According to three new studies, e-cigarette use is rising, putting more Americans at risk of blood vessel damage and heart disease. In the first study, researchers found that nearly 1 in 20 adults use e-cigarettes.
“Our study may have important public health implications and ramifications for educational strategies aimed at targeting various population segments to inform them of the health effects and risks associated with the use of e-cigarettes.”Lead author Dr. Mahmoud Al Rifai, a cardiology fellow at Baylor College of Medicine in Houston.
A new study adds to mounting evidence that the use of electronic cigarettes (e-cigarettes), or vaping, has increased in recent years among U.S. adults, with nearly 1 in 20 reporting current use of e-cigarettes, according to research presented at the American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).
In addition, two studies examining blood samples suggest e-cigarette exposure is roughly equivalent to tobacco smoke in terms of promoting oxidative stress that can lead to blood vessel damage and heart disease.
The first study, based on a survey of more than 930,000 U.S. adults Of those, nearly 29,000 said they were current e-cigarette users, which translates to nearly 11 million American adults overall.
The proportion of survey respondents reporting current e-cigarette use rose from 4.3% in 2016 to 4.8% in 2018.
While vaping rates rose across the overall population from 2016-2018, the increase was particularly pronounced in certain groups.
The increase was striking among women, with their current e-cigarette use rising from 3.3% to 4.3%. It also rose from 3.9% to 5.2% among 45- to 54-year-olds, and from 5.2% to 7.9% among former smokers.
Vaping is also growing in popularity among users of smokeless tobacco. Their use of e-cigarettes rose from 9.2% in 2016 to 16.2% in 2018, the study found.
“While an increase of 0.5% over three years may not sound like a large increase, that’s a lot of [new] e-cigarette users once you extrapolate out to the overall population.”
“Based on our findings, I think the trend is only going to go upward, but we don’t know yet what the long-term health effects are.”Mahmoud Al Rifai, MD, MPH, a cardiology fellow at Baylor College of Medicine and the study’s lead author.
For this study, researchers analyzed data from the Behavioral Risk Factor Surveillance System, a large phone-based survey conducted annually for more than 35 years that is designed to be representative of the U.S. adult population. Survey participants who said they used e-cigarettes every day or on some days were counted as current e-cigarette users.
Al Rifai said he believes the trends may reflect a push by e-cigarette makers to position their products for smoking cessation. He added that the findings underscore an urgent need for further research on the prevalence of vaping and to understand its potential long-term health implications for both the individual and public health.
Al Rifai suspects the trends reflect manufacturers’ efforts to market e-cigarettes as products for smoking cessation.
Growing Evidence Points to Potential Heart Risks
Meanwhile, two studies from the University of California, Los Angeles being presented bolster emerging evidence for potential links between e-cigarette use and heart disease, found that vaping might not be as harmless as some people think.
In fact, it may increase heart disease risk by causing oxidative stress, a process that can trigger cell damage, researchers said.
“Elevated oxidative stress in otherwise healthy young people who vape may predict increased risk for premature cardiovascular disease,” said Dr. Holly Middlekauff, a UCLA cardiologist who led both studies.
For these studies, researchers compared blood samples from non-smokers, smokers and e-cigarette users to examine immune cell characteristics and markers of oxidative stress associated with plaque buildup in the heart’s arteries. They found that using e-cigarettes led to many of the same characteristics as tobacco smoke at the cellular level, with both e-cigarette users and tobacco smokers showing significantly more evidence of harmful oxidative stress than non-smokers.
“Oxidative stress is one of the main instigators for many diseases that contribute to aging.”
“We found that not only do the immune cells that are circulating have greater oxidative stress in smokers and e-cigarette users than non-smokers, there are also more of these chronic inflammatory cells present. Our study suggests there is a continuum of harm, with non-users having the least amount of oxidative stress, electronic cigarette users showing an intermediate level and chronic tobacco smokers having the largest amount of oxidative stress.”Holly Middlekauff, MD, a cardiologist at the University of California, Los Angeles, and senior author of the studies.
In the UCLA studies, researchers compared blood samples from nonsmokers, tobacco smokers, and e-cigarette users. The aim was to look for differences in immune cells and markers of oxidative stress linked to the buildup of plaque in arteries.
They found that vaping caused the same cell changes and increases in oxidative stress as cigarette smoke.
The findings from these studies are scheduled to be presented Wednesday during an online meeting of the American College of Cardiology. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.
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