Health issues: Vaping

Vaping might seem safer than smoking but your heart could tell a different story

You may have heard that vaping is the “safer” choice than smoking. But what if the very thing designed to protect your health also puts your heart at risk?

Vaping does not exist in isolation. It is part of a wider story about smoking, inequality and the growing burden of heart disease Even after years  of public health campaigns,  smoking remains common in England’s most deprived areas.

The reasons are complex. People living with financial strain, insecure jobs and chronic stress are more likely to smoke. Targeted marketing and limited access to stop-smoking services make it even harder to quit. At the same time, one in two UK adults have high cholesterol, and many do not know it.

Reports show that people in the poorest communities have the highest rates of smoking and other risk factors for cardiovascular disease, including raised cholesterol.

As vaping becomes more common in these same communities, a new form of nicotine use could be replacing one heart risk with another. Many people now switch from cigarettes to vapes to reduce harm, but growing evidence suggests the benefits may not be as clear-cut as once thought.

Several studies have now linked vaping to arterial damage in both the brain and heart

Research shows that vaping can help some people quit smoking more effectively than other methods, but newer findings challenge the belief that e-cigarettes are a harmless substitute.

Several studies have now linked vaping to arterial damage in both the brain and heart, even among people who have never smoked traditional cigarettes. The cells that line our blood vessels, known as the endothelium, keep arteries supple, regulate blood pressure and stop fatty deposits from sticking to the walls. When these cells are damaged, arteries lose elasticity and blood flow becomes less efficient, raising the risk of cardiovascular problems.

This arterial stiffening increases the likelihood of heart attack, stroke and dementia.

One study found that regular vapers had impaired blood vessel function. Their arteries could no longer expand and contract properly. Other research on humans and animals exposed to vapour showed less flexible arteries, higher blood pressure and damaged endothelium in both the brain and heart. This arterial stiffening increases the likelihood of heart attack, stroke and dementia.

So what is behind this damage? When someone vapes, the vapour carries nicotine, chemicals and microscopic particles into the bloodstream. These trigger inflammation and oxidative stress, meaning the body’s defences go into overdrive and start attacking healthy tissue. Vaping also reduces nitric oxide, a molecule that helps vessels relax, while increasing harmful free radicals. Together, these effects make arteries less able to do their job and more prone to disease, increasing the risk of heart problems.

Vaping can also raise blood pressure and heart rate, even after a single session. Over time, this mix of irritation, inflammation and stress wears down the arteries, even in people who have never smoked before.

The UK’s NHS Health Check programme mainly screens people aged forty and over for heart-disease risks. Yet vaping is most common among people under 40, and routine screening is not designed to detect early vessel injury in this age group. Young vapers may therefore carry silent artery damage for years before any problem appears on standard tests. Evidence suggests that vaping can cause early artery changes similar to those caused by smoking, increasing the risk of cardiovascular disease (CVD) later in life.

That is why education and prevention are so important. Schools and public health campaigns play a vital role in showing young people that vaping carries long-term risks, including damage to the heart. Programmes that combine classroom learning with interactive activities have been shown to make a real difference. Initiatives such as Catch Your Breath and Essex’s Break the Vape aim to stop young people from vaping before they start, and to support those who want to quit, reducing their future risk of heart disease.

The wide differences in heart disease deaths across England show that prevention efforts are still not reaching everyone equally. A whole-system approach to CVD prevention is essential. Schools, councils, NHS services and local communities need to work together to tackle shared risk factors such as smoking and vaping.
Screening cannot yet detect early artery damage in younger adults, but education remains our best defence. Helping young people understand how vaping affects the heart can protect the next generation from the hidden dangers of nicotine addiction and cardiovascular harm.

Authors Preeti Mahato. Lecturer in Global Health, Royal Holloway, University of London
Anusha Seneviratne. Lecturer in Health Studies, Royal Holloway University of London

First published on The Conversation