Semin Thromb Hemost 2014; 40(01): 060-065
DOI: 10.1055/s-0033-1363468
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

E-Cigarettes and Cardiovascular Risk: Beyond Science and Mysticism

Giuseppe Lippi
1  Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
Emmanuel J. Favaloro
2  Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, New South Wales, Australia
Tiziana Meschi
3  Department of Clinical Sciences, University of Parma, Parma, Italy
Camilla Mattiuzzi
4  Service of Clinical Governance, General Hospital of Trento, Trento, Italy
Loris Borghi
3  Department of Clinical Sciences, University of Parma, Parma, Italy
Gianfranco Cervellin
5  Emergency Department, Academic Hospital of Parma, Parma, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
16 December 2013 (online)


Cigarette smoking is the most important cause of premature death, and it is currently listed as a major independent risk factor for cardiovascular disease. Because of restrictive measures and widespread control policies, tobacco companies are now using aggressive marketing strategies in favor of smokeless tobacco, including electronic nicotine delivery systems, which are also known as electronic cigarettes or e-cigarettes. Although the regular use of these devices appears less hazardous than traditional cigarettes or other forms of smokeless tobacco, recent studies have shown that various potentially harmful substances, especially nicotine, ultraparticles, and volatile organic compounds, may be effectively inhaled or liberated in exhaled air during repeated e-cigarette puffing. This would enhance the risk of cardiac arrhythmias and hypertension, which may predispose some users to increased risk of cardiovascular events, which may be further magnified by other potential adverse effects such as arrhythmias, increased respiratory, and flow respiratory resistance. Some cases of intoxication have also been described, wherein large amounts of nicotine and other harmful compounds may be effectively absorbed. As the use of e-cigarettes is continuously rising, and it is also considered a potentially effective method for smoking cessation, more focused research is urgently needed to definitely establish the cardiovascular safeness of these devices.