You've probably heard countless times that smoking is bad for your health. Unfortunately, it’s still the top cause of preventable deaths and illnesses in the United States, claiming more than 480,000 lives annually. Cigarette use has, fortunately, declined in recent years — but meanwhile, e-cigarettes are surging.
E-cigarettes (otherwise known as “vaping” or “Juuling”) deliver their effects via aerosol rather than smoke. Manufacturers tout the devices as less-harmful alternatives to cigarettes and a way to quit smoking. While it’s true that e-cigarettes have fewer chemicals than smoked cigarettes, there’s a catch: e-cigarettes still contain nicotine, and often at even higher levels than their traditional counterparts.
And e-cigarettes may also contain cancer-causing chemical additives.
Many people, especially adolescents and young adults, are taking up e-cigarettes under the assumption they are safe. In the U.S. in 2023, some 4.6% of middle schoolers and 10% of high school students had used an e-cig in the past 30 days, per the Centers for Disease Control and Prevention.
What’s more, nicotine-infused products like flavored chewing gum, lozenges, gummies and similar items are gaining in popularity for use outside of the context of quitting smoking.
Nicotine is a potent substance that doesn’t just fuel addiction; it also directly interferes with the heart’s function. Regardless of the delivery method — be it traditional cigarettes, modern e-cigarettes or direct nicotine supplements — when you take in nicotine, it can directly affect your heart health in the several ways:
Nicotine stimulates the release of adrenaline, the "fight or flight" hormone, temporarily increasing heart rate and blood pressure. While these effects might seem fleeting, repeated exposure can have lasting implications on cardiovascular health.
Nicotine constricts blood vessels, which increases resistance to blood flow and forces the heart to work harder to pump blood throughout the body. Over time, this added strain can lead to high blood pressure, a major risk factor for more severe cardiovascular conditions like heart attack and stroke.
Nicotine plays a sinister role in atherosclerosis, a condition characterized by the buildup of fatty substances, cholesterol and other materials on the walls of arteries. This buildup can restrict blood flow and, if a plaque ruptures, a blood clot can form, which can cause a heart attack.
It's clear that the conversation around nicotine is more important than ever. While we've long known the perils of smoking, it’s crucial to understand that all sources of nicotine carry risks to our heart health.
Smokeless products might seem like a ray of hope for those looking to ditch traditional smoking, and it’s true they can be helpful tools for some people, when used correctly. But it's vital to approach them with caution and recognize that they're not benign.
The bottom line: It’s crucial that we reduce nicotine use in all its forms. And — particularly for young folks — it’s best to avoid ever starting this highly addictive habit in the first place.
Natalie Stokes, M.D., is a cardiologist with the UPMC Heart and Vascular Institute.
First Published: April 19, 2024, 9:30 a.m.
Updated: April 20, 2024, 12:53 a.m.
