November 15, 2019

expert reaction to the VESUVIUS study comparing the cardiovascular effects of smoking and vaping

Research from the VESUVIUS study, as published in the Journal of the American College of Cardiology, reports on the difference in the effects on the cardiovascular system between smoking and vaping.

This roundup accompanied an SMC Briefing.

Prof Peter Hajek, Director of the Tobacco Dependence Research Unit, Queen Mary University of London, said:

“There has been a stream of scares concerning cardiovascular effects of vaping. These were typically based on pouring e-liquid on cells in petri dishes, poisoning mice with huge doses of chemicals that have no relationship to human vaping, or misinterpreting acute stimulant effects of vaping that are similar to effects from drinking coffee as a health risk.

“Finally, here is a randomised study in humans that provides some relevant data. Smokers who switch to vaping experience significant cardiovascular benefits – or to put this more accurately, avoid the cardiovascular risks of smoking. Importantly, the benefits are the same for nicotine and for nicotine-free e-cigarettes.

“Switching to vaping removes practically all further cancer risks from continuing smoking, but due to the wave of misinformation, some smokers may have been put off switching to vaping thinking that this does not reduce the risk of heart attacks and strokes. This study is important in correcting this and hopefully encouraging more smokers who cannot or do not want to stop using nicotine to switch to the much less risky alternative.”

Dr Jamie Hartmann-Boyce, Senior researcher in Health Behaviours and Managing Editor of the Cochrane Tobacco Addiction Group, University of Oxford, said:

“This is an important and well-conducted study which shows improvements in vascular health a month after switching from smoking to vaping. Importantly, these improvements were seen regardless of whether people were vaping electronic cigarettes with nicotine or electronic cigarettes without nicotine.

“Though recently we’ve seen many stories about how electronic cigarettes and nicotine might worsen heart health, those studies focus on very short-term data, and many of them are not conducted in people. This study should provide reassurance as it has studied more people and followed them up for longer than many of the recently reported studies. Its results are in line with statements from numerous public health and medical bodies who agree that vaping is considerably safer than smoking.

“Vaping is not risk free, and non-smokers should not start. However, people who smoke should consider switching.”

Prof John Britton, Director of the UK Centre for Tobacco & Alcohol Studies and Consultant in Respiratory Medicine, University of Nottingham, said:

“This randomised trial provides clear evidence of a reduction in a marker of cardiovascular disease risk in people who switch from smoking to vaping, and that the reduction is similar irrespective of whether nicotine was used in the electronic cigarette. The outcome is an indirect marker but the finding of the study, that vaping is less harmful than smoking, is intuitively correct on the grounds of the lower range and levels of emissions known to be present in vapour relative to tobacco smoke.

“The finding contradicts the findings of observational studies that find that people who vape are at higher risk of heart disease, because those studies are inevitably and irreversibly confounded by former smoking. 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.”

‘Cardiovascular Effects of Switching From Tobacco Cigarettes to Electronic Cigarettes’ by Jacob George et al. was published in the Journal of the American College of Cardiology at 19:00 UK time on Friday 15 November 2019. 

DOI: 10.1016/j.jacc.2019.09.067

Declared interests

None to declare