Vaping Worse Than Smoking for Boosting Odds for Stroke at Young Age

Adults who vape could suffer a stroke at least a decade younger than those who smoke tobacco, a new study has found.

E-cigarette users have a 15% higher risk of stroke at a younger age than traditional tobacco smokers, according to preliminary findings.

"The median age to have a stroke was 48 years of age for e-cigarette users compared to 59 years of age for traditional tobacco smokers," said study co-author Dr. Neel Patel. He's a research scholar in the public health department at the Icahn School of Medicine at Mount Sinai in New York City.

People who both smoke and vape tended to have a stroke at age 50 on average, the study showed.

These results show that e-cigarettes aren't as benign as first thought, said Dr. Karen Furie, chair of the neurology department at Brown University's Warren Alpert Medical School.

"Children and young adults start using e-cigarettes and have a perception that they convey less risks of heart disease and stroke," Furie said. "In fact, this study suggests that there may be a detrimental effect that increases risk of stroke."

For the study, researchers analyzed data from the U.S. National Health and Nutrition Examination Survey gathered between 2015 and 2018. They identified nearly 80,000 adults with a history of stroke who either smoked or vaped.

Among the people identified, just under 10% vaped, 61% smoked and 30% used both.

Stroke was more prevalent among traditional tobacco smokers. Nearly 7% of smokers had suffered a stroke compared with 1% of e-cigarette users and 4% of people who both smoked and vaped.

However, e-cigarette users tended to suffer from a stroke years earlier than their smoking counterparts.

"It's quite possible that exposure at a younger age may cause irreversible damage to blood vessels throughout the body and particularly in the brain," Furie said.

E-cigarette liquid that's been superheated to form an inhalable vapor contains a number of toxic substances, including formaldehyde, fine particles, benzene, toluene, xylenes, volatile organic compounds and polycyclic aromatic hydrocarbons, said Patel.

Vaping these toxins can increase inflammation in the brain, weaken the blood-brain barrier, cause increased heart rate and blood pressure, disrupt blood vessel function and promote clotting in the arteries, Patel said -- all risk factors for stroke.

People who are thinking about using e-cigarettes to help quit smoking should take these findings into consideration, as well as the fact that people who vape are much more likely to relapse to smoking, said co-author Dr. Urvish Patel, a research scholar and chief education officer in the Departments of Public Health and Neurology at the Icahn School of Medicine.

"We would encourage them not to switch to an e-cigarette," Urvish Patel said.

The results are scheduled for presentation at the upcoming American Heart Association online annual meeting. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Sources

• Neel Patel, MD, research scholar, Department of Public Health, Icahn School of Medicine at Mount Sinai, New York City

• Urvish Patel, MD, MPH, research scholar and chief education officer, Departments of Public Health and Neurology, Icahn School of Medicine at Mount Sinai, New York City

• Karen Furie, MD, MPH, chair, department of neurology, Brown University's Warren Alpert Medical School, Providence, R.I.

• American Heart Association, online annual meeting, Nov. 13-15, 2021