Switching to vaping from smoking leads to significantly less fatal and life-threatening cardiac events in people with heart disease, a landmark new study has shown.
The study from South Korea, published in the European Heart Journal, found that switching to vapes was equally as beneficial as quitting smoking entirely without using any alternatives.
The report said: “..switching to e-cigarettes was associated with a significantly lower risk of MACE (Major Adverse Coronary Event) than continued combustible cigarette use, similar to quitting smoking.”
Researchers followed a group of almost 18,000 adult smokers who had been diagnosed with coronary artery disease (CAD).
They had all undergone percutaneous coronary intervention (PCI) - a non-surgical procedure that improves blood flow to the heart by opening blocked coronary arteries.
Following the PCI, almost half (49.8 per cent) of the group continued to smoke, 9.4 per cent switched to vapes (either alongside cigarettes or exclusively), and 40.7 per cent successfully quit smoking.
Risk of fatal or life-threatening events lower among vapers
After a follow up of up to 4.5 years, the percentage of people who had suffered a MACE was significantly lower among those who either switched to vaping or quit smoking entirely than in those who continued to smoke.
For patients who continued to smoke, it was 17 per cent. Meanwhile, for those who switched to vapes (either exclusively or alongside cigarettes), it was 10.8 per cent and for those who quit altogether it was 13.4 per cent.
The number of MACEs was even lower among those who switched exclusively to vaping (9.6 per cent), compared to those who both smoked and vaped (12.2 per cent).
Switching to vapes a ‘viable alternative’
The report noted that less than half of the patients managed to successfully quit smoking after treatment for CAD, for which smoking is a key risk factor.
It said: “First, although successful quitting smoking after PCI was associated with a significantly lower risk of MACE than continued combustible cigarette use, only 40.7 per cent of the patients quit smoking after PCI.
“Second, patients switching to e-cigarettes used markedly fewer combustible cigarettes than those who continued combustible cigarette use [alone], which may have contributed to the reduced risk of MACE.
“Third, patients who completely switched to e-cigarettes after PCI had significantly lower risks of MACE than dual users.”
It added: “ These findings suggest that switching to e-cigarettes could be a viable alternative for patients who find it challenging to quit combustible cigarettes after PCI.”
The report said that although the best strategy for smokers undergoing PCI is to stop smoking altogether, switching to vapes at least some of the time is worth considering for patients unable to quit.
Dr Konstantinos Farsalinos, a cardiologist and research fellow at the Onassis Cardiac Surgery Center in Athens, Greece, said the study should help lay to rest the misconception that nicotine is a risk factor for heart disease.
He said: “This study will be the beginning of the end for the misconception that nicotine use is a strong risk factor for cardiovascular disease, a misconception that is widely spread not only among non-experts but also among healthcare professionals.”
He said the findings contradict a recent controversial study that suggests vaping carries the same cardiovascular risk as smoking.
“It also exposes the problematic recent metanalysis [where data from multiple studies is combined] which claimed that e-cigarettes confer the same cardiovascular risk as smoking, a metanalysis that will soon be heavily criticised in a paper that is currently under review,” he said.
Dr Farsalinos added that the study also highlights how difficult smokers can find it to quit, even after being diagnosed with smoking-related cardiovascular disease.
He said: “I can imagine that many healthcare professionals have strongly condemned any attempt of such patients to quit smoking with the help of e-cigarettes. This means that fewer patients had the chance to make a lifestyle change that would benefit their health.”
