New study shows suggests e-cigarette flavorings may pose health risk

Henrietta Brewer
May 30, 2019

Exposing the cells to flavourings from e-cigarettes or blood from people who'd just vaped triggered blood vessel dysfunction that could increase the risk of heart disease.

The cells also were less able to help form new blood vessels or participate in wound healing, the findings showed.

Endothelial cells lining the interior surface of blood vessels play a critical role in heart health, the researchers explained. "Eventually, they want to stop using e-cigarettes the same way a traditional smoker wants to quit smoking cigarettes", said Marc Steinberg, lead author of the study.

In the study, which Wu's team conducted, six e-liquids with varying concentrations of nicotine were used and the results showed evidence of poor cell survival and increased inflammation on a type of cardiovascular cell. "The cells were less viable in culture, and they began to exhibit multiple symptoms of dysfunction". Lee said. "This study demonstrates and supports that human-induced pluripotent stem cells derived endothelial cells represent a robust model for investigating endothelial biology with clear advantages over primary human endothelial cells". Doing so allowed them to closely observe the effect of the flavorings with and without nicotine on the cells' biology and function.

A paper describing the findings was published online May 27 in the Journal of the American College of Cardiology. He is the paper's senior author and leader of the research group.


It follows evidence that people who use e-cigarettes are more likely to suffer a heart attack or coronary artery disease. Health experts are concerned about devices such as e-cigarettes putting children and adolescents at high risk of becoming addicted to drugs and nicotine early in life.

Among the e-cig users who used federal Food and Drug Administration-approved smoking cessation products, 74% who tried cessation aids like nicotine gum or patches endorsed them and almost 67% of those who tried smoking cessation medications endorsed that quit method. In 2018, the FDA restricted the sale of flavored e-cigarettes to adults-only venues, with the exception of tobacco, menthol and mint flavors, which can be sold wherever traditional cigarettes are sold.

Professor Wu said: "Until now, we had no data about how these e-liquids affect human endothelial cells".

The cells were exposed to e-liquids flavored with fruit, tobacco, sweet tobacco with caramel and vanilla, sweet butterscotch, cinnamon and menthol.

They found that some of the effects of exposure to the various e-liquids were dependent on the nicotine concentration, but others, like cellular migration and decreases in cell viability, were independent of nicotine.


One in five high school students have tried e-cigarettes.

Scientists who tested the flavored "e-liquids" used in the devices found they damage the cells which line blood vessels, which could lead to cardiovascular disease. Caramel and vanilla flavors also disrupted the cells, but not as severely. Which flavor component is most responsible for these effects and how it works is yet unclear, Wu added.

After 10 minutes of smoking, the nicotine levels were comparable between both.

Dr Wu warned "When you're smoking a traditional cigarette, you have a sense of how many cigarettes you're smoking". More than 25% have tried to quit using e-cigarettes in the past year.

"And now we know that e-cigarettes are likely to have other significantly toxic effects on vascular function as well".


United States public health officials are alarmed by an explosion of underage vaping, but Dr Wu said it's not just a question for teens.

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