Increased blood clot formation and vascular impact from vapes in young people

Annually, between 7-8 million people die from tobacco smoking, a figure that means 50% of tobacco smokers die. Several previous studies have shown that the vapor from e-cigarettes inhaled into the lungs contains nicotine levels as high as those in regular cigarettes.

E-cigarettes with nicotine on healthy young people

The study involved healthy young people over a short period, where they smoked e-cigarettes with or without nicotine. Blood samples were taken before vaping and at several points afterward to measure how much the blood was affected. Circulation in the body’s smallest blood vessels, the capillaries, was also studied before and after e-cigarette use.
– "Shortly after the participants smoked e-cigarettes, we observed increased blood clot formation and reduced circulation in the capillaries. These two factors have long been known to contribute to atherosclerosis, heart attacks, and strokes. We see similar consequences of e-cigarettes on blood vessels, lungs, and the heart as with regular tobacco smoking. What becomes increasingly evident in this and previous studies is that nicotine is a more toxic substance than generally recognized," says Associate Professor Magnus Lundbäck, cardiologist and research leader for e-cigarette studies at Danderyd Hospital and Karolinska Institutet.

Poorer blood vessel function and narrower airways can lead to heart disease and COPD

The same research group has previously demonstrated several negative effects on lungs and blood vessels as a result of e-cigarette smoking.
– We have seen clearly that the airways become narrower when one smokes an e-cigarette with nicotine, which could potentially lead to COPD as one ages. We have also seen that blood vessels become stiffer after using e-cigarettes with nicotine. This can increase the risk of atherosclerosis and, in the long term, a higher risk of major public health diseases such as heart attacks and strokes. We know that a large number of toxins in e-cigarettes are harmful, but the significant difference between vaping with and without nicotine surprised us, says Gustaf Lyytinen, specialist physician at Helsingborg Hospital and doctoral student at Karolinska Institutet.


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Study details and number of participants

The research study on young people at Danderyd Hospital was published in the medical journal Cardiovascular Toxicology on August 7, 2023.
The study is a randomized controlled crossover study, making it the most robust type of study design. All participants were young, healthy, and as similar to one another as possible at the start. They were exposed on two occasions to e-cigarettes—once with nicotine and once without. Measurements were taken at baseline (before exposure) and then at repeated intervals after the exposures. Furthermore, each participant served as their own “control” (the same measurements were taken before and after both exposures), providing statistical significance even with a relatively small number of participants.
During ethical approval by the Ethics Authority, researchers conducted a so-called power calculation, estimating the number of participants needed to detect statistically significant differences. The authority’s basis for minimizing participant numbers is due to the risks and discomforts involved. Danderyd Hospital’s study was approved to include about 20 participants; exceeding this would violate ethical approval.

Study results on young people vaping with or without nicotine

• E-cigarettes with nicotine showed an increased tendency for blood to clot and reduced circulation in small blood vessels.
• The consequence may pose a risk factor for developing cardiovascular disease, atherosclerosis, and eventually suffering a heart attack or stroke.