MANILA, Philippines — A large-scale nationwide study in South Korea published in the European Heart Journal suggests that switching entirely to electronic cigarettes (e-cigarettes) may significantly reduce the risk of major cardiovascular events compared to continued smoking for smokers who have undergone a major heart procedure.
E-cigarettes are among a category of tobacco harm reduction (THR) products, alongside heated tobacco and nicotine pouches, designed to reduce harm by eliminating smoke.
The study, titled “Prognosis after switching to electronic cigarettes following percutaneous coronary intervention,” focused on patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI), a procedure used to open clogged heart arteries.
The research team, led by Danbee Kang and colleagues at the Samsung Medical Center and Sungkyunkwan University, tracked a nationwide cohort to observe how post-surgery smoking habits impacted long-term health.
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The study revealed that the reduction in risk for those who switched entirely to e-cigarettes was comparable to the benefits seen in patients who quit smoking altogether.
“Among smokers with CAD undergoing PCI, switching to e-cigarettes was associated with a significantly lower risk of Major Adverse Cardiovascular Events (MACE) than continued combustible cigarette use, similar to quitting smoking,” the study concluded.
“Specifically, patients who completely switched to e-cigarettes experienced a greater reduction in the risk of MACE than dual users. These findings suggest that switching to e-cigarettes could be a viable alternative for patients who find it challenging to quit combustible cigarettes after PCI,” the study added.
While the European Society of Cardiology (ESC) maintains that the complete cessation of all nicotine products is the gold standard, the Korean study provides evidence for a “harm reduction” strategy.
“The best lifestyle change for current smokers… is to stop smoking without any nicotine supply,” the researchers noted. “However, if this is not possible, it is worth considering switching to e-cigarettes.”
The study points to recent clinical trials showing that when smokers switch to vaping, their endothelial function (the health of the blood vessel lining) improves to a degree similar to those who quit entirely. This suggests that removing toxic combustion products, such as tar and carbon monoxide, allows the vascular system to begin healing.
While the study confirms that total cessation remains ideal, it suggests that for the nearly 60 percent of patients who struggle to quit smoking after a major heart event, switching completely to e-cigarettes represents a viable path toward reducing further cardiac risk. /mr