A new, groundbreaking study has shown that smokers who switch to vaping have significantly reduced risk of cardiovascular disease (heart attacks and stroke) within a month.

The 'Vesuvius' study allocated 114 smokers to three groups: continuing smoking, vaping with nicotine and vaping without nicotine. The researchers measured the blood flow and the stiffness of the arteries, both of which are strongly linked to cardiovascular disease.

After one month, significant improvements in both vaping groups were found compared to smokers and were even found in those who did not quit completely. The authors concluded:

"Smokers, particularly females, who switch from tobacco cigarettes to electronic cigarettes derive significant benefits in terms of vascular health, and this improvement is seen early on"

Findings in those who switched to vaping included:

• Significant improvement in 'vascular endothelial function'. This means the arterial linings were much healthier. Unhealthy linings of the arteries are strongly linked to cardiovascular disease
• Significant reduction in vascular stiffness in vapers who were heavy ex-smokers. Stiffness in the arteries is associated with developing future cardiovascular disease
• Significantly greater benefits in women compared to men
• Reduced heart rate. Heart disease is less likely with a lower heart rate

The authors acknowledge that longer follow-up is required to be sure that the changes are sustained.

This study from the University of Dundee is the largest study to date comparing the effect of vaping to smoking on vascular disease. It was as published today in the Journal of the American College of Cardiology and was commissioned by the British Heart Foundation.

Professor John Britton, Director of the UK Centre for Tobacco & Alcohol studies said:

"This study is a major breakthrough and one from which vapers can take reassurance that substituting smoking with vaping is likely to generate significant health benefits"

Other research criticised

Previous reviews have concluded that vaping has significantly lower risk for heart disease compared to smoking. For example this review by leading expert Professor Neal Benowitz concludes

"Although e-cigarettes might pose some cardiovascular risk to users, particularly those with existing cardiovascular disease, the risk is thought to be less than that of cigarette smoking.  The adoption of e-cigarettes rather than cigarette smoking might, therefore, result in an overall benefit for public health"

However, several recent studies have raised false concerns. Most of these have been flawed and have been widely criticised by other experts. Most have been conducted in mice, based on laboratory testing in petri dishes or have flawed methodology.

A study in the European Heart Journal recently claimed that vaping causes damage to the brain, heart blood vessels and lungs. The conclusions were harshly criticised by UK experts here.

Another study by Dr Stan Glantz here claiming that vaping increases heart attack risk has also been discredited as fatally flawed science, for example by researcher Dr Farsalinos here and here.

Conclusion

The new study supports the conclusion that smokers who switch to vaping will reduce their risk of future heart attacks and other cardiovascular disease. The risk reduces rapidly and is greater in women.

However, vaping does carry some risks and is not recommended for non-smokers or young people.

Study

George J et al. Cardiovascular Effects of Switching From Tobacco Cigarettes to Electronic Cigarettes. Journal of the American College of Cardiology. 2019

Expert commentary via the UK Science Media Centre

Commentary by Dr Konstantinos Farsalinos, E-Cigarette Research

Vaping may be less harmful to blood vessels than smoking cigarettes. British Heart Foundation

Smokers who switch to vaping could soon 'have healthier hearts'. UK National Health Scheme blog

Posted by Colin Mendelsohn, colin@athra.org.au

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