Vaping as dangerous as smoking – it raises the risk of heart attack

Regular vaping could increase the risk of high blood pressure – a key driver of deadly heart attacks – a new study suggests.

Britons are taking up vaping in unprecedented numbers, with more than one in ten adults now estimated to regularly use e-cigarettes, which were originally introduced to help smokers quit tobacco.

Despite NHS chiefs insisting vaping is safer than smoking, experts have long warned it is not risk free. E–cigarettes also contain harmful toxins, and their long–term effects remain a mystery. 

Furthermore, experts say many users now vape and continue to smoke conventional cigarettes – which in some cases doubles their nicotine intake. 

While dual use is also likely to compound the risks of triggering a serious coronary incident such as having a heart attack or stroke, researchers at the University of Exeter are concerned that vaping alone could be enough to drive up blood pressure, a contributing factor for both conditions. 

The new study, published in the American Journal of Physiology, looked at the relationship between smoking or vaping and high blood pressure, medically known as hypertension.

The researchers tracked 6,262 participants, aged 12 to 80–years–old from the US National Health and Nutrition Examination Survey. 

Of this group, 1,190 admitted to using a nicotine product within the past five days – whether that was traditional smoking, vaping or a combination of both. 

Smoking was the most popular, with 790 participants recently smoking.

Participants’ blood pressure and heart rate were measured with an upper arm cuff three times to get an average reading.

Elevated blood pressure was considered anything equal to or over 120/70mmHg, whilst hypertension was defined as 140/90mmHg or above. 

Blood samples were also analysed for total cholesterol and c–reactive protein (CRP) levels. 

The liver produces CRP in response to inflammation, with high levels suggesting repetitive tissue injury – for example from smoking – which drives the risk of deadly heart events. 

Results showed that participants who smoked or vaped had significantly higher blood pressure compared to non–smokers and were 46 per cent more likely to suffer from hypertension. 

Those who exclusively vaped had a 15 per cent increased risk of elevated blood pressure, and were 5 per cent more likely to be diagnosed with high blood pressure than non–smokers, but the finding was not statistically significant due to the small sample size, researchers said.

Tobacco use seemed to be particularly harmful for diastolic blood pressure – the pressure at which blood pushes against artery walls while the heart rests between beats. 

Professor Andrew Agbaje, clinical epidemiologist and study co–author, speculated that this increase in pressure may decrease the amount of time needed for the heart to rest before the next cycle, ‘ultimately compromising the heart, leading to arrhythmia, irregular heartbeats, heart failure and heart attacks.’ 

In general, the data revealed that smokers and vapers were younger, had higher CRP and cholesterol levels  and had more excess fat than non–smokers. 

Prof Agbaje said: ‘It is highly likely that if the current number of exclusive vape users were tripled, the relationship between vaping and hypertension would be statistically significant.’ 

He added, given that the direction of the relationship is positive, vaping could predict hypertension. 

‘Taken together’, he said, ‘our findings suggest that combined smoking and vaping exposure may confer additional risk, though long–term prospective studies comparing exclusive smokers, vapers and dual users are need to quantify potential additive effects.’ 

In particular, researchers found that cholesterol played a significant role in how nicotine use elevates blood pressure. 

It has long been hypothesised that smoking enhances free radical damage to lipids –  fats in the blood including cholesterol – which in turn raises blood pressure, increasing the risk of heart disease. 

The new study confirmed these findings, with participants who smoked and vaped found to have considerably higher cholesterol levels. 

The researchers concluded: ‘Interventions to reduce smoking prevalence have been inconsistent especially since the lowered smoking prevalence seems to have been overtaken by an increase in vaping.

‘Encouraging youths to avoid smoking and vaping initiation may be a safer approach to preventing long–term hypertension and cardiovascular disease.’ 

In July last year, the World Health Organisation (WHO) labelled the evidence surrounding e–cigarettes ‘complex’, despite them becoming the new frontline in Europe’s fight against tobacco. 

Vapes cannot be recommended as way to stop smoking as too little is known about the harms and benefits, the UN agency said.

In June 2025 disposable vapes were banned in a bid to stop young people engaging in the harmful habit. 

But experts have warned the move risks undermining the Government’s progress towards a smoke–free Britain – with hundreds if not thousands taking up smoking as an alternative.

Smoking has been linked to at least 16 different types of cancer as well as various heart and lung diseases, infertility and a host of other complication, killing over 8million people every year.

Analysis by the cancer charity found that on average, nearly 160 cancer cases attributed to smoking were diagnosed every day in 2023.

Doctors have expressed fears there could be a wave of lung disease and cardiovascular conditions in the coming decades in people who pick up the habit at a young age.

This was also referenced in the study. 

‘The European Society of Cardiology has advocated – and we agree – that vaping must be included in the next European Union smoking ban,’ said Professor Agbaje.

‘It is now established that adolescents who initiate vaping are four times more likely to smoke their first cigarette.

‘We need both societal and governmental interventions to save young people from the dangerous effects of vaping, not just traditional tobacco smoking.

‘Adolescents deserve protection, not addiction.’

Dr Nicola Lindson, an expert n tobacco addiction and smoking interventions from the University of Oxford, who was not involved in the study, said: ‘A relatively small number of people in the study reported exclusive vaping and it is impossible to know how many of those people had a history of smoking. 

‘However, we can reasonably assume that some of them had, as vaping is commonly used as a strategy for quitting smoking. 

‘This means that we cannot disentangle the effects of vaping from smoking and we also cannot be sure that nicotine is the cause of the health outcomes measured in this paper.’