Flavorings Used in E-Cigarettes Can Up Your Risk for Heart Disease
Flavorings Used in E-Cigarettes Can Up Your Risk for Heart Disease

  • Flavoring
    chemicals added in electronic cigarettes or e-cigarettes are harmful and
    cause damage to heart and blood vessels and are not a safe option
  • Previous studies
    have suggested that e-cigarettes are less likely to cause lung cancer
    since they contain much lower levels of cancer-causing chemicals, but the effect of e-cigarettes on the heart
    and blood vessels were not known
  • Use of
    e-cigarettes particularly among young people has risen alarmingly in the
    US and the FDA estimates that over 3.5 million middle and high school
    students experimented using e-cigarettes in 2018

Flavoring liquids added in electronic cigarettes, or
e-cigarettes such as cinnamon, menthol,
caramel, fruit flavor, caramel, vanilla and butterscotch have found
to be harmful and may increase risk of heart disease when inhaled finds recent
study led by Won Hee Lee, PhD, now an assistant professor at the University of
Arizona, and Sang-Ging Ong, PhD, now an assistant professor at University of

The findings of the study appear online in the Journal of
the American College of Cardiology

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Using Lab Generated
Endothelial Cells To Study Effects of E-Cigarettes

Although e-cigarettes reduce the risk of lung cancer, their effect on the heart and blood
vessels are less clear and the study aimed to look at the
effects of nicotine and flavoring liquids in e-cigarettes on the heart.

To this end, the study team analyzed human endothelial cells created in the laboratory from induced
pluripotent stem cells
, or iPS cells. Human iPS cells are capable of
differentiating into several cell types, and enable scientists to study changes
in human cells, which otherwise would be difficult to obtain directly from a

‘With traditional cigarettes, we are aware of how many cigarettes we smoke but with e-cigarettes, we are more likely to be exposed to a much larger concentration of nicotine in a short time. Both the nicotine in e-cigarettes and the added chemical flavorings are harmful to the heart and blood vessels and are therefore not considered a safe alternative to traditional cigarettes.’
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Endothelial cells are cells that line the interior of blood vessels and have several important functions
including the
formation of new blood vessels and promoting wound healing.
This is the first
study to use endothelial cells
derived from human stem cells
to directly analyze the effects of nicotine and added flavorings on their
structure and function.

Effects of
E-Cigarettes on Endothelial Cells

  • The study team looked
    at the effects on
    stem cells derived endothelial cells of six different popular flavors
    added to e-cigarettes namely fruit, sweet tobacco with caramel and vanilla,
    tobacco, cinnamon, menthol and sweet butterscotch with nicotine levels varying
    from 0, 6, and 18 mg/ml.
  • They found that most flavors were moderately toxic to the
    endothelial cells, but the menthol and
    cinnamon flavored e-cigarettes markedly reduced the viability
    of cultured
    endothelial cells even when the e-cigarettes did not contain nicotine.
  • The e-liquids also increased the endothelial cell
    concentrations of reactive oxygen species (chemicals that cause DNA damage) as
    well as levels of molecules involved in programmed cell death.
  • Addition of cinnamon
    and menthol flavored e-liquids
    to the cell culture markedly affected the ability of the cells to
    form new blood vessels necessary for wound
  • The caramel and vanilla flavored e-liquids also disrupted
    new blood vessel formation but not as severely as menthol and cinnamon flavors.
  • Endothelial cells exposed to caramel, cinnamon and vanilla
    flavors showed an increased uptake of low-density lipoproteins and lipids,
    which increases blood vessel inflammation and injury as well as a decreased
    ability for wound healing.
  • Certain effects of the different e-liquids were dependent on
    the nicotine levels, but reduced migration of endothelial cells to the site
    of injury and loss of viability were independent of nicotine levels suggesting that both nicotine and the
    e-liquids had combined injurious effect on the blood vessels.
  • On comparing the blood levels of nicotine in people after
    smoking e-cigarettes with those who smoked traditional cigarettes, it was seen
    that the nicotine concentrations in the
    blood were similar in the two groups after smoking for 10 minutes
    at a constant rate.

The findings of the study suggest that e-cigarettes are not
safe for heart and blood vessels and can adversely affect the health of young
kids smoking e-cigarettes, believing them to be safe

According to Joseph Wu, MD, PhD, director of the Stanford
Cardiovascular Institute and professor of cardiovascular medicine and of
radiology, “Until now, we had no data about how these e-liquids affect
human endothelial cells. This study clearly shows that e-cigarettes are not a
safe alternative to traditional cigarettes. When we exposed the cells to six different flavors of e-liquid with
varying levels of nicotine, we saw significant damage
. The cells were less
viable in culture, and they began to exhibit multiple symptoms of


In summary, flavoring liquids added to e-cigarettes cause significant damage to
heart and blood vessels and strict regulations should be enforced to control the use
of e-cigarettes especially among children. In fact, the FDA has ruled that only
tobacco, menthol and mint flavors can be sold at all shops while the other
flavors including cinnamon can only be sold at adult venues

References :

  1. E-cigarette use, flavorings may increase heart disease risk, study finds – (https://med.stanford.edu/news/all-news/2019/05/e-cigarette-use-and-flavorings-may-increase-heart-disease-risk.html)

Source: Medindia

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