Risk of stroke higher among young vapers than smokers, says study

E-cigarette smoking increases the risk of a stroke at a younger age by 15% compared with puffing on traditional cigarettes, new research presented to the American Heart Association on Monday shows.

“Adults who used e-cigarettes were younger when they had their first stroke — at a median average age of 48 years, compared to 59 years of age for people who smoked traditional cigarettes and 50 years of age for those who used both,” stated co-lead author Dr Urvish Patel, from New York’s Icahn School of Medicine.

But stroke remains “far more common” among cigarette smokers (6,75%) than among e-cigarette users (1%), the scientists noted.

In SA, nearly a million young South Africans — an estimated 978,000, about 2,5% of South Africans over the age of 15 — used e-cigarettes, the SA Demographic and Health Survey found in 2016.

Younger users of e-cigarettes need to be aware that they are raising their risk of a stroke, said Dr Karen Furie, from the US’s Brown University’s neurology department. “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.”

National Council Against Smoking deputy director Dr Sharon Nyatsanza said: “SA, with 37.4% of our population below the age of 19, requires close monitoring of youth trends and regulation to prevent a youth e-cigarette epidemic.

“Children and adolescents who start using e-cigarettes double their risk of later smoking tobacco cigarettes.

“Many people are aware that nicotine is a chemical in vaping products, as well as in conventional cigarettes. However, there are lots of other chemicals included that can directly affect the lining of the blood vessels.”

Nearly half a million Americans die prematurely every year of stroke and heart attacks, for which cigarette smoking is a “major risk factor”, the American Heart Association reports.

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.

—  Dr Karen Furie, US neurologist

Patel said: “E-cigarettes should not be considered as an alternative to traditional smoking, especially among people with existing risk factors, such as history of heart attack, high blood pressure and high cholesterol.”

The latest study, conducted among Spanish-speaking Americans, found that a third of women who had suffered strokes smoked cigarettes, while 36% of them used e-cigarettes.

The researchers analysed data from 80,000 adults with a history of stroke and smoking: traditional cigarettes (61%), e-cigarettes (10%) or both (40%). The survey was conducted from 2015 to 2018.

The use of e-cigarettes was more than three times higher than the use of traditional cigarettes among Mexican-American participants and non-Mexican-American Hispanic participants.

The researchers did not have data on the severity or type of strokes for their study.

“People need to be warned that e-cigarettes should not be promoted as an alternative option to smoking traditional, combustible cigarettes,” said Patel, suggesting their research should shape policy.

The global use of e-cigarettes has “substantially increased in recent years”, but there is little scientific evidence on their safety and risks, according to the American Heart Association.

Nyatsanza said studies internationally have found the popularity of e-cigarettes was higher elsewhere than that reported in SA, for example, in Italy (18%) and Poland (23%).

No regulations control the marketing or sale of e-cigarettes in SA, she said.

“The Tobacco Control Bill should be urgently passed into law to close down this regulatory loophole.”