Global Heart (Oct 2021)

E-Cigarettes: A New Threat to Cardiovascular Health – A World Heart Federation Policy Brief

  • Eduardo Bianco,
  • Andrii Skipalskyi,
  • Fastone Goma,
  • Hanin Odeh,
  • Koji Hasegawa,
  • Mawya Al Zawawi,
  • Michal Stoklosa,
  • Regina Dalmau,
  • E Ulysses Dorotheo,
  • Florence Berteletti,
  • Jeremiah Mwangi,
  • Yunshu Wang

DOI
https://doi.org/10.5334/gh.1076
Journal volume & issue
Vol. 16, no. 1

Abstract

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Tobacco is widely recognized as a leading cause of cardiovascular morbidity and mortality, accounting for approximately seventeen percent of all cardiovascular disease deaths globally. Electronic nicotine delivery systems such as e-cigarettes have been developed and advertised as safer alternatives to traditional tobacco cigarettes. Aggressive marketing strategies, as well as misleading claims by manufacturers, have largely contributed to the belief that e-cigarettes are harmless. In reality, e-cigarettes are far from innocuous. E-cigarette solutions and aerosols generally contain harmful substances that are commonly found in tobacco cigarette emissions. A growing body of literature suggests that e-cigarettes are associated with an increased risk of cardiovascular morbidity and mortality. In addition, the effectiveness of e-cigarettes as smoking cessation tools has yet to be determined. Concerningly, most smokers do not give up on tobacco cigarettes and eventually become dual users. Unregulated, e-cigarettes constitute a serious threat to established tobacco control policies. Fortunately, many countries have demonstrated that strong regulations were effective in protecting their populations from the dangers of e-cigarettes. The World Heart Federation recommends applying the precautionary principle and a set of measures to protect vulnerable populations, prevent exposure to second-hand smoking, and address misleading claims. In this regard, we recommend that governments, policymakers, and other relevant stakeholders enact or support the following measures, among others: Prohibit the sale and distribution of e-cigarettes to minors, as well as the use of flavouring agents. Prohibit the use of e-cigarettes anywhere tobacco cigarettes have been banned. Prohibit marketing, advertising, and misleading claims regarding e-cigarettes. Apply excise taxes on e-cigarettes. Conduct more research regarding the long-term effects of e-cigarettes on cardiovascular health. Lastly, countries that have banned the commercialization of e-cigarettes should maintain these measures.

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