Cardiologists sound the alarm about e-cigarettes

Menthol, fruit or candy. These are some of the flavours you can choose if you want to smoke — or more accurately, vape — e-cigarettes.

Norway does not allow the fluid used in e-cigarettes to contain nicotine. Although the Norwegian Storting legalized the use of nicotine in e-cigarettes in 2016, the law has not yet been implemented.

Maja-Lisa Løchen, a professor of preventative medicine at UiT - The Arctic University of Norway, hopes that politicians will change their minds, and that e-cigarettes containing nicotine will never be sold in Norway.

She is one of the researchers who is now sounding the alarm about what e-cigarettes can do to the heart.

Løchen is a member of the European Association of Preventive Cardiology. The group believes there is enough research to demonstrate the harmful effects of vaping e-cigarettes to encourage people to stop.

Higher blood pressure and risk of heart attack

E-cigarettes are still a relatively new product, which means that most of the research on their effects is done in the laboratory. Researchers conduct experiments on cells or animals, among other things. But there have been some human studies.

Løchen has identified a number of findings that cardiologists are concerned about.

«It is quite clear that e-cigarettes increase blood pressure. And high blood pressure increases the risk of all cardiovascular disease. For women, high blood pressure is perhaps the biggest risk factor for cardiovascular disease, after smoking,» she said.

People who vape also have a higher risk of having a heart attack, she said. And there are studies that show that e-cigarettes damage the arteries that supply our organs with oxygen-rich blood.

«They change the inside of the arteries so that they become stiffer, which increases the risk of blood clots forming inside these arteries,» Løchen said.

Increase among young people in the United States

European heart researchers report that they are particularly concerned about the increase in vaping among young people and young adults. They base their concern on figures from the United States, which show that more young people are vaping now than ever before.

«Young people who don’t smoke don’t need to use e-cigarettes to stop smoking, which is how the industry mainly markets to adult tobacco users. So the argument that switching to e-cigarettes is less dangerous doesn’t apply,» Løchen says.

She agrees that e-cigarettes are less dangerous than smoking, but is afraid that young people who have never smoked will find it fun to vape. That could provide a gateway to the use of regular cigarettes.

The European Heart Organization therefore believes that e-cigarettes should be strictly regulated.

Erik Lund, a Norwegian sociologist and tobacco researcher at the Norwegian Institute of Public Health (NIPH), strongly disagrees.

Not popular among Norwegian youths

«Norwegian youths haven’t fallen in love with e-cigarettes, and Løchen's concern is unfounded,» Lund wrote to sciencenorway.no.

He described a study that shows Norwegian youths may try e-cigarettes in secondary school, but when they are a little older they think vaping is childish.

Unnecessary for smokers to risk their lives

At the same time, Lund says he has no doubts that vaping can be harmful. But he still has reached the opposite conclusion of the European heart researchers.

«A continued sales ban, as Løchen recommends, will prevent smokers from switching to a clearly less harmful alternative and maintain the import of nicotine-containing liquid from unsafe supply sources on the internet,» he wrote.

«It is completely unnecessary for smokers to risk their lives for their nicotine dose as long as there are less dangerous alternatives that can give roughly the same satisfaction,» Lund wrote.

The health benefits for smokers who switch to vaping are so great that it is worth it at the societal level, Lund believes.

But smokers don’t switch, Løchen says. Smokers are starting to use e-cigarettes in addition to regular cigarettes. She believes Lund’s opinion is simply wishful thinking.

Disagree on what the research shows

The two researchers disagree on what the research shows about the effects of vaping on helping people stop smoking.

Løchen believes that there is no evidence in the research that shows that e-cigarettes help people stop smoking. And she's most worried about young non-smokers starting to vape.

«Taste and colours are especially appealing to children and young people and are very tempting. E-cigarettes shouldn’t taste so good! We have eliminated these enticements from regular cigarettes, so we shouldn’t repeat the mistake with e-cigarettes,» Løchen said.

Translated by Nancy Bazilchuk.

Reference:

M. Kavousi et al: Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC), European Journal of Preventive Cardiology 2020.