For months news from the US about illnesses and deaths caused by e-cigarettes also unsettle users in this country. Now, a new study is likely to cause further concern. Researchers warn in the journal "Cardiovascular Research" of potential risks of heart-health vapors.
For their study, physicians analyzed the data from several short- and long-term studies on the consequences of e-cigarette use on the cardiovascular system. "Many people believe these products are safe, but there are more and more reasons to worry about their effects on heart health," said Loren Wold of the Ohio State University College of Medicine. "E-cigarettes contain nicotine, particulate matter, metals and flavorings and not just harmless water vapor."
It is already known that fine dust, which is inhaled through the air, enters the bloodstream and ultimately acts directly on the heart. Although the data available so far are not sufficient, they suggest that the same applies to e-cigarettes, said Wold.
Good for weaning, bad as a start
Nicotine, for example, increases blood pressure and heart rate, while particulate matter leads to arterial hardening, inflammation and oxidative stress. "We know about these problems from studies on the short-term effects of steaming – but research is inconsistent and the consequences of chronic e-cigarette use still an absolute mystery," said Wold. "The potential damage to the heart has basically not been investigated."
Originally, e-cigarettes were mainly used as a smoking cessation tool, but critics also consider it a potential entry aid to smoking. It is clear that the vapors contain less pollutants than tobacco smoke – but are therefore not completely harmless, as the pulmonary doctors of the German Lung Foundation in February explained.
According to Wold, the new analysis shows that it needs larger and longer-term impact studies. But above all, she should give e-cigarette users something to think about and discourage those who did not smoke before. "It's too great a risk to assume that one does not become dependent and that there are no negative consequences," he said. "That's just not worth the risk."
When swallowed harmless – and when inhaling?
In Germany, ingredients for e-cigarettes are much stricter regulated than in the US. Here, the Tobacco Products Act states that "in the production of the liquid to be evaporated other than nicotine, only ingredients are used which in heated and unheated form pose no risk to human health."
However, the flavorings are often approved only for food. Accordingly, it is proven that it does not hurt to swallow them. However, the effect they have when inhaled is usually not investigated. The authors of the current study also explain that propylene glycol, glycerol – the main constituents of liquids – as well as inhaling aromas are unlikely to have the same effects as oral ingestion.
Traditional cigarette smoking is indeed the most avoidable risk factor for cardiovascular disease and corresponding deaths, the researchers emphasize. Many smokers would therefore have switched to e-cigarettes or a combination of both, which significantly reduces the risk of complications according to the current state of knowledge. However, there are also many newcomers.
Worrying: Number of users among children and adolescents
"The most worrisome is the number of children and adolescents who have become accustomed – and may never have started smoking conventional cigarettes," says Nicholas Buchanan, co-author of the study. "We do not know what health effects this has on them." Most of the current research is focused on adults, and especially those who smoked classic cigarettes in the past. An assessment of the consequences for young people is correspondingly difficult.
Also unknown are the possible effects of e-cigarettes on fetuses when a pregnant woman vaporizes, according to physician Wold. The consequences of passive inhalation are also unclear. Adults are beginning to realize that the health effects of steam are not fully understood and the risks may be high. "I'm afraid this is not the case with young people."
In Germany, more and more young people and young adults try e-cigarettes, as a survey commissioned by the German Cancer Research Center (DKFZ) showed. Between 2014 and 2018, the proportion of 16- to 29-year-olds who had ever moved to an evaporator almost doubled from 11 to 20 percent.