Young adults who smoke both tobacco cigarettes and e-cigarettes are nearly three times more likely to have a stroke than their nonsmoking counterparts, and they have nearly double the odds of stroke than those who smoke traditional cigarettes alone, a new study suggests.
Researchers from Virginia and Georgia analyzed self-reported data from the Centers for Disease Control and Prevention’s 2016−2017 Behavior Risk Factor Surveillance System to determine the prevalence of e-cigarette and combustible cigarette use among 161,529 adults between 18 and 44 years old, as well as their use in association with stroke.
They found that, compared with those who have never smoked, those who currently smoke combustible cigarettes had 1.59 times the odds of experiencing a stroke; current e-cigarette users who formerly smoked tobacco cigarettes had 2.54 times the risk; and those who were current e-cigarette and combustible cigarette users were nearly three times more likely – with an odds ratio of 2.91 – to experience a stroke. Dual users also had nearly double the likelihood – 1.83 to 1 – of having a stroke compared to those who only smoked traditional cigarettes.
“Switching from combustible cigarette smoking to e-cigarette use did not curtail risk of stroke in young adults,” the study said.
The results also showed that sole e-cigarette users had lower odds of stroke than sole combustible cigarette users. “Potentially, this is due to the relatively younger age of those with sole e-cigarette use, as well as their lower health risk, higher insurance enrollment and higher (socioeconomic status), which cumulatively indicate overall better health and access to care,” the study said.
Using e-cigarettes alone with no history of smoking combustible cigarettes was not associated with a greater chance of having a stroke than nonsmokers, according to the results, and current sole e-cigarette users had about half the odds – 0.43 to 1 – of having a stroke compared to current sole combustible cigarette users.
Still, the researchers determined there to be “no clear benefit” for users to switch from smoking combustible cigarettes to e-cigarettes to lower their odds of having a stroke, though they urged caution, with further research need, due to the data lacking information on when users switched from one product to the other.
“Although e-cigarettes are labeled by some as a safer option to active smoking cessation, nicotine dependence and toxicity remain a great concern in low-risk young adults who smoke e-cigarettes for flavors and fun,” according to the study, published Tuesday in the American Journal of Preventive Medicine.
“Studies have shown an increased risk of cigarette smoking initiation among e-cigarette users, which could lead to an additive nicotine level and its potential cerebrovascular effects,” the study said. “If the newer tobacco products become gateways to other tobacco products and recreational drug use, there is urgency in regulating such products to avoid economic and population health consequences.”
