The American Heart Association is urging the public to recognize the mounting scientific evidence that e-cigarette use poses significant risks to heart health. In a new statement, the organization emphasizes that e-cigarette aerosol, often misrepresented as harmless water vapor, contains a mix of chemicals, additives, sweeteners, and flavoring agents, many of which are classified by the U.S. Food and Drug Administration as harmful or potentially harmful constituents.
A study published earlier this month in Circulation: Arrhythmia and Electrophysiology found that synthetic cooling chemicals used in some e-cigarettes may disrupt heart rhythm, pointing to potential risks such as irregular heartbeat and cardiac arrest. "We've long known about the health threats of cigarettes and other traditional tobacco products, but as increasing numbers of e-cigarettes and other newer nicotine products are introduced into the market, we are learning more about the health threats of these products," said Dr. Jason J. Rose, American Heart Association volunteer and associate professor of medicine at the University of Maryland School of Medicine.
Multiple lines of evidence point to potential harm. Studies show that e-cigarettes expose users to toxic substances like formaldehyde and heavy metals, which are linked to cardiovascular, respiratory, and cancer-related health risks. Nicotine, in addition to being highly addictive, can damage the heart and other vital organs. Researchers are increasingly able to determine the extent of chemical exposure from these products.
How vaping may affect the heart and brain is a growing area of research. Inhaling e-cigarette aerosol may contribute to oxidative stress, inflammation, damage to blood vessel function, and changes that can lead to atherosclerosis. Nicotine adds to cardiovascular strain by raising blood pressure and heart rate, narrowing blood vessels, and forcing the heart to work harder. Over time, these effects can lead to heart attack, stroke, and heart failure. Nicotine also can increase blood clotting and contribute to peripheral artery disease.
Adding to concerns is the level of nicotine in e-cigarettes. One e-cigarette can contain as much or more nicotine as a pack of cigarettes, increasing the risk of addiction. Nicotine fuels a powerful addiction cycle, with temporary calm followed by irritability, anxiety, and strong cravings as nicotine levels drop. Claims of cognitive benefits from nicotine are not supported by evidence; available research suggests that any short-term changes in attention are modest and often reflect relief from withdrawal symptoms rather than true improvement.
Youth use is also on the rise, with most young users reporting flavored products, which appeal to young people and increase the likelihood of continued use. Nicotine exposure during adolescence can have long-lasting effects on brain development, affecting attention, learning, impulse control, and memory. The American Heart Association supports public policies to prohibit the sale of all flavored commercial tobacco and nicotine products, including menthol, and to support quitting, prevent initiation, and strengthen research.
"The tobacco industry relentlessly targets kids and communities with fruit-, candy-, and menthol-flavored tobacco products that encourage use, facilitate addiction, and increase profits," said Nancy Brown, chief executive officer of the American Heart Association. "After decades of selling products that cause disease and death, tobacco and nicotine companies cannot be trusted to protect public health. No tobacco or nicotine product can be considered safe."
For more information, the American Heart Association offers resources on Five Steps to Quit Smoking and Vaping and details its policy positions on tobacco products.
