Smoking and vaping can both stiffen the arteries and increase the risk of developing adverse lung conditions, scientists have found.
A clinical review of evidence gathered from multiple sources by an international team of researchers found tobacco cigarettes, in general, were more harmful than electronic cigarettes.
The team also said waterpipe smoking, which involves passing smoke through water before inhaling, using a hookah, is as damaging as tobacco smoking and “cannot be considered a healthy alternative”. They added that both smoking and vaping may increase the risk of people developing severe Covid-19 symptoms.
Based on their findings, published in the European Heart Journal, the scientists are urging people to try to give up smoking, regardless of which method they use. But experts argue the review does not provide clarity on whether the harmful effects seen in e-cigarette smokers come from prior tobacco use, saying most users were former tobacco smokers.
The researchers looked at the effects of each on medical conditions, including lung cancer and chronic obstructive pulmonary disease (COPD). Compared to non-smokers, tobacco cigarettes increased the risk of COPD by 704%, waterpipes by 218%, and e-cigarettes by 194%.
Tobacco cigarettes and waterpipes also increased the risk of lung cancer by 1,210% and 122% respectively, when compared to those who did not smoke. The researchers said there was not enough evidence to assess the risk of e-cigarettes on lung cancer.
The team also looked at how much the three techniques stiffened the arteries, an important indicator for the risk of heart problems and stroke. Compared to non-smokers, tobacco cigarettes increased arterial stiffness by 10%, waterpipes by 9%, and e-cigarettes by 7%.
Professor Thomas Munzel, of the department of cardiology of the University Medical Centre Mainz in Germany, who is first author on the study, said: “The World Health Organisation also warns that although e-cigarettes appear to be less harmful than tobacco cigarettes, there is growing evidence they also may cause side-effects in the lungs, heart and blood vessels and that e-cigarette use may increase the risk of Covid-19 infection.”
Commenting on the study, Jacob George, a professor of cardiovascular medicine and therapeutics at the University of Dundee, who was not involved in the research, said: “What we cannot say for certain, and the study does not provide further clarity on either, is how much of the effects seen in e-cigarette smokers are due to prior tobacco cigarette use.
“No study so far has accurately and absolutely quantified prior impact of tobacco cigarette smoking on vascular dysfunction in individual e-cigarette users as we know that most e-cigarette smokers are former users of tobacco cigarettes and a number are dual users also.
“Disentangling this from the distinctive impact of e-cigarettes on vascular function is still required to fully understand the risks versus the benefits of e-cigarettes, which on a comparative basis contains significantly fewer than the 7,000 harmful chemicals present in every tobacco cigarette that is smoked.”