cheap vape deals typically deliver an aerosol of nicotine and other flavors by heating a liquid and are promoted as a safer alternative to conventional cigarettes, which generate the nicotine aerosol by burning tobacco.

While e-cigarettes deliver lower levels of carcinogens than conventional cigarettes, they both deliver ultrafine particles – which are 1/50 to 1/100 the size of a human hair – and other toxins that have been linked to increased cardiovascular and non-cancer lung disease risks.

The new analysis involved 69,452 people who were interviewed through National Health Interview Surveys in 2014 and 2016, a cross-sectional study in which in-person interviewers asked participants whether they had ever used e-cigarettes and/or cigarettes, and whether they had ever been told by a doctor or other health professional that they had had a heart attack.

Among the 9,352 current and former e-cigarette users, 333 (3.6 percent) had experienced a heart attack at some point, with the highest percentage (6.1 percent) among those who used e-cigarettes daily. In the analysis, a quarter of the 2,259 people who currently used e-cigarettes were former smokers of conventional cigarettes and about 66 percent of current e-cigarette users were also current cigarette smokers.

The researchers found that the total odds of having a heart attack were about the same for those who continued to smoke cigarettes daily as those who switched to daily e-cigarette use. For those who used both products daily, the odds of having had a heart attack were 4.6 times that of people who had never used either product.

The authors also said that that while there was a “lasting effect” associated with being a former smoker, there was not a significant increase in myocardial infarction risk for former or (sometimes) e-cigarette users. They proposed that the risks of e-cigarette use may dissipate rapidly when someone stops using them, that some people briefly experiment with e-cigarettes and stop using them before any lasting damage is done, or that e-cigarettes have not been available long enough to cause permanent damage to the cardiovascular system.

“The only way to substantially reduce the risk of a heart attack is to stop using tobacco,” Glantz said.

The authors noted that it was not known whether the heart attacks occurred relative to e-cigarette use, and that some of the heart attacks that subjects reported are likely to have occurred before e-cigarettes became available in the U.S. (around 2009), which would lead them to underestimate the effects of e-cigarettes on heart attack risk.

The paper’s co-authors are Talal Alzahrani, M.D., Ivan Pena, M.D., and Nardos Temesgen, M.D., all of George Washington University. Glantz’ work was supported by grant R01DAO43950 from the National Institute of Drug Abuse and P50CA180890 from the National Cancer Institute and the Food and Drug Administration Center for Tobacco Products.u2022eney7485yyWEEEEDD