- Cigarette smokers had 11% higher odds of developing cardiovascular disease than non-smokers
- Two inflammation markers in the blood – hsCRP and sICAM-1 – help explain much of that increased risk
- No statistically significant link was found between exclusive vape use and cardiovascular disease
- Inflammation markers explained much of the increased heart disease risk seen in smokers
A new U.S. study has found no statistically significant link between exclusive vaping and heart disease, while confirming that cigarette smoking is associated with a higher risk of cardiovascular conditions.
The research, published in the Journal of the Louisiana Public Health Association, analysed health data from 6,473 adults who took part in the long-running Population Assessment of Tobacco and Health (PATH) Study. All participants were free of cardiovascular disease at the start and were followed over several years.
Researchers divided people into three groups: cigarette smokers (including dual users who also vaped), exclusive vape users, and people who did not use cigarettes or vapes. They then looked at who went on to report being diagnosed with conditions such as heart attack, stroke or heart failure.
Smoking linked to higher risk
The study found a clear statistical association between cigarette smoking and cardiovascular disease. Smokers had about 11 per cent higher odds of developing a cardiovascular condition compared with non-users.
By contrast, although exclusive vape users showed slightly higher odds than non-users, the difference was not statistically significant. In practical terms, that means the researchers could not rule out the possibility that the difference was due to chance.
The authors wrote that “no significant effect was found for exclusive e-cigarette users.”
The role of inflammation
The researchers also wanted to understand why smoking increases heart disease risk. To do that, they examined 59 biological markers measured in blood and urine samples. Two markers stood out:
- High-sensitivity C-reactive protein (hsCRP)
- Soluble intercellular adhesion molecule-1 (sICAM-1)
Both are linked to inflammation in the body. Long-term inflammation is known to damage blood vessels and contribute to heart disease.
The study found that smokers tended to have higher levels of these inflammation markers. People with higher levels of these markers were also more likely to develop cardiovascular disease. When researchers took those inflammation levels into account, the direct statistical effect of smoking itself became insignificant.
In other words, much of the increased heart disease risk seen in smokers appears to operate through inflammation-related biological processes.
For smokers, hsCRP explained around 20 per cent of the effect, and sICAM-1 explained a much larger share. Together, they accounted for most of the difference in cardiovascular disease risk between smokers and non-users.
For exclusive vape users, the same pattern was not observed at a statistically significant level.
What this does – and does not – mean
This study does not say vaping is risk-free. It does say that, in this group of adults over the period studied, researchers did not detect a statistically significant increase in cardiovascular disease among people who exclusively used vapes.
It also does not compare vaping to smoking in terms of overall safety, only in relation to reported cardiovascular disease outcomes in this dataset.
There are some limitations, for example cardiovascular diagnoses were self-reported. The number of people who developed disease during the study was relatively small compared with the total sample. The research did not fully account for how long people had smoked or vaped, and it did not include every type of tobacco product.
The authors note that further research is needed, particularly to understand long-term effects and whether these inflammation markers can reliably predict future cardiovascular risk.
What it means for consumers
For smokers, the findings reinforce long-standing evidence that cigarette smoking is linked to heart disease and that inflammation appears to be a key pathway in that harm.
For adult smokers considering switching, the results add to a body of research suggesting that exclusive vape use does not show the same measurable association with cardiovascular disease events – at least in the medium term covered by this study.
The key distinction in this research is exclusive use. Dual use and other tobacco patterns may carry different risks.
As always, the safest option for cardiovascular health is not to use tobacco at all. But for people who already smoke, understanding the differences between products – and what the science does and does not show – is essential.
