In a recent article published by the American College of Cardiologists, researchers from the University of Kentucky’s Bridging Research Efforts and Advocacy Toward Healthy Environments (BREATHE) in the College of Nursing are asking health care providers to consider the potential effects of e-cigarettes when advising patients on what they can do to prevent heart disease. The article was selected as an ‘Editors Pick’ and is being featured this week on the American College of Cardiology’s website (ACC.org).

The Expert Analysis article is one of a series in ACC’s Prevention Clinical Topic Collection that builds on the 2019 ACC/American Heart Association guideline of the primary prevention of cardiovascular disease. Most experts agree that complete abstinence from all tobacco products, including e-cigarettes, is the only way to sufficiently reduce the risk of heart disease.

“We know that e-cigarettes contain oxidizing chemicals, polycyclic aromatic hydrocarbons, and particulates, which have been associated with endothelial dysfunction and platelet activation, mechanisms long associated with increased cardiovascular risk,” according to the study. “The impacts of e-cigarettes on the cardiovascular system are also informed by the immediate and well-known effects of nicotine on the cardiovascular system, which are generally dose-dependent.”

The authors make five recommendations, considering the new primary prevention of heart disease guideline:

1. Use a cautious approach to e-cigarettes. Less harm does not equal no harm. Evidence of the acute effects of e-cigarette use on the heart and circulation are clearly notable and warrant additional research.
2. Doctors should not advise patients to use e-cigarettes as a way to quit smoking. The evidence on the use of e-cigarettes as a smoking cessation strategy in adults and adolescents is insufficient or limited.
3. Do not switch to e-cigarettes. The tobacco industry has a long history of promoting "switch to quit" strategies with adults, while concurrently promoting youth initiation of tobacco products.
4. Avoid exposure to secondhand smoke and aerosol. E-cigarettes pollute the air.
5. Use established ways to quit using tobacco. Quitting tobacco (including e-cigarettes) is the most important thing you can do to promote heart health.

Visit the UK College of Nursing’s BREATHE website for more information.