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E-cigs Increase the Risk for Stroke

Latest in Stroke Research

The use of e-cigarettes is skyrocketing, especially among youth. And while e-cigarettes may provide individuals an alternative to smoking, there is still much to be studied about their long-term effects.
Recent research suggests e-cigarettes may not be as innocent as they seem. Scientists collected data from the 2016 Behavioral Risk Factor Surveillance System. Of the 400,000 individuals questioned, 66,795 reported having used e-cigarettes. Compared to non-users, they had a 71 percent higher risk of stroke.

Two Northwestern Medicine stroke experts discuss the link between smoking and strokes, and what these findings could mean for other potential dangers of e-cigarettes.

The Link Between Smoking and Stroke

“The link between cigarettes and increased risk for stroke has been well established. There are several mechanisms by which that happens,” says Fan Z. Caprio, MD, a vascular neurologist at Northwestern Memorial Hospital.

Cigarettes contain 600 ingredients and create more than 7,000 chemicals when burned — with at least 69 known to cause cancer. “These toxins can cause inflammation and damage in the lungs and the blood vessels, which then contribute to hardening of blood vessels,” says Dr. Caprio.

Matthew B. Potts, MD, neurosurgeon at Northwestern Memorial Hospital, adds that while e-cigarettes were developed as an alternative to regular cigarettes, they also contain nicotine as well as other chemicals. Besides highly addictive nicotine, e-cigarettes can contain flavorants such as diacetyl (a chemical linked to lung disease), heavy metals, organic compounds and ultrafine particles that can be absorbed by the lungs. “Because e-cigarettes are not well regulated, we don’t fully yet understand the health consequences,” says Dr. Potts.

Dr. Caprio agrees. “We don’t know why this link exists, but it’s the first study to show cardiovascular adverse events,” she says. “There are other variables, so it’s impossible to draw a cause and effect relationship, but the risk is there.”

Reduce Your Risk

Because smoking is known to be one of the modifiable risk factors of stroke, smoking cessation programs are important for prevention.

“Stroke prevention is the best way to treat a stroke,” says Dr. Caprio. “Every patient is different, so I try to spend the time to talk to patients and discuss their individual factors.” It’s important to have an established relationship with your primary care physician to have your risk factors evaluated.

In addition to smoking cessation, you can reduce your risk of stroke by eating a healthy diet that is low in fat and high in fiber, and by following an exercise program. Regular exercise also can reduce your risk for other conditions, such as diabetes and high blood pressure


“When it comes to a stroke, time is of the essence. You need to call 9-1-1 right away,” says Dr. Potts. Know the signs so you can react F.A.S.T.

See other ways to manage your risk for stroke.