Using electronic cigarettes is not associated with acute adverse effects on cardiac function, researchers from the Onassis Cardiac Surgery Center, Athens, Greece, reported at the European Society for Cardiology 2012 Conference in Munich, Germany. Dr Konstantinos Farsalinos added that according to currently available data, electronic cigarettes are considerably less harmful than smoking tobacco, and switching from smoking tobacco to using electronic cigarettes is most likely a good health move.

According to the World Health Organization WHO), smoking will have caused over 1 billion deaths by the end of this century. It is the most preventable risk factor for lung and cardiac disease. Electronic cigarette manufacturers and sellers have been promoting the product as a safer alternative for regular smokers. Millions of people worldwide regularly use electronic cigarettes today.

An electronic cigarette mimics the sensations and actions experienced by tobacco smoking, but instead of breathing in smoke, the user inhales vapor. The device contains a cartridge filled with liquid, a heating element to evaporate the liquid, and a battery.

Previous studies have shown that electronic cigarettes contain fewer toxins than tobacco cigarettes. The majority of studies have not detected nitrosamines in electronic cigarettes. (tobacco-specific) Nitrosamines form part of an important group of carcinogens in tobacco products. The few that did detect nitrosamines in the devices reported levels 500 to 1,400 less than what most cigarettes contain. In order to breathe in the nitrosamines contained in one tobacco cigarette, an electronic cigarette user would need to use his/her device every day for 4 to 12 months.

Regular tobacco smoking is associated with heart disease and death; 40% of smoking-related mortality is due to just coronary artery disease. Dr. Farsalinos and team set out to determine what acute effects electronic cigarettes might have on cardiac function.

As electronic cigarettes are marketed specifically at tobacco smokers as a healthier option, the scientists wanted to compare their results against the acute effects of tobacco cigarettes on cardiac function.

Studies had already shown that inhaling tobacco smoke produces immediate defects in myocardial function. This probably means that healthy young regular tobacco smokers with no current symptoms may already have sustained some type of subclinical dysfunction.

The team wanted to see whether the signs detected in tobacco smokers were also present in regular electronic cigarette users.

Their study involved 42 volunteers – 20 healthy regular smokers aged 25 to 45 years and 22 regular electronic cigarette users of the same age. Both groups were tested before and after smoking one tobacco cigarette or using an electronic cigarette for seven minutes.

Dr. Farsalinos explained that they only used experience electronic cigarette users, because they tend to use the device more intensely.

Those in the electronic cigarette group had cartridges with a solution of nicotine (concentration 11mg/ml). An independent toxicology lab was used to test the solution – they found no traces of nitrosamines or polycyclic aromatic hydrocarbons.

Echocardiography, blood pressure, and heart rates were examined to determine myocardial function.

The scientists found that:

  • After smoking one tobacco cigarette, acute myocardial dysfunction was clearly detected
  • After using an electronic cigarette for 7 minutes, no adverse effects on cardiac function were detected
  • After smoking a single tobacco cigarette, heart rate and diastolic blood pressure both went up considerably
  • Using an electronic cigarette for 7 minutes raised diastolic blood pressure very slightly.

Dr Farsalinos said:

“This is an indication that although nicotine was present in the liquid used (11mg/ml), it is absorbed at a lower rate compared to regular cigarette smoking.”

The ultrasound scan (echocardiography examination) looked at how effectively the heart pumps blood to the whole body – it focused on the left ventricle of the heart. The left ventricle receives oxygen-rich blood from the lungs (diastolic phase) and pumps out blood (systolic phase).

The researchers found that:

  • Left ventricular function after smoking one tobacco cigarette was significantly undermined. The echocardiography exam detected four parameters which indicate worsening function.
  • Left ventricular function after using an electronic cigarette for 7 minutes was not significantly worsened.

Dr Farsalinos said:

“Diastolic dysfunction is very important because it is usually the first defect that is detected before any clinically-evident cardiac disease develops.

It is too early to say whether the electronic cigarette is a revolution in tobacco harm reduction but the potential is there. It is the only available product that deals with both the chemical (nicotine delivery) and psychological (inhaling and exhaling ‘smoke’, holding it, etc) addiction to smoking, laboratory analyses indicate that it is significantly less toxic and our study has shown no significant defects in cardiac function after acute use.

More clinical studies need to be done before suggesting that this is a revolutionary product. However, considering the extreme hazards associated with cigarette smoking, currently available data suggest that electronic cigarettes are far less harmful and substituting tobacco with electronic cigarettes may be beneficial to health.”

Electronic cigarettes, also known as E-cigarettes or vaporizer cigarettes are cigarette-like devices that emit vapor instead of smoke. The user sucks and inhales the vapor just as he/she would with a tobacco product. The device is powered by a small battery.

The e-cigarette user can inhale vaporized nicotine or non-nicotine vaporized solutions. Tobacco smoke is known to have over 4,000 different types of chemicals, a high proportion of which are bad for human health.

Electronic cigarette makers, and a growing number of users say the device provides a very similar sensation to inhaling tobacco smoke. However, as there is no combustion, no harmful smoke is inhaled.

Written by Christian Nordqvist