- A handful of studies published this year are beginning to reveal the health effects of e-cigarettes, and they are not all positive.
- While some research has suggested that e-cigs may help adults quit smoking conventional cigarettes, other studies have found that they might encourage teens to start.
- Scientists have also found evidence of toxic metals like lead in e-cig vapor, and a new study suggests vaping may be linked with an increased risk of heart attacks.
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. Reaching for a vape pen instead of a conventional cigarette might also be helpful for quitting smoking, though the evidence is somewhat limited.
We don’t have a ton of research on how vaping affects the body and brain. But a handful of studies published this year have begun to illuminate some of the potential health effects of e-cigs.
Vaping every day is linked with twice the risk of a heart attack, while smoking is linked with triple the risk
One of the most worrisome outcomes of that research is a study linking daily vaping to a significantly higher risk of heart attacks.
It is the very first study to show a long-term health impact of e-cigarettes.
The analysis, presented on Saturday at the annual meeting of the nonprofit Society for Research on Nicotine and Tobacco, suggests that people who vape every day may double their risk of having a heart attack compared with people who do not vape or smoke. In comparison, daily cigarette smoking potentially triples the risk.
But the people most at risk are "dual users," or people who use both devices, according to Stanton Glantz, the lead author on the presentation and a professor of medicine at the University of California, San Francisco as well as its director of the Center for Tobacco Control Research and Education. People who smoked and vaped every day faced five times the risk of a heart attack as those who took up neither habit, Glantz told Business Insider.
Dual users make up a significant proportion of overall vapers, Glantz said.
”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."
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. Also, only the study’s abstract has been peer-reviewed; the full paper is still awaiting publication. Glantz said one of the reasons they decided to make the abstract public was to get the word out about the findings 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," Glantz said.
To arrive at his findings, Glantz 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 compared with 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.
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.
The study isn’t the first to suggest that e-cigarettes may come with some important risks.
Some of the same toxic metals that can be found in cigarettes are also found in e-cigs
In 2015, a group of researchers from medical schools across the globe decided to find out just what was inside the vapors that e-cig users were inhaling.
After recruiting 56 daily e-cig users in Baltimore and testing their devices in a lab at the Bloomberg School of Public Health, researchers found that, trapped deep in the aerosol particles that vapers breathe, lurk some of the same toxic metals and metallic elements found in conventional cigarettes, including cadmium and nickel.
They also found potentially unsafe levels of several other dangerous substances such as arsenic, chromium, and manganese.
They published their findings earlier this week in the journal Environmental Health Perspectives.
"These heating coils, as currently made, seem to be leaking toxic metals — which then get into the aerosols that vapers inhale," Ana Maria Rule, an assistant scientist at the Johns Hopkins Bloomberg School of Public Health who led the study, said in a statement.
Despite these findings, it remains unclear what inhaling these levels of substances does. Still, consistently inhaling high levels of these metals has been tied to health problems in the lungs, liver, immune system, heart, and brain, as well as some cancers, according to the US Department of Labor’s Occupational Health and Safety Administration.
"We’ve established with this study that there are exposures to these metals, which is the first step, but we need also to determine the actual health effects," Rule said.
The largest report on the health effects of vaping found that e-cigs could help adults quit smoking — but may encourage teens to start
A large recent report on the health effects of vaping from the National Academies of Sciences, Engineering, and Medicine found that e-cigarettes may be helpful for adults looking to quit smoking. One of the reasons may be that vaping not only exposes people to fewer of the cancer-causing substances in conventional cigarettes but may also be less addictive.
But while adults sometimes use e-cigs as a tool to quit smoking, young people may end up using them to start, the authors of the newest report concluded.
As a result, "e-cigarettes cannot be simply categorized as either beneficial or harmful," David Eaton, a vice provost at the University of Washington at Seattle who led the committee that wrote the report, said in a statement.
Eaton said that in certain circumstances, such as when teens use them and become addicted to nicotine, e-cigarettes "adverse effects clearly warrant concern." But in other cases, like when adults turn to e-cigs to quit smoking, "they offer an opportunity to reduce smoking-related illness."
We need more research on regular vapers
Most research surrounding e-cigs has focused on so-called cigalikes, first-generation devices that look like regular cigarettes and include a disposable mechanism preloaded with liquid.
But people who vape every day typically use reusable devices they can tweak to match their preferences. These devices, known as mods or "tank-style" devices, come with a battery, a mouthpiece, and include a tank to be refilled with liquid.
Nailing down the precise health effects of these devices is a tall order — the outcomes could vary as much as the devices, with users being able to modify things like the nicotine content, heat, and inhalation time. But researchers will need to tackle this obstacle before we know the real effects of these devices.
"Direct sampling from e-cigarette consumers rather than purchasing e-cigarettes from a store or company is thus needed to assess typically used devices," Rule wrote in her paper.
SEE ALSO: Vaping instead of smoking still exposes you to toxic metals like lead — here’s how worried you should be
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