Health & Fitness

E-cigarettes with nicotine linked to heart attacks

Smoking an electronic cigarette. AFP PHOTO
Smoking an electronic cigarette. AFP PHOTO  

Users of e-cigarettes containing nicotine face a high risk of heart attack and stroke in later life, a new study shows. The cigarettes lead to stiffens of arteries and have cancer-causing agents, according to findings released last week.

The study adds that e-cigarettes shouldn’t be marketed as a safe alternative to conventional cigarettes. The electronic device is increasingly gaining popularity around the world, particularly among young people. It functions by heating flavoured liquid, which often contains nicotine, into a vapour that is inhaled much like traditional cigarettes.

Researchers found carcinogens in several types of e-cigarettes. Formaldehyde, a substance found in building materials and embalming fluids, was also identified at levels 10 times those found in the smoke from regular cigarettes.

University of Rochester researchers suggest that e-cigarettes are a toxic replacement of tobacco products. Presenting research findings at the European Respiratory Society International Congress, Magnus Lundbäck said the number of cigarette users increased dramatically in recent years.

“E-cigarettes are regarded by the public as almost harmless. The cigarette industry markets its products as a way to reduce harm and to help people stop smoking tobacco cigarettes. However, the safety of e-cigarettes is debated, and a growing body of evidence is suggesting several adverse health effects, said Dr Lundbäck.

“The results are preliminary, but in this study we found a significant increase in heart rate and blood pressure in volunteers who were exposed to e-cigarettes containing nicotine. Arterial stiffness increased around three-fold in those who were exposed to e-cigarettes containing nicotine compared to the nicotine-free group,” he said.

Dr Lundbäck, a research leader and clinical registrar at the Danderyd University Hospital in Stockholm, Sweden, and his colleagues recruited 15 young, healthy volunteers to take part in the 2016 study.

The volunteers were seldom smokers (smoking a maximum of 10 cigarettes a month), and they had not used e-cigarettes before the study.

The average age was 26. Fifty nine per cent were female and 41 per cent male. They smoked e-cigarettes with nicotine for 30 minutes on one of the study days and those without nicotine on the other day.

The researchers measured blood pressure, heart rate and arterial stiffness of participants immediately after smoking the cigarettes.

“In the first 30 minutes after smoking e-cigarettes containing nicotine, there was a significant increase in blood pressure, heart rate and arterial stiffness; no such effect was seen on the heart rate and arterial stiffness in volunteers who smoked e-cigarettes without nicotine,” according to the research.

“The immediate increase in arterial stiffness is most likely attributed to nicotine,” said Dr Lundbäck. “The increase was temporary. The same effects have been demonstrated in conventional cigarette smoking. Chronic exposure to both active and passive cigarette smoking causes a permanent increase in arterial stiffness.

“Therefore, we speculate that chronic exposure to e-cigarettes with nicotine may cause permanent effects on arterial stiffness in the long term. It is important that the results of this and other studies reach the public and professionals working in preventive health care, for example in smoking cessation.”

The findings underline the necessity of maintaining a critical and cautious attitude towards e-cigarettes, especially for health care professionals, he said.

“Cigarette users should be aware of the dangers of the product so that they can decide whether to continue or quit based on scientific facts.”

Dr Lundbäck and his colleagues are investigating effects of e-cigarettes on blood vessels and lungs. In the European Union, use of e-cigarettes increased from 7.2 per cent in 2012 to 11.6 per cent in 2014, according to research.

To evaluate the content of cigarette refills, Constantine Vardavas from the University of Crete and his colleagues selected a random sample of cigarette liquids from the most popular brands in Greece, Spain, Germany, the Netherlands, the UK, Hungary, Romania, Poland and France.

Every liquid they tested contained at least one substance that has some level of risk to health according to the United Nations classification system.

These included methyl cyclopentanolone (found in 26.3 per cent of samples) and a-ionone (8.7 per cent of samples), both “may cause allergy or asthma symptoms or breathing difficulties if inhaled,” according to the classification.

Other substances, such as menthol (42.9 per cent of samples), ethyl vanillin (16.5 per cent) and acetyl pyrazine (8.2 per cent), are classified as “able to cause respiratory irritation.

The EU Tobacco Products Directive notes that e-liquids should not contain ingredients that pose a risk to human health.