Switching from smoking to e-cigarettes has the same benefits as quitting without alternatives for patients after coronary angioplasty

Reasons to switch from smoking to e-cigarettes, why vaping is better, dangers of smoking, dangers of vape and how to stay healthy with vaping. Start to vape.

A landmark cohort study from South Korea, published in the European Heart Journal, examined 17.973 smoking patients who had a percutaneous coronary intervention (PCI) for coronary heart disease and had a repeated medical examination after 3 years, to identify how quitting smoking (without the use of any alternative products) and switching to e-cigarette use affects the risk for Major Cardiac Adverse Events (MACE, defined as the composite of all-cause death, spontaneous MI, and repeat revascularization) compared to continuous smoking. The study found that almost 50% (49.8%) of the patients continued to smoke despite having had a diagnosis for smoking-related heart disease that required medical intervention, while 9.4% switched to e-cigarettes (4.35% were dual users and 5.05% were exclusive vapers) and 40.8% quit smoking without using any alternatives.

After a median follow-up of 2.4 years, the authors identified that switching to e-cigarette use had identical benefits in reducing the risk for MACE to quitting smoking without the use of alternatives (18% risk reduction for switchers vs. 13% risk reduction for quitters). Astonishingly, this benefit referred to dual users and exclusive vapers combined, which means that dual users were included in the analysis. When dual users were specifically compared to exclusive vapers, the latter had a 29% reduced risk, verifying the importance of complete switching from smoking to e-cigarette use and implying that the benefits for exclusive vapers were even stronger. Benefits were also observed for all-cause mortality, myocardial infarction, repeat revascularization and death from cardiovascular disease, pulmonary disease and cancer, although not all outcomes reached statistical significance (most likely due to the small sample size).

The study identifies the well-known difficulty in quitting smoking, with half of the smoking patients being unable to quit even after being diagnosed with smoking-related cardiovascular disease. I can imagine that many healthcare professionals have strongly condemned any attempt of such patients to quit smoking with the help of e-cigarettes. This means that fewer patients had the chance to make a lifestyle change that would benefit their health. This study will be the beginning of the end for the misconception that nicotine use is a strong risk factor for cardiovascular disease, a misconception that is widely spread not only among non-experts but also among healthcare professionals. It also exposes the problematic recent metanalysis which claimed that e-cigarettes confer the same cardiovascular risk as smoking, a metanalysis that will soon be heavily criticized in a paper that is currently under review.