Switching to E-cigarettes Fails to Protect Against Stroke Risk

Many adults addicted to regular cigarettes turn to e-cigarettes in the hope that they may help them to quit smoking tobacco.  Researchers from the Massachusetts General Hospital’s Tobacco Research and Treatment Center showed that using e-cigarettes daily helped U.S. smokers to quit smoking regular cigarettes.

Adults following this approach believe that e-cigarettes are safer than regular cigarettes because they don’t contain tobacco and all the carcinogenic chemicals produced by smoking tobacco.  Switching to e-cigarettes, they believe, will help protect their health.

A recent study, however, casts doubt on that assumption.

Researchers from George Mason University found that when it comes to the risk for stroke, e-cigarettes are no safer than regular cigarettes.  Those who use both types of cigarettes were nearly twice as likely to suffer a stroke as those who smoked only traditional cigarettes, and almost three times as likely as nonsmokers.

Study Finds Switching from Traditional to E-cigarettes Doesn’t Protect Against Stroke

For the study, researchers analyzed 2019 data from the Behavior Risk Factor Surveillance System, a nationally representative, cross-sectional telephone survey.  The sample size was about 161,000 participants aged 18-44 years.  Scientists looked for an association between e-cigarette use and stroke.

Results showed that those who had used traditional cigarettes in the past and then switched to e-cigarettes actually had a higher risk of stroke than those who continued to use traditional cigarettes (2.54 times the risk vs. 1.59, compared to nonsmokers).

Those who used both e-cigarettes and regular cigarettes had 2.91 times higher risk of stroke versus nonsmokers, and 1.83 times higher risk versus users of only traditional cigarettes.  Those having used only e-cigarettes the entire time, however, did have lower odds of stroke versus those using only traditional cigarettes.

“While we already know that combustible cigarette use is one of the most important risk factors for stroke,” said lead author Dr. Tarang Perekh, “[dual use] of e-cigarettes couple potentially have an additive effect that may lead to a stroke at a younger age.  In terms of a healthy alternative, if smokers were to switch to an e-cigarette, stroke risk does not change.”

Perekh also warned that though this study showed no increased risk of stroke among users of e-cigarettes only, users should not take that as reassuring, since e-cigarettes have been on the market for only a few years, and their long-term effect on cardiovascular health is not yet known.

Other Studies Show Cardiovascular Risks Associated with E-cigarettes

Other research shows that many adults trying to switch from regular cigarettes to e-cigarettes end up using both.  In a 2019 study, researchers wrote, “Dual use of combustible and electronic cigarettes is a growing use pattern; more than half of e-cigarette users are dual users.”

Of additional concern is the growing epidemic of e-cigarette use among young people, which seems to lead to the use of traditional cigarettes down the road.  A 2019 study published in JAMA Network Open showed that American teens and tweens who used e-cigarettes were more than 4 times as likely to try regular cigarettes than those who never tried e-cigarettes.

E-cigarettes also have their own health risks that are just now being discovered.  A 2018 study involving nearly 70,000 people from the University of California showed that daily use of e-cigarettes was associated with nearly a doubling of the odds of a heart attack.  Using both e-cigarettes and traditional cigarettes together increased the risk by 5 times compared to non-smokers.

“The finding of increased heart attack risk for e-cigarette use, in addition to the risks of any smoking, is particularly troubling,” said senior author Stanton Glantz, Ph.D., “because most people who use e-cigarettes continue to smoke cigarettes.”