Analysis underscores the health risks of e-cigarettes

E Cigarettes

A Johns Hopkins Medicine-led analysis of medical information gathered from almost 250,000 people over four years has significantly clarified the link between the exclusive use of e-cigarettes and COPD. It was also linked to high blood pressure in a group of adults aged 30 to 70 years.

The group’s findings were detailed in “E-cigarette Use and Incident Cardiometabolic Conditions in the All of Us Research Program,” which was published in Nicotine & Tobacco Research. The study provides context to inform advice and regulatory policies about the health risks of vaping products.

The researchers noted in a news release that while the use of both e-cigarettes and traditional cigarettes is linked to higher risks and rates of COPD, the effect is substantially stronger for traditional cigarettes. Despite this, e-cigarettes still pose a danger.

Michael Blaha, MD, MPH, senior author of the study and professor of cardiology and epidemiology at the Johns Hopkins University School of Medicine, said that while the dangers of traditional cigarettes are well known, there needs to be more research done on e-cigarettes.

“There remains a great uncertainty about the relative harm of e-cigarettes as compared to traditional smoking,” Dr. Blaha said. “Until now, there has been scant longitudinal data in large, high-quality datasets linking exclusive e-cigarette use to new onset cardiometabolic health conditions.”

For the analysis, researchers looked at medical information on 249,190 people, including 203,932 who reported never using either e-cigarettes or traditional cigarettes, 3,164 who reported exclusively using e-cigarettes, 33,778 who reported exclusively using traditional cigarettes and 8,316 who reported using both e-cigarettes and traditional cigarettes.

In the follow-up period of almost four years, increased instances of multiple illnesses were found, including:

  • 23,745 new cases of hypertension
  • 13,179 new cases of type 2 diabetes
  • 7,925 new cases of COPD
  • 9,801 new cases of heart failure
  • 6,139 new cases of atherosclerotic cardiovascular disease

Of those cases, it was found that exclusive e-cigarette use was not significantly associated with type 2 diabetes, heart failure or atherosclerotic cardiovascular disease, but it was significantly associated with COPD.

In contrast, results showed that exclusive use of traditional cigarettes significantly increased the risks of all outcomes. Similar results were shown for dual use of traditional cigarettes and e-cigarettes, although the risk estimates were slightly larger than for exclusive use of traditional cigarettes.

“These results are a critical stepping stone for future prospective research on the health effects of e-cigarettes,” Dr. Blaha said. “While in this short-term study there was no association between exclusive e-cigarette use and cardiovascular events, there was an association with incident COPD and possibly hypertension that will need to be closely watched over longer term follow-up.”

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