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A preliminary report on a study purporting to show similar adverse cardiovascular consequences from vaping and smoking has faced criticism from harm-reduction experts.
The study by Maxime Boidin at Manchester Metropolitan University’s Institute of Sport has not yet been published in a peer-reviewed journal. However, Boidin was concerned enough about the results that he shared preliminary data with a newspaper in the UK, where the university is based.
The study was to look at the long-term impact on cardiovascular health. In it, Boidin measured the vascular function of 20 vapers, 20 smokers and a control group of 20 who neither smoked nor vaped. Participants were aged 18 to 45, with an average age of 27 and similar levels of fitness. Manchester Metropolitan said this was the first study of its kind to consider other factors that could also impact vascular health, outside of smoking or vaping.
Throughout the study, the elasticity of blood vessels in arms and necks was to be measured as an indicator of vascular health. A further fitness test to measure cerebral blood flow was given. Finally researchers gave a fitness test 30 minutes after smoking or vaping to separately assess immediate impacts on health.
Testing theory on long-term effects of vaping
Results from the tests were shared with the Daily Mirror tabloid newspaper in the UK, which joined the study to observe participants in its closing stages. Researchers appeared to have a theory they would find some issues with long-term vaping use. The press release announcing the start of the study suggested they theorised regular use would have significant impacts and that they considered symptoms such as coughing, chest pain or lung dysfunction in vapers as early indications of dysfunction.
“We hope that our findings will help to inform guidelines and regulations on the sale of e-cigarettes in the future,” said Boidin at that time. “We should heed the lessons from the mistakes made in the 1980s regarding traditional cigarettes and avoid repeating similar errors with e-cigarettes.”
Boidin told the Mirror this theory was confirmed – though he said the extent to which it was exceeded his expectations. He labelled the dangers of vaping as no different from smoking. He said the study found artery walls of both vapers and smokers could no longer dilate, while both also had similar blood flow issues – suggesting future serious cardiovascular problems.
He said he theorises this was due to inflammation caused by nicotine, as well as metals and chemicals inhaled while vaping – some of which are known to be causes of inflammation or oxidative stress.
Boidin further told the Mirror that one of the issues with vaping in comparison to smoking was fewer limitations on where e-cigarette users could vape. Current smoke-free legislation limits smokers as to where they could light up, which largely clamped down on just how much time they could dedicate to smoking. In comparison, it was much easier to continuously vape, due to laxer policies and social stigmas, and this more regular usage could be a cause for concern. He called for vaping to only be available for a short time on prescription as a cessation tool.
Preliminary results shared with tabloid
However, many in the public health sphere were puzzled by both the results and the method of their announcement – being shared with a British tabloid before being peer-reviewed or published in a relevant journal.
Manchester Metropolitan told ECigIntelligence that the study would be completed and published in the next few months but that Boidin had shared some of his interim findings and what the data was indicating thus far.
Nonetheless, several harm-reduction specialists had questions about specifics they said should have been addressed when the preliminary findings were released. For example, the definition of “long-term vaping” was never addressed in any initial results published. It appears it was defined as being more than three months by researchers, according to a social media post soliciting participants.
Criticism from public health commentators
But it was also unclear how past smoking behaviour had been dealt with. Were the vapers prior smokers that had started vaping? Or were they nicotine naive before picking up an e-cigarette? This also fed into a separate criticism. Public health commentators thought a comparison with former smokers that had ceased smoking through an alternative method than vaping would be the most valid comparison. But the study only compared vapers and smokers to those that had done neither (for at least the past three months it seems, according to the social media post).
Participants were also tested in a fasted state with no food, caffeine, conventional cigarettes or vaping products used that day in order to eliminate other possible variables. However, one public health expert questioned whether doing so put participants in a state of nicotine withdrawal and whether this would have interfered with cardiovascular measurements.
Further study necessary
Manchester Metropolitan declined to address any of the specific questions put to it by ECigIntelligence. A spokesperson told ECigIntelligence that, to avoid confusion, Boidin would rather not share anything further at this point.
Overall, the point of the study was seemingly to assess the health risk of vaping in itself at a time when there are several discussions about the future of vaping in a post-cessation world. The study is theoretically demonstrating vaping is not harmless.
But vaping supporters would say it was never said to be an entirely risk-free activity – only that it would prove, overall, to be 95% safer than smoking. Despite the criticisms, some public health experts agreed that the preliminary results were important and that further work in this area was necessary – particularly given known adverse effects from vaping ingredients like nicotine.
– Freddie Dawson ECigIntelligence staff
Image: AI-generated
