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The WHF policy brief, E-Cigarettes: A New Threat to Cardiovascular Health, summarizes the latest evidence on electronic cigarettes and heart health. The document aims to help readers understand the dangers of e-cigarettes and make informed decisions regarding their health.
The policy brief provides a summary of relevant research on e-cigarettes and cardiovascular health. It also recommends a set of measures that governments can adopt to protect vulnerable populations, prevent exposure to second-hand vaping, and address the industry’s marketing and sales strategies.
The policy brief has been developed for a broad range of stakeholders, including the global cardiovascular and health community, the tobacco control community, healthcare professionals, the general public, and policymakers.
In recent years, the popularity of e-cigarettes has surged exponentially worldwide, especially among young populations. Aggressive marketing strategies, as well as misleading claims by manufacturers, have largely contributed to the belief that e-cigarettes are harmless.
Nonetheless, a growing body of literature suggests that e-cigarettes are associated with an increased risk of cardiovascular and other morbidity and mortality. In fact, many studies have already confirmed that e-cigarettes are far from harmless, and that e-liquids, as well as e-cigarette aerosols, contain harmful substances that are commonly found in conventional cigarette emissions.
The policy brief can be used as an awareness raising and advocacy tool by all relevant stakeholders.
The document also recommends a set of policies that governments, policymakers, and other relevant stakeholders can enact or support to protect their populations from the dangers of e-cigarettes.
E-cigarettes, also referred to as electronic cigarettes, are a type of electronic nicotine delivery system. They constitute a group of products that can differ considerably in terms of shapes, capabilities, and functionalities. Regardless of the model, all e-cigarettes deliver nicotine by heating and transforming a solution, known as e-liquid, into an aerosol inhaled by the user.
In contrast to conventional cigarettes, e-cigarettes do not contain or involve the combustion of tobacco. E-cigarettes deliver nicotine by heating and transforming a solution, known as e-liquid, into an aerosol inhaled by the user.
Aggressive marketing strategies, as well as misleading claims by manufacturers, have largely contributed to the belief that e-cigarettes are harmless. As a result, electronic cigarettes are generally perceived as safer, healthier, and less addictive substitutes for traditional tobacco cigarettes.
However, a growing body of literature suggests that e-cigarettes are associated with an increased risk of cardiovascular and other morbidity and mortality. A number of studies have already confirmed that e-cigarettes are far from innocuous, and that e-liquids, as well as e-cigarette aerosols, contain harmful substances that are commonly found in conventional cigarette emissions.
Many studies have confirmed that e-cigarettes are associated with an increased risk of cardiovascular morbidity and mortality. The use of e-cigarettes is correlated with physiological changes that are typically observed in individuals who develop cardiovascular diseases.
Electronic cigarettes are associated with an increase in heart rate and blood pressure, as well as an irregular heartbeat. Studies have also linked e-cigarettes to a wide range of vascular injuries and problems. In addition, e-cigarettes are also associated with an increased risk of myocardial infarction. In fact, habitual e-cigarette users are 1.79 times more likely to develop myocardial infarction than non-smokers.
Nicotine is directly associated with the development of cardiovascular diseases and can induce an increase in heart rate and blood pressure, as well as a wide range of vascular problems. Nicotine can also affect brain development, which can be especially hazardous for infants, adolescents, and pregnant women.
Nicotine is widely recognized as a highly addictive drug. Modern e-cigarettes can deliver concentrations of nicotine that are comparable to traditional cigarettes and are able to both generate and maintain dependence.
Although not harmless, current evidence suggests that completely switching from tobacco cigarettes to electronic cigarettes would reduce exposure to toxicants, in terms of quality and quantity, and could result in some health improvements in the short term.
Nevertheless, surveys indicate that a large majority of e-cigarette users do not give up on tobacco cigarettes and become dual users of both conventional and electronic cigarettes. Dual users are generally exposed to a higher number and concentration of harmful constituents and may incur higher risks of developing cardiovascular diseases.
Despite claims from the industry, the effectiveness of e-cigarettes as smoking cessation tools has yet to be determined. To date, e-cigarettes have not been officially approved as smoking cessation therapies by any relevant authorities or countries.
In fact, recent sources have indicated that e-cigarette users are less likely to quit smoking. The use of e-cigarettes in young populations is generally associated with a transition to traditional tobacco cigarettes. Studies suggest that adolescents who smoke e-cigarettes are 3.5 times more prone to start smoking conventional cigarettes than non-smoking peers.
In addition, surveys also indicate that a large majority of e-cigarette users do not give up on tobacco cigarettes and become dual users of both conventional and electronic cigarettes. Dual users are generally exposed to a higher number and concentration of harmful constituents and may incur higher risks of developing cardiovascular diseases.
E-cigarette users exhale aerosols containing nicotine and other harmful constituents in the air. There is strong evidence supporting the idea that e-cigarettes can affect the quality of air indoors and that bystanders breathe in aerosols, as well as their constituents, in some capacity.
The regulation of e-cigarettes can vary significantly from one country or region to another, with no global standard currently available. In 2018, electronic cigarettes were banned in 40 countries worldwide, while being entirely unregulated in 39 others. In general, policy options include prohibiting or restricting the possession, use, marketing, and/or flavours of e-cigarettes.
Article 5.3 of the WHO Framework Convention on Tobacco Control and its guidelines state that there is “a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests”.
Unfortunately, nearly all the major transnational tobacco companies, including Philip Morris, British American Tobacco and Japan Tobacco, are already involved in the business of e-cigarettes.
The tobacco industry is capitalizing on electronic cigarettes to interfere with existing tobacco control laws. It aims to exploit loopholes in current legislation to sabotage tobacco denormalization and encourage defiance against tobacco control policies. In addition, the industry has also been pushing for e-cigarette-friendly regulation while continuing to oppose effective regulation of conventional cigarettes and other tobacco products.
The tobacco industry has a long history of using deceitful and misleading claims to advertise its products. One of its current objectives is to ensure that e-cigarettes are perceived as safer or harmless alternatives to conventional tobacco cigarettes. To this end, the industry has funded several studies that severely downplayed the dangers of e-cigarettes.