Vaping and heart disease
Public health matters
By John Newton
A controversial study that reported that vapers had the same risk of heart disease as smokers was recently withdrawn by the journal as it did not take into consideration that almost all the vapers involved were current or former smokers.
A better understanding of the effect of e-cigarettes on the heart is beginning to emerge. A randomised control trial that measured the vascular effects of smokers switching to vaping was published in December with encouraging results. Those who switched to e-cigarettes completely experienced the largest improvement in their vascular health, getting close to the healthy “control”. Larger studies with longer follow up will provide greater confidence. The debate continues here and here.
Harms compared to smoking
Only one in three adults in England knows that vaping is far less harmful than smoking. Yet in 2018 the US National Academies of Sciences, Engineering and Medicine (NASEM) found that the available evidence suggests e-cigarettes are “far less harmful” than conventional smoking.
Public Health England’s 2015 independent evidence report, concluded that: “While vaping may not be 100% safe, most of the chemicals causing smoking-related disease are absent and the chemicals which are present pose limited danger.”
More research is needed into the relative harms of e-cigarettes. Last month PHE commissioned the final and most ambitious report in the current series of e-cigarette updates. A team that combines authors of PHE’s previous reports with other international experts are starting work on a wide range of systematic reviews, including one on safety, to permit our most authoritative assessment in 2022.
A major UK NIHR funded clinical trial was published in February 2019. Involving nearly 900 participants, it found that in Local Stop Smoking Services, a standard e-cigarette was twice as effective at helping smokers to quit compared with the quitters’ choice of combination nicotine replacement therapy (NRT).
A separate study from UCL found that e-cigarettes helped an additional 50-70,000 smokers in England to quit in a single year.