Can electronic cigarettes cause heart problems?

In recent years, the consumption of electronic cigarettes (e-cigarettes or vapes) has increased, especially among young people, with the belief that they are less harmful and safer than conventional cigarettes. E-cigarette aerosols are known to have fewer toxic substances than the 7,000 contained in conventional cigarettes, so you might think they are less harmful; but that's not the case. The long-term effects of using electronic cigarettes are not yet known, but studies carried out so far suggest they are harmful. According to a survey published by the Ministry of Health in 2021, 44.3% of adolescents between the ages of 14 and 18 had tried electronic cigarettes at least once.

Many e-cigarettes contain nicotine, which is addictive. This substance is toxic for foetuses in pregnant women and is detrimental to brain development in adolescents and young adults. E-cigarette use among the young is associated with the use of other tobacco products, including conventional cigarettes. A study published by the CDC (Center for Disease Control and Prevention) observed that many adults used e-cigarettes to stop smoking conventional cigarettes, but the results obtained showed that they ended up smoking both.

Electronic cigarettes and heart problems

A study published in the journal Nature states that the inhalation of aerosols from electronic cigarettes causes cardiac arrhythmias in mice. They also alter the heart rate and ventricular repolarisation (a stage that is part of the electrical pattern of the heart).

E-cigarette aerosols are what is inhaled and exhaled when smoking. They contain harmful substances such as nicotine, ultrafine particles that can enter deep into the lungs, cancer-causing chemicals, heavy metals, volatile organic compounds and aromas such as diacetyl (a chemical linked to severe lung disease).

The study results show that nicotine and acrolein (a combustion by-product) in particular can affect cardiac electrophysiology. Acute inhalation of these aerosols causes changes in the cardiac conduction systems; these are the structures that produce and transmit the electrical stimuli that make the heart contract. Aerosols also contain solvents, such as vegetable glycerine and propylene glycol, which induce bradyarrhythmias (slower heart rates) and heart rate variability during inhalation.

Possible lung problems

There is currently a lung disease related to the use of electronic cigarettes known as e-cigarette or vaping use-associated lung injury (EVALI) which is associated with these devices. The disease appeared in the US in 2019 and more than 2,000 cases have been reported so far.

The symptoms of EVALI are: coughing, chest pain, increased heart rate, fever or chills, nausea, vomiting, diarrhoea and weight loss. The causes are not known, but it is believed that it could be associated with vitamin E acetate, which is used to thicken vaping products. The liquids in e-cigarettes can alter their composition when changing from a liquid to the gas (vapour) state and can produce substances that are harmful to the lungs.

Thus, to stop smoking, you should use pharmacological and psychological support as an alternative to vaping. This treatment is offered in Primary Care Centres and the smoking department of the Hospital Clinic Addictions Unit.