cancer of the lung, skin, liver, and bladder.
- Benzene is used to manufacture other chemicals. It can cause cancer, particularly leukemia, in humans.
- Cadmium is a metal used to make batteries. Cadmium and cadmium compounds can cause lung cancer and have been associated with kidney and prostate cancer.
- Chromium VI is used to make alloy metals, paint and dyes. Chromium VI compounds cause lung cancer and have been associated with cancer of the nose and nasal sinuses.
- Formaldehyde is used to make other chemicals and resins. It is also used as a preservative. Formaldehyde causes leukemia and cancer in respiratory tissues.
- Polonium-210 is a radioactive element that has been shown to cause cancer in animals.
- Tar is not one single chemical, instead it describes several chemicals that are in tobacco smoke. It leaves a sticky, brown residue on your lungs, teeth and fingernails.
Carbon monoxide & nicotine: A dangerous duo
Carbon monoxide is a harmful gas you inhale when you smoke. Once in your lungs, it’s transferred to your bloodstream. Carbon monoxide decreases the amount of oxygen that is carried in the red blood cells. It also increases the amount of cholesterol that is deposited into the inner lining of the arteries which, over time, can cause the arteries to harden. This leads to heart disease, artery disease and possibly heart attack.
Nicotine is a dangerous and highly addictive chemical. It can cause an increase in blood pressure, heart rate, flow of blood to the heart and a narrowing of the arteries (vessels that carry blood). Nicotine may also contribute to the hardening of the arterial walls, which in turn, may lead to a heart attack. This chemical can stay in your body for six to eight hours depending on how often you smoke. Also, as with most addictive substances, there are some side effects of withdrawal. And some e-cigarettes and newer tobacco products deliver even more nicotine than traditional cigarettes.
Smokers aren’t the only ones affected by tobacco smoke. Secondhand smoke and vapor is a serious health hazard for nonsmokers, especially children. Nonsmokers who have high blood pressure or high blood cholesterol have an even greater risk of developing heart diseases when they’re exposed to secondhand smoke. Secondhand tobacco smoke contributes to thousands of premature heart disease and lung cancer deaths. Studies show that the risk of developing heart disease is about 25-30 percent higher among people exposed to environmental tobacco smoke at home or work. Secondhand smoke promotes illness, too. Children of smokers have many more respiratory infections than do children of nonsmokers.
Cigarettes, e-cigarettes and tobacco products contain many dangerous toxins. The best thing you can do for your health is to quit tobacco entirely. Don’t spend the rest of your life chained to a nicotine addiction. Thousands of people kick the habit every year, and you can be one of them. It may not be easy, but you can do it!
“Until now, little has been known about cardiovascular events relative to e-cigarette use. These data are a real wake-up call and should prompt more action and awareness about the dangers of e-cigarettes,” said Mohinder Vindhyal, MD, assistant professor at the University of Kansas School of Medicine Wichita and the study’s lead author.
E-cigarettes — sometimes called “e-cigs,” “vapes,” “e-hookahs,” “vape pens” or “electronic nicotine delivery systems” — are battery-operated, handheld devices that mimic the experience of smoking a cigarette. They work by heating the e-liquid, which may contain a combination of nicotine, solvent carriers (glycerol, propylene and/or ethylene glycol) and any number of flavors and other chemicals, to a high enough temperature to create an aerosol, or “vapor,” that is inhaled and exhaled. According to Vindhyal, there are now more than 460 brands of e-cigarettes and over 7,700 flavors.
E-cigarettes have been gaining in popularity since being introduced in 2007, with sales increasing nearly 14-fold in the last decade, researchers said. But they are also hotly debated — touted by some as a safer alternative to smoking tobacco, while others are sounding the alarm about the explosion of vaping among teens and young adults.
This study found that compared with nonusers, e-cigarette users were 56 percent more likely to have a heart attack and 30 percent more likely to suffer a stroke. Coronary artery disease and circulatory problems, including blood clots, were also much higher among those who vape — 10 percent and 44 percent higher, respectively. This group was also twice as likely to suffer from depression, anxiety and other emotional problems.
Most, but not all, of these associations held true when controlling for other known cardiovascular risk factors, such as age, sex, body mass index, high cholesterol, high blood pressure and smoking. After adjusting for these variables, e-cigarette users were 34 percent more likely to have a heart attack, 25 percent more likely to have coronary artery disease and 55 percent more likely to suffer from depression or anxiety. Stroke, high blood pressure and circulatory problems were no longer statistically different between the two groups.
“When the risk of heart attack increases by as much as 55 percent among e-cigarettes users compared to nonsmokers, I wouldn’t want any of my patients nor my family members to vape. When we dug deeper, we found that regardless of how frequently someone uses e-cigarettes, daily or just on some days, they are still more likely to have a heart attack or coronary artery disease,” Vindhyal said.
The study, one of the largest to date looking at the relationship between e-cigarette use and cardiovascular and other health outcomes and among the first to establish an association, included data from a total of 96,467 respondents from the National Health Interview Survey, a Centers for Disease Control and Prevention-fielded survey of Americans, from 2014, 2016 and 2017. The 2015 survey did not include any e-cigarette-related questions. In their analyses, researchers looked at the rates of high blood pressure, heart attack, stroke, coronary artery disease, diabetes and depression/anxiety among those who reported using e-cigarettes (either some days or daily) and nonusers. Those who reported using e-cigarettes were younger than nonusers (33 years of age on average vs. 40.4 years old).
Researchers also compared the data for reported tobacco smokers and nonsmokers. Traditional tobacco cigarette smokers had strikingly higher odds of having a heart attack, coronary artery disease and stroke compared with nonsmokers — a 165, 94 and 78 percent increase, respectively. They were also significantly more likely to have high blood pressure, diabetes, circulatory problems, and depression or anxiety.
The researchers also looked at health outcomes by how often someone reported using e-cigarettes, either “daily” or “some days.” When compared to non-e-cigarette users, daily e-cigarette users had higher odds of heart attack, coronary artery disease and depression/anxiety, whereas some days users were more likely to have a heart attack and suffer from depression/anxiety, with only a trend toward coronary artery disease. Researchers said this could be due to decreased toxic effects of e-cigarette usage, early dissipation of the toxic effects, or the fact that it has not been studied long enough to show permanent damage to portray cardiovascular disease morbidity.
“Cigarette smoking carries a much higher probability of heart attack and stroke than e-cigarettes, but that doesn’t mean that vaping is safe,” Vindhyal said, adding that some e-cigarettes contain nicotine and release very similar toxic compounds to tobacco smoking. Nicotine can quicken heart rate and raise blood pressure.
There are some limitations. For example, the study design doesn’t allow researchers to establish causation, but Vindhyal said it does show a clear association between any kind of smoking and negative health outcomes. He added that self-reported data is also subject to recall bias. The researchers were also unable to determine whether these outcomes may have occurred prior to using e-cigarettes. Further longitudinal data is needed.
Heart palpitations from vaping
Just curious if this is a thing. I had bad palpitations a few weeks ago. Admittedly i was stoned, on modafinil, and vaping alot the first time it happened. Basically just lying down in bed reading I suddenly felt my heart skip, but not your normal skip but it was heavy, and followed by tight chest, dizziness, sick feeling. These are symptoms of a heart attack. I also had this weird cold feeling in the back of my throat as this happened. I freaked out. I thought I was having a heart attack and I was stoned, and my mind was still operating at an higher level thanks to the modafinil. I searched symptoms for some interactions or causes as waves of palpitations/dizziness came and went. I came to the conclusion I was having a panic attack from smoking on the tail end of a modafinil day. Anyway, these symptoms passed in fifteen mins and I was left with mild flutteryness in my chest and anxiety.
I got to sleep with some deep breathing exercises that night, but I got dizziness and palpitations regularly for the following 2 weeks. Sometimes driving I would start to get dizzy, then tight chested, cool throat, and then it would pass, leaving me with this fluttery chest and weird surreal feeling about reality. Alot of the time it would be as I drifted to sleep. Literally as I was drifting away I would suddenly feel my chest skip and beat and tighten, causing me to instantly wake and get out of bed. This would be preceeded by flutteryness chest and anxiety. I remember even during the day time when I hadn’t eaten for a while symptoms started. Cool throat feeling, dizziness, tight chest and surreal perception of reality.
Anywho, so this was concerning me alot as you can imagine. After the first few times, and day time experiences I couldn’t chalk it up to night terrors, or panic attacks anymore. I stopped taking modafinil completely because I was certain it was the cause (its a stimulant so yeah), completely stopped smoking weed (incase this was mental related/panic attacks), reduced my caffeine intake to 1 or 2 green teas a day.
I still vaped though. I vaped alot and had a routine of vaping before bed. These symptoms continued after I ruled out every other cause. This saga came to its peak about 2 weeks after my first scary experience. By this point not every night but at least every second I would be waking from drifting off to sleep with heavy palpitations. This happened again, and it was intense. I could feel my heart rate was irregular. Not too quick, but irregular with a tight chest. I couldn’t chalk it up to anything else now. I was probably having a heart attack or dying. I downloaded a cardiograph app to be certain. It flashed up DANGER. I freaked the fuck out and threw on some shorts and a dirty old shirt and drove myself to hospital at 2am. Triage checked my heart rate and told me it was irregular, then left me to wait for 8 hours in the waiting room. Lol. Happy days.
Eventually I had a chest xray, blood test, and an echo. Nothing at all. I didn’t even have an irregular heart beat by this point. Doc advised me if it happened again to go to the GP and get a holter monitor to figure it out, but other than that my heart was fine. Once I got out I was so relieved. I was tired, and sat in the sun vaping for awhile, before driving home and trying to get some rest. But when i laid down to sleep the same shit happened. Heart palpitations everytime i got close to drifting off to sleep.
So yeah basically after that I had a few more day time experiences happen. The last after driving and vaping, at which point I went and brought a pack of darts. It took about a week after that for my body to return to normal, no palpitations, tight chest or anything. I see correlation with vaping and these episodes.
I had recently switched to a higher nicotine level before this all happened (12MG on a very basic mouth to lung Aramax pen), and switched to a new flavor. My thoughts are either a compound in the flavoring or PG related, however evidence apart from experiences for this is hard to find. I have vaped once since. After drinking. For about a period of 24 hours I was vaping, during which i had a tight chest, not terrible, and totally could have been some type of anxious association but felt real. I don’t think its nicotine related… I mean I would have to experiment to be certain, but I dont get this from smoking cigarettes.
So my question after that is wtf and has anyone experienced this before?
Vaping every day could double your risk of a heart attack, new research suggests
- The true effects of e-cigarettes on human health are just beginning to emerge.
- Risks of vaping include inhaling toxic metals like lead and potentially doubling one’s risk of a heart attack, according to a new study published by UCSF researchers.
- Despite these emerging health concerns, e-cig companies like Juul, the Silicon Valley startup recently valued at $15 billion, are booming.
Smoking kills. No other habit has been so strongly tied to death.
In addition to inhaling burned tobacco and tar, smokers breathe in toxic metals like cadmium and beryllium, as well as metallic elements like nickel and chromium — all of which accumulate naturally in the leaves of the tobacco plant.
It’s no surprise, then, that much of the available evidence suggests that vaping, which involves puffing on vaporized liquid nicotine instead of inhaling burned tobacco, is at least somewhat healthier. But vaping is linked with its own set of health risks, a spate of new research is beginning to reveal. Those risks include inhaling toxic metals like lead, becoming addicted to nicotine, and now, potentially doubling one’s risk of a heart attack.
That latest finding comes from a large study out of the University of California, San Francisco. The study suggests that people who vape every day may face twice the risk of a heart attack compared with people who neither vape nor smoke at all. The research also suggests that daily conventional cigarette smokers face three times the risk of a heart attack, while people who both vape and smoke (so-called “dual users”) face nearly five times the risk.
That should be a significant concern for e-cig users who also smoke cigarettes, Stanton Glantz, the lead author on the paper and the director of the Center for Tobacco Control Research and Education at the University of San Francisco, told Business Insider. It also adds to a growing list of health concerns faced by e-cig companies like Juul, the booming Silicon Valley startup recently valued at $15 billion.
‘We’re the first people to show a long term impact of e-cigarettes’
People use electronic vaporizers with cannabidiol (CBD)-rich hemp oil while attending the International Cannabis Association Convention in New York, October 12, 2014. Eduardo Munoz/Reuters
Glantz’ recent paper, published on Wednesday in the American Journal of Preventive Medicine, is one of the first studies of its kind to show a long-term health impact of e-cigarettes.
Business Insider spoke with Glantz in February when the peer-reviewed summary of his study was first made public.
He and his research team presented those findings early in an attempt to get the word out about the research — which he found deeply concerning — as soon as possible.
“We’re the first people to show a long term impact of e-cigarettes, and given that it’s consistent with what we know biologically about how vaping effects the heart, we wanted to get this out there,” he said.
Still, the study has a number of limitations, most notably the fact that it could not conclude that vaping (or even smoking, for that matter) caused heart attacks — only that the two were linked.
To arrive at the findings, Glantz and his research team looked at national survey data on 70,000 Americans which asked people about their use of e-cigarettes and regular cigarettes. It also asked if they’d ever suffered a heart attack. After controlling for factors that could muddle their results, like hypertension, the researchers found that people who vaped every day were twice as likely to have suffered a heart attack as people who didn’t vape or smoke at all. Daily smokers were three times as likely as non-smokers to have suffered a heart attack.
The people most at risk, however, are “dual users,” or people who both vape and smoke. Dual users faced approximately five times the risk of a heart attack as those who took up neither habit, the study suggested.
Other studies in animals and cells have suggested that vaping could stiffen the heart and blood vessels, potentially creating an increased risk of heart disease and heart attacks, but this was the first to line up those limited findings with actual health impacts in humans.
People who vape and smoke are most at risk
Jordan Michelle vapes a CBD oil made from hemp at the Cannabis World Congress Conference on June 16, 2017 in New York City. Billed as ‘the leading trade show and conference for the legalized cannabis, medical marijuana, and industrial hemp industries,’ the 4th annual conference brings together dozens of both small and large businesses involved in the growing hemp and marijuana market. Spencer Platt/Getty Many e-cig manufacturers promote their devices as a tool for either quitting smoking or for “switching” from smoking conventional cigarettes to vaping, which is generally seen as less harmful. Juul, the San Francisco-based startup behind the most popular e-cig in America, encourages consumers to “make the switch” from traditional cigarettes to the Juul.
But the new study suggests that the people most vulnerable to an increase in heart attacks are those who make both smoking and vaping a daily habit. Glantz said this group of people also represent the largest population of e-cig users.
”E-cigarettes are widely promoted as a smoking cessation aid but for some, they actually make it harder to quit, so most people end up doing both,” Glantz said. “This is the dominant use.”
Juul, which was recently valued at $15 billion and is already rapidly expanding both in the US and internationally, has come under fire for a range of other health issues, namely its popularity among teens who are particularly susceptible to nicotine addiction.
“At Juul Labs, our definition of switching is aligned with the American Cancer Society, National Academy of Science, and Public Health England: Smokers should switch completely away from combustible tobacco,” a representative for the company told Business Insider.
“We are committed to helping current adult smokers who want to end their relationship with combustible cigarettes.”
Snowballing evidence of health concerns tied to vaping
California Department of Public Health Evidence still suggests that inhaling vapor is healthier than breathing in burned tobacco. Still, researchers urge people to recognize that e-cigs come with their own set of health concerns.
Chief among those issues is the high concentration of nicotine in e-cig fluid. This may be part of the reason why teens who vape are seven times more likely to smoke regular cigarettes than young people who never use e-cigs.
Ana Rule, a professor of environmental health and engineering at Johns Hopkins University, said the makers of these devices fail to address “the increased risk to this huge market they are creating among teenagers and young adults that never have smoked, and would have never even considered smoking” had they not vaped.
Researchers are also not convinced that e-cigs actually help adult smokers quit.
So far, the evidence suggests they don’t. In January, a study in the journal The Lancet found that e-cigs were linked with “significantly less quitting” among smokers. Several months later, a study in the Annals of Internal Medicine found that e-cig users were less likely than non-vapers to abstain from tobacco use over six months. And a study published in the journal PLOS One this month found no evidence that vaping helped adult smokers quit.
Nicholas Chadi, a clinical pediatrics fellow at Boston Children’s Hospital, spoke about the Juul at the American Society of Addiction Medicine’s annual conference in April.
“After only a few months of using nicotine, describe cravings, sometimes intense ones. Sometimes they also lose their hopes of being able to quit,” Chadi said.
For these reasons, several nonprofit anti-tobacco agencies strongly oppose Juul, including the nonprofit Campaign for Tobacco-Free Kids and the California Department of Public Health. On Tuesday, Israel became the first country to ban Juul devices entirely, citing health concerns linked with the their high nicotine content. In a statement, Israel’s Health Ministry said the devices pose “a grave risk to public health.”