January 07, 2020
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Stroke risk may nearly triple with combined e-cigarette, combustible cigarette use

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Tarang Parekh

Patients aged 18 to 44 years who currently smoke combustible cigarette or both e-cigarettes and combustible cigarettes had an increased risk for stroke compared with those who did not smoke, according to a study published in the American Journal of Preventive Medicine.

The use of e-cigarettes alone was not independently linked to an increased stroke risk, according to the study.

“Recently, U.S. FDA raised the minimum age to buy tobacco products with nicotine from 18 to 21, and also announced partial banning of most of the flavored e-cigarettes, which would potentially help reduce their use in youth,” Tarang Parekh, MBBS, MSc, assistant researcher at George Mason University College of Health and Human Services in Fairfax, Virginia, told Healio. “In addition, we need to expand our research efforts in tobacco control and prevention approaches within the evolving aspect of e-cigarette and concomitant cigarette use. Physicians and other health professionals should also adapt screening for e-cigarette and vaping, particularly in combustible cigarette smokers with comorbid cardiovascular risk factors.”

Researchers analyzed data from 161,529 participants (53% women) aged 18 to 44 years from the 2016-2017 Behavioral Risk Factor Surveillance System. A telephone survey was conducted to collect information on combustible cigarette and e-cigarette use.

Most participants in the study were aged 18 to 24 years (68.9%), and most participants who currently smoked combustible cigarettes only were aged 35 to 44 years (47.2%).

Participants who currently smoked both e-cigarettes and combustible cigarettes increased the risk for stroke compared with nonsmokers (adjusted OR = 2.91; 95% CI, 1.62-5.25). These participants also had an increased stroke risk compared with those who only smoked combustible cigarettes (aOR = 1.83; 95% CI, 1.06-3.17).

Currently smoking e-cigarettes alone did not significantly increase the risk for stroke compared with nonsmokers (aOR = 0.69; 95% CI, 0.34-1.42). The risk for stroke was lower in participants who smoked e-cigarettes alone compared with those who only smoked combustible cigarettes (aOR = 0.43; 95% CI, 0.2-0.93).

“People are looking at e-cigarettes as a ‘healthy’ alternative to cigarettes, and we currently have an epidemic of e-cigarettes use,” Parekh said in an interview. “At the same time, now we are seeing an outbreak of adverse events as well, mainly ‘vaping-associated lung injuries.’ However, it could also affect blood vessels, heart and brain. Studies have shown that naive e-cigarette users are more likely to start using combustible cigarettes within a shorter period of time. While we still have a considerable lack of clarity as consequences of e-cigarette use and its health effects, this study provides preliminary findings that using an e-cigarette with a combustible cigarette could potentially increase stroke risk at a young age.” – by Darlene Dobkowski

For more information:

Tarang Parekh, MBBS, MSc, can be reached at drtarangparekh@gmail.com.

Disclosures: The authors report no relevant financial disclosures.