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Canadian Journal of Cardiology

Vaping, Smoking Cessation, and Harm Reduction? Look Before You Leap

  • Andrew L. Pipe
    Correspondence
    Corresponding author: Dr Andrew L. Pipe, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada. Tel.: +1-613-882-4400.
    Affiliations
    Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
    Search for articles by this author
Published:April 07, 2021DOI:https://doi.org/10.1016/j.cjca.2021.02.002
      Tobacco addiction, arguably the most significant and deadly of the modifiable cardiovascular risk factors—and the most neglected—has long been a challenge for the cardiovascular specialist.
      • Rigotti N.A.
      • Clair C.
      Managing tobacco use: the neglected cardiovascular disease risk factor.
      Notwithstanding the significant reduction in smoking that has occurred in Canada over the past 50 years—only 14%-16% of Canadians are now smokers—it remains a persistent pathologic feature of the lives of many of our patients. Cardiovascular clinicians have been enjoined to address the challenge of smoking cessation by supporting a systematic approach to the management of their smoking patients with the use of cessation aids and supportive counselling.
      • Pipe A.L.
      • Eisenberg M.J.
      • Gupta A.
      • et al.
      Smoking cessation and the cardiovascular specialist: Canadian Cardiovascular Society position paper.
      Smoking cessation is not easy. Nicotine is the most addictive product encountered in the community. Most smokers know why they should not smoke and do not wish to be smokers, and many of them make several, unsuccessful private attempts to quit each year. Given the carnage that results from tobacco addiction, opportunities to assist cessation are to be welcomed. The suggestion, therefore, that the introduction of vaping devices, or electronic nicotine delivery systems (ENDS), would facilitate cessation and mitigate the harms of smoking warrants careful consideration.
      • George J.
      • Hussain M.
      • Vadiveloo T.
      • et al.
      Cardiovascular effects of switching from tobacco cigarettes to electronic cigarettes.
      • Abrams D.B.
      • Glasser A.M.
      • Pearson J.L.
      • et al.
      Harm minimization and tobacco control: reframing societal views of nicotine use to rapidly save lives.
      • Boakye E.
      • Obisesan O.H.
      • Osei A.D.
      • et al.
      The promise and peril of vaping.
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      Linked Article

      • Vaping Instead of Cigarette Smoking: A Panacea or Just Another Form of Cardiovascular Risk?
        Canadian Journal of CardiologyVol. 37Issue 5
        • Preview
          Since 2007, the electronic cigarette (EC), with its increasingly diverse array of device options, has gained popularity both among long-term tobacco cigarette (TC) smokers and among never-smoking youth. The absence of a number of known toxic by-products of TC smoking has helped cultivate the perception that ECs are healthy. However, an expanding literature has provided concerning evidence that a number of EC constituents, including nicotine, and their thermal degradation by-products may have adverse effects, including cardiovascular effects.
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