Traditional cigarette smoking continues to be a major public issue as it has continuously been shown to have many pathogenic and negative effects on the heart. Presently, cardiovascular diseases (CVDs) are the number one cause of death among Americans, killing approximately 630 000 persons annually.1 Despite strong efforts to reduce smoking, traditional smoking continues to be one of the most preventable risk factors for heart disease as 15% of the population use combustible cigarettes.2 Resultantly, marketing for alternatives to tobacco smoking and nicotine replacements has skyrocketed in recent years. More specifically, since being introduced in 2006, electronic cigarettes (e-cigarettes) บุหรี่ไฟฟ้า
have become more popular due to their perceived safety when compared with traditional cigarette smoking. These public perceptions of safety have made e-cigarettes not only appealing to smokers attempting to quit but have also gained popularity among non-smokers, who constitute a substantial segment of the e-cigarette market. From 2011 to 2015, the use of e-cigarettes among middle school and high school students grew from 1.5% to 16%, making it the most used tobacco product by teens and young adults.3 As of 2018, the National Youth Tobacco Survey reported that 20.8% of the same population reported current use of e-cigarettes.4 While e-cigarettes have generally been advertised to contain less toxic constituents than traditional cigarettes, they do contain a variety of potentially toxic compounds that have yet to be thoroughly studied in preclinical and clinical research.5
In this review, we discuss recent, relevant studies from the available literature, focusing on the components of and potential cardiovascular risks associated with exposure to e-cigarette vapour. In their recent work, Benowitz and Fraiman6 evaluated a related topic with a focus on the cardiovascular effects of e-cigarettes vs. tobacco cigarettes. Here, we focus on evaluating and extensively discussing data from preclinical and epidemiological studies regarding the cardiovascular effects of acute (short-term) and chronic (long-term) e-cigarette exposure (summarized in Table 1). Furthermore, we have reviewed various constituents of e-cigarettes for their potential cardiovascular toxicity and disease burden. Few studies have reported no adverse effects associated with e-cigarette usage, while others suggest that e-cigarettes could increase a users’ risk of CVDs. Heightened concern over the safety profile of e-cigarettes from these studies displays an urgent need for additional studies to establish and better understand the acute and chronic health consequences of e-cigarette use.