The American Heart Association is raising alarms about the cardiovascular dangers of e-cigarettes, citing a growing body of scientific evidence that links chemicals in these products to heart health risks. In a recent statement, the organization emphasized that e-cigarette aerosol is often misrepresented as harmless water vapor but actually contains a mix of chemicals, additives, and flavoring agents that the U.S. Food and Drug Administration (FDA) classifies as harmful or potentially harmful constituents.
A study published earlier this month in Circulation: Arrhythmia and Electrophysiology found that synthetic cooling chemicals used in some e-cigarettes may disrupt heart rhythm, pointing to potential risks such as irregular heartbeat and cardiac arrest. This adds to previous research showing that e-cigarette users are exposed to toxic substances like formaldehyde and heavy metals, which are linked to cardiovascular, respiratory, and cancer-related health risks. Nicotine, a highly addictive chemical present in nearly all e-cigarettes, can damage the heart and other vital organs by raising blood pressure and heart rate, narrowing blood vessels, and forcing the heart to work harder.
“We’ve long known about the health threats of cigarettes and other traditional tobacco products, but as increasing numbers of e-cigarettes and other newer nicotine products are introduced into the market, we are learning more about the health threats of these products,” said Dr. Jason J. Rose, an American Heart Association volunteer and associate professor of medicine at the University of Maryland School of Medicine. Dr. Rose chaired the writing group for the Association’s 2023 scientific statement on e-cigarettes. “A growing body of research shows that people who use e-cigarettes can be exposed to chemicals that can harm the heart and blood vessels.”
Research suggests that inhaling e-cigarette aerosol may contribute to oxidative stress, inflammation, damage to blood vessel function, and changes that can lead to atherosclerosis. Nicotine also increases blood clotting and can contribute to peripheral artery disease, which raises the risk of serious cardiovascular events, including lower limb amputation. One e-cigarette can contain as much or more nicotine as a pack of cigarettes, increasing the risk of addiction and perpetuating a cycle of use.
Claims that e-cigarettes or nicotine products improve cognitive function are not supported by evidence. While nicotine may produce short-term changes in attention, these effects are modest and often reflect relief from withdrawal symptoms rather than true improvement. Over time, nicotine exposure, especially among young people, can harm brain development and is associated with changes in attention, learning, and impulse control, according to the Centers for Disease Control and Prevention.
Youth use remains a major concern, with most young e-cigarette users reporting flavored products, which appeal to them and increase the likelihood of continued use. Nicotine exposure during adolescence can have long-lasting effects on brain development. The American Heart Association supports policies to prohibit the sale of all flavored commercial tobacco and nicotine products, including menthol, and advocates for evidence-based cessation tools.
“The tobacco industry relentlessly targets kids and communities with fruit-, candy-, and menthol-flavored tobacco products that encourage use, facilitate addiction, and increase profits,” said Nancy Brown, chief executive officer of the American Heart Association. “After decades of selling products that cause disease and death, tobacco and nicotine companies cannot be trusted to protect public health. No tobacco or nicotine product can be considered safe.”
