A growing body of scientific evidence indicates that e-cigarettes pose significant risks to heart health, challenging the perception that vaping is a harmless alternative to smoking. The American Heart Association is urging policymakers and the public to recognize the potential cardiovascular harms associated with these products, as research identifies toxic chemicals and their effects on the heart and blood vessels.
E-cigarette aerosol, often misrepresented as harmless water vapor, contains a mix of chemicals, additives, sweeteners, and flavoring agents, according to the U.S. Food and Drug Administration (FDA). These include substances classified 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.
Multiple lines of evidence point to exposure 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 how much of these chemicals people are exposed to when using these products.
Inhaling e-cigarette aerosol may contribute to conditions that lead to heart disease, including oxidative stress, inflammation, damage to blood vessel function, and changes that can cause 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, according to the American Heart Association. Nicotine also can increase blood clotting and contribute to peripheral artery disease.
One e-cigarette can contain as much or more nicotine as a pack of cigarettes, increasing the risk of addiction. Claims of cognitive benefits from nicotine are not supported by evidence; research suggests that any short-term changes in attention are modest and often reflect relief from withdrawal symptoms rather than true improvement. Over time, nicotine exposure, especially among young people, can harm brain development.
Youth use remains a major concern, with most young users consuming flavored products that appeal to them 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 policies to prohibit the sale of all flavored commercial tobacco and nicotine products, including menthol, and to support quitting and prevent initiation.
“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 on quitting smoking and vaping, visit the American Heart Association’s resources on Five Steps to Quit Smoking and Vaping.
