Major research study finds significant improvements in vascular health of long-term smokers who switch to e-cigarettes

New research from the UK—the largest study to date on how e-cigarettes and traditional cigarettes affect vascular health—proves vaping less harmful than smoking to vascular health. Smokers to switch to vaping can benefit from better vascular health, with women experiencing bigger benefits.

The British Heart Foundation commissioned the study, called VESUVIUS. The Journal of the American College of Cardiology published the findings here.

It consisted of a two-year trial and focused on actual human smokers. During the trial, some of the smokers continued to smoke, while others switched e-cigarettes. Of the e-cigarette vapers, some used e-cigarettes with nicotine, and others without.

Within four weeks, the smokers who switched showed a significant improvement in their vascular health. The female patients showed greater gains after they switched. Those patients who transitioned completely to e-cigarettes without nicotine showed more improvement compared to the people who vaped nicotine.

Vaping is safer than smoking, but not harmless

The study’s Chief Investigator, Professor Jacob George, explained some of the nuances of the findings in a press release.

“It is crucial to emphasize that e-cigarettes are not safe, just less harmful than tobacco cigarettes when it comes to vascular health,” said Professor George, who is in Cardiovascular Medicine and Therapeutics at the University of Dundee. “Smoking of any kind is a preventable risk factor for heart disease.”

However, the results showed notable improvements in vascular function within just four weeks of transitioning between regular cigarettes and vaping for long-term smokers.

“To put into context, each percentage point improvement in vascular function results in a 13 percent reduction in cardiovascular event rates such as heart attack,” Professor George said in the press release. “By switching from cigarettes to e-cigarettes we found an average percentage point improvement of 1.5 within just one month. This represents a significant improvement in vascular health.”

Study strengths and limitations

The issue of what nicotine does to vascular health and how is an issue for further study. Professor George comments in the press release: “We also found that, in the short term at least, regardless of whether the e-cigarette does or does not contain nicotine, a person will see vascular health improvements compared to smoking a traditional cigarette.”

Many of the studies on vaping and cardiovascular health we have seen in the news lately feature a very small number of healthy adults, or even a small number of mice. In contrast, VESUVIUS study ticks most of the research best practices boxes:

  • the team recruited 114 long-term cigarette smokers

  • for participants, the team defined “long-term” by setting a minimum of 15 cigarettes every day for at least two years before the study

  • the team sorted participants into one of three groups: smokers, vapers of e-cigarettes with nicotine, and vapers of e-cigarettes without nicotine

  • the participants went through vascular testing before the trial started

  • the team monitored the participants throughout the four weeks

  • the participants went through vascular testing once more, after the trial

In terms of limitations, the authors mention that there were no controls used. Obviously this is true as it is unethical to put people who want to stop smoking into the “smoker” group. (To keep it truly random, they would have had to do that.)

They also mention the need for follow up on both the nicotine issue and the gender difference.

Furthermore, the team tested just one e-cigarette, although there are many out there. The one they used was “Vapourlites,” a UK brand.

[One thing we at VV find notable is that Juul is currently the biggest e-cigarette in the US, with about 75 percent of the market share. As we will soon we reporting, new research shows Juul may also deliver nicotine more effectively than other brands. If more nicotine means more cardiovascular damage, that will be something researchers should compare in future studies, including the Juul brand.]

Smoking cessation and youth vaping: two different issues

This study is important because it focuses on e-cigarettes and their role in smoking cessation. Focusing on what vaping does to teens is a different issue.

Whether vaping is safe is the wrong question. No one who doesn’t smoke should start, in any form. The question is whether vaping is safer than smoking for people who already smoke or use some form of tobacco. That is the only issue addressed in this research.

The researchers do acknowledge the other issue, however. Professor George says in the release: “[E-cigarettes] should not be seen as harmless devices for non-smokers or young people to try.”

Meanwhile in the United States, ongoing pushes across the country to ban vaping altogether continue to miss the point. The illnesses aren’t coming from these smoking cessation products—although those products are not intended for youths and may not be good for their health.

Those lung injuries are coming from an additive, mostly found in THC products in places where they are illegal. Meanwhile, the research here proves vaping less harmful than smoking for vascular health—and we already know that smoking will kill you.