Vaping and Heart Health: What the VapeScan Study Found in 2026
Bottom line: A major new study published in JACC: Advances found that long-term vaping raises blood pressure in young adults. Vapers who never smoked had systolic blood pressure 4.79 mmHg higher than non-vapers. The more puffs per day, the higher the blood pressure. Vaping provided no cardiovascular risk reduction compared to not vaping or smoking. If you vape, these findings are relevant to your heart health — especially if you started vaping without ever smoking.
Participants
SBP Increase
Median Vaping
Scope: United States, adult vapers and non-vapers aged 18-49. Data from the VapeScan Study conducted by Columbia University researchers, published September 1, 2026 in JACC: Advances. This article also references the American Heart Association scientific statement, the HCHS/SOL hypertension study, and a June 2026 study on cooling ingredients and cardiac arrhythmias. Information verification date: September 14, 2026.
The relationship between vaping and heart health has been one of the most debated questions in tobacco and nicotine research. E-cigarettes were initially marketed as a safer alternative to combustible cigarettes, and some evidence supports reduced exposure to certain toxins compared to smoking. But the VapeScan Study — the first to directly measure subclinical cardiovascular markers in young adult vapers — found that long-term vaping is associated with measurably higher blood pressure, with a clear dose-response effect. This guide breaks down what the study found, what it means, and what the limitations are.
This article answers four questions: What did the VapeScan Study measure? How much does vaping raise blood pressure? Does vaping provide any cardiovascular benefit compared to not vaping? And what should you do with this information?
What Is the VapeScan Study?
The VapeScan Study is a cross-sectional research study conducted by researchers at Columbia University Irving Medical Center and Icahn School of Medicine at Mount Sinai. It was published on September 1, 2026 in JACC: Advances, a peer-reviewed journal of the American College of Cardiology. The study was designed to measure early (subclinical) markers of cardiovascular risk in young adults who vape.
In plain terms: Instead of waiting decades to see if vapers develop heart disease, the researchers measured early warning signs — blood pressure, blood vessel function, and coronary artery calcification — in 372 young adults. This approach lets us see potential cardiovascular effects of vaping long before clinical disease appears.
Researchers recruited 372 cardiovascular disease-free participants aged 18 to 49 in the New York City metropolitan area between May 2021 and May 2024. Participants were classified into four groups:
- Vaping/never smoking — e-cigarette users who had never smoked combustible tobacco
- Vaping/former smoking — e-cigarette users who had quit smoking
- Dual use — current e-cigarette users who also currently smoked
- Never vaping/never smoking — the control group
The median age was 26 years (range: 18-49), 50.5% were male, and the median duration of vaping was 4 years (interquartile range: 2-6 years). Participants completed detailed questionnaires on vaping habits (puffs per day, days per month, device type, nicotine concentration, years of use), smoking history, cannabis use, and demographics. Urinary cotinine was measured in a subset of 110 participants to verify nicotine exposure.
The study measured three markers of cardiovascular risk:
| Marker | What It Measures | Why It Matters |
|---|---|---|
| Systolic/Diastolic Blood Pressure | Pressure in arteries when heart beats/rests | Hypertension is the #1 risk factor for cardiovascular disease |
| Framingham Reactive Hyperemia Index (fRHI) | Endothelial function (blood vessel health) | Impaired endothelial function is an early marker of atherosclerosis |
| Spatially Weighted CAC Score | Coronary artery calcification | Calcium buildup indicates subclinical atherosclerosis |
Key Finding #1: Vaping Raises Blood Pressure
The most significant finding of the VapeScan Study was that vaping is associated with higher blood pressure in young adults. After adjusting for age, gender, education, and body mass index (BMI), the study found:
| Group | Systolic BP Increase (mmHg) | 95% Confidence Interval | p-value |
|---|---|---|---|
| Vaping/never smoking | +4.79 | 1.83 to 7.75 | Statistically significant |
| Vaping/former smoking | +1.60 | -1.65 to 4.85 | Not significant |
| Dual use (vaping + smoking) | +1.10 | -1.86 to 4.06 | Not significant |
For diastolic blood pressure, the pattern was similar: vaping/never smoking participants had DBP 2.88 mmHg higher (95% CI: 0.54-5.21) than never vaping/never smoking participants.
What this means: The strongest blood pressure signal was in the vaping/never smoking group — people who started vaping without ever having smoked. This is particularly important because this group represents the "pure" vaping effect, without any confounding from prior tobacco smoking. A 4.79 mmHg increase in systolic blood pressure is clinically meaningful: at a population level, every 2 mmHg increase in SBP is associated with approximately 10% higher risk of stroke mortality and 7% higher risk of ischemic heart disease mortality.
Interestingly, the vaping/former smoking and dual use groups did not show statistically significant blood pressure differences compared to the control group. The researchers noted this may reflect smaller sample sizes in these groups, or that former smokers' blood pressure may have already been elevated prior to switching to vaping.
Key Finding #2: Dose-Response — More Puffs, Higher Blood Pressure
The VapeScan Study found a clear dose-response relationship between vaping intensity and blood pressure. When researchers compared participants who vaped more than 100 puffs per day to those who vaped fewer than 36 puffs per day, they found:
| Metric | >100 puffs/day vs <36 puffs/day | 95% Confidence Interval |
|---|---|---|
| Systolic BP difference | +4.84 mmHg | 0.94 to 8.74 |
| Diastolic BP difference | +3.57 mmHg | 0.74 to 6.41 |
The researchers modeled the relationship as restricted quadratic splines and found that systolic blood pressure increased nonlinearly with increasing e-cigarette puffs per day. This means the blood pressure effect was not a simple linear increase — the relationship became steeper at higher puff counts, suggesting that heavy vaping may carry disproportionate cardiovascular risk.
In plain terms: The more you vape, the higher your blood pressure. This is the same kind of dose-response relationship that exists between cigarette smoking and cardiovascular risk. The fact that the effect is nonlinear means that heavy vapers (100+ puffs/day) may be at disproportionately higher risk than light vapers.
Key Finding #3: No Risk Reduction for Vapers
One of the most striking findings of the VapeScan Study was that vaping alone or vaping plus smoking provided no risk reduction for hypertension compared to never vaping or smoking. This challenges the narrative that vaping is a safer alternative to smoking for cardiovascular health.
What the data shows: The vaping/never smoking group had the highest blood pressure, not the lowest. Dual users (vaping plus smoking) did not show significantly higher blood pressure than the control group, but this does not mean dual use is safe — it means the study may not have had enough statistical power to detect the combined effect. The key takeaway is that vaping does not reduce cardiovascular risk compared to not using any tobacco or nicotine products.
This finding is particularly important for young adults who started vaping without ever smoking. The harm reduction argument for vaping typically applies to adult smokers who switch to e-cigarettes to reduce exposure to combustion byproducts. But the VapeScan Study shows that for never-smokers, vaping introduces cardiovascular risk that would not otherwise exist.
For context on the switching debate, our [menthol vape switching science analysis](menthol-vape-switching-science-full) covers the evidence on switching rates from smoking to vaping. The VapeScan findings do not contradict the switching evidence — they simply highlight that vaping is not risk-free, especially for never-smokers.
Key Finding #4: Endothelial Function and Coronary Calcification
The VapeScan Study measured two additional cardiovascular markers with unexpected results:
Endothelial Function (fRHI)
CAC Score (Inverse)
Clinical Significance
The study found no association between vaping categories and the Framingham Reactive Hyperemia Index (fRHI), a measure of endothelial function. This means that while blood pressure was higher in vapers, the small blood vessels' ability to dilate was not measurably impaired — at least not at the median 4-year exposure level studied.
For coronary artery calcification (CAC), the study found an inverse association between vaping categories and spatially weighted CAC scores compared to never vaping/never smoking. This means vapers had lower CAC scores than non-vapers. The researchers noted this finding requires further investigation and may reflect the younger age of the vaping groups, shorter exposure duration, or the fact that coronary calcification takes decades to develop and the 4-year median vaping exposure may be insufficient to detect calcification differences.
Important caveat: The inverse CAC finding does not mean vaping protects against coronary calcification. The researchers themselves flagged this as requiring further study. It is likely a confounding effect — coronary calcification takes decades to develop, and the study's median 4-year vaping exposure is too short to see this outcome. The blood pressure findings are the more reliable signal of cardiovascular risk.
What Other Studies Show
The VapeScan Study is not the only research on vaping and cardiovascular risk. Here's how it fits into the broader evidence base:
AHA Scientific Statement (2024)
Source: American Heart Association. Published in Circulation. Peer-reviewed scientific statement.
The American Heart Association's scientific statement on the cardiopulmonary impact of electronic cigarettes found that nicotine-containing e-cigarette use causes acute increases in systolic blood pressure (approximately +2 mmHg) and heart rate (+2 bpm). The AHA noted that the relative impact compared to combustible cigarettes may be lower, but the long-term effects remain unknown.
Strengths
- Comprehensive systematic review
- Published by leading cardiology authority
- Covers acute and chronic effects
Limitations
- Mostly short-term data available
- Few long-term studies existed before VapeScan
HCHS/SOL Hypertension Study (2025)
Source: Published in JACC: Advances. Hispanic Community Health Study/Study of Latinos.
A prior study published in JACC: Advances found that e-cigarette ever use was associated with incident hypertension (HR: 1.49; 95% CI: 1.14-1.95), and current use had an even stronger association (HR: 1.89; 95% CI: 1.12-3.18). This means current e-cigarette users had approximately 89% higher risk of developing hypertension compared to non-users.
Strengths
- Large population-based cohort
- Longitudinal design (followed over time)
- Directly measured hypertension incidence
Limitations
- Hispanic/Latino population only
- Self-reported e-cigarette use
Cooling Ingredients and Arrhythmia (June 2026)
Source: Published in Circulation: Arrhythmia and Electrophysiology. American Heart Association.
A study published in June 2026 found that synthetic cooling ingredients (such as WS-23) added to e-cigarettes caused abnormal heartbeats (arrhythmias) and increased cardiovascular risk measures in mice and lab-grown human heart cells. This is the first study to show that synthetic cooling agents in e-cigarettes may negatively affect heart rhythm. The effects included ventricular premature beats and increased epinephrine levels, some persisting after exposure ended.
Strengths
- First study on cooling agents and heart
- Published in top arrhythmia journal
- Both animal and human cell data
Limitations
- Animal/lab model, not human clinical
- Dosing may not match real-world use
Conflicts and Limitations
No single study provides a complete picture. The VapeScan Study has important limitations that readers should understand:
Key limitations: The study is cross-sectional, meaning it captures a single point in time rather than tracking changes over years. Cross-sectional studies can show associations but cannot prove causation. The median vaping duration of 4 years may be too short to detect long-term cardiovascular damage, particularly coronary calcification, which takes decades to develop. The study also relied on self-reported vaping habits (puffs per day, years of use), which may not perfectly reflect actual exposure.
- Cross-sectional design: Cannot determine whether vaping caused the higher blood pressure or whether people with higher blood pressure were more likely to vape. Longitudinal studies are needed to establish causation.
- Sample size by group: While 372 total participants is substantial, some subgroups (especially dual users) may have been too small to detect statistically significant differences.
- Self-reported vaping data: Puffs per day, nicotine concentration, and years of use were self-reported. Urinary cotinine was measured in only 110 participants, and self-reported data may include measurement error.
- NYC metro area only: Participants were recruited in the New York City area, which may limit generalizability to other populations or regions.
- Short exposure duration: Median 4 years of vaping may be insufficient to detect long-term effects like coronary calcification or clinical cardiovascular events.
- Funding considerations: The study was funded by the National Institutes of Health (NIH) and the American Heart Association. No industry funding was reported, which supports independence, but readers should always verify funding sources.
For a broader perspective on vaping science, see our analysis of [menthol vape switching rates](menthol-vape-switching-science-full), which covers the evidence that menthol-flavored e-cigarettes help adult smokers switch from combustible cigarettes.
The Regulation in Plain English
In plain terms: The FDA authorizes e-cigarette products through the PMTA (Premarket Tobacco Product Application) process. As of September 2026, 48 products from 5 brands (Vuse, NJOY, Logic, JUUL, and Glas) have received FDA marketing authorization. The VapeScan Study did not distinguish between FDA-authorized and unauthorized products — it measured vaping behavior in general. State laws may further restrict which products are legal to sell. See our [state flavor ban guide](vape-flavor-bans-by-state-2026-complete-guide) for details.
- FDA PMTA authorization does not mean a product is safe — it means the FDA determined that allowing the product on the market is "appropriate for the protection of public health." The VapeScan findings may influence future FDA regulatory decisions.
- State laws vary widely. California bans all disposable vapes (AB 762). Seventeen states maintain PMTA product directories. Texas bans Chinese-made vapes. Check your state's laws before purchasing.
- The American Heart Association has called for more research on vaping's cardiovascular effects. The VapeScan Study directly responds to this call.
- Nicotine is the likely mechanism for the blood pressure effect. Nicotine acutely raises blood pressure and heart rate by activating the sympathetic nervous system. The VapeScan findings suggest this acute effect may become chronic with long-term vaping.
FDA Status: As of September 14, 2026, 48 vape products from 5 brands have received FDA PMTA marketing authorization. The VapeScan Study measured vaping behavior in general and did not distinguish between authorized and unauthorized products. State laws may independently restrict product availability.
Who's Affected?
Young adults who vape (18-49): The VapeScan Study directly measured cardiovascular risk in this age group. If you vape, the study suggests your blood pressure may be elevated. If you vape more than 100 puffs per day, your risk is higher. Consult your healthcare provider for a blood pressure check.
Never-smokers who started vaping: The strongest blood pressure signal was in the vaping/never smoking group. If you started vaping without ever smoking combustible cigarettes, the cardiovascular risk-benefit calculation is different from that of a smoker switching to vaping. Vaping introduces cardiovascular risk that would not otherwise exist.
Former smokers who switched to vaping: The vaping/former smoking group did not show statistically significant blood pressure differences, but the study may not have had enough power to detect this effect. If you switched from smoking to vaping, the cardiovascular picture is more nuanced — you may have reduced exposure to combustion byproducts, but the VapeScan data suggests vaping itself is not without cardiovascular risk.
Dual users (vaping + smoking): The dual use group also did not show statistically significant blood pressure differences. This does not mean dual use is safe — it means the study may not have been large enough to detect the combined effect. Dual use is generally considered the worst option because it maintains exposure to combustion byproducts while adding vaping exposure.
Healthcare providers: The VapeScan findings suggest that blood pressure screening should include questions about vaping habits, particularly in young adult patients. The dose-response relationship means that heavier vaping is associated with higher blood pressure.
Who Should Do What?
The Never-Smoker Vaper (started vaping without smoking)
Best action: Get your blood pressure checked. The VapeScan Study found the strongest blood pressure signal in this group. If your blood pressure is elevated, discuss vaping cessation or reduction with your healthcare provider. Consider nicotine-free alternatives if you vape for flavor or social reasons.
For FDA-authorized products that meet regulatory standards, see our [FDA-authorized vapes buying guide](best-fda-authorized-vapes-2026-buying-guide).
The Former Smoker Who Switched to Vaping
Best action: Monitor your blood pressure regularly. The VapeScan Study did not find a statistically significant blood pressure increase in this group, but the study had limited power for this subgroup. If your blood pressure is normal, vaping may be a less harmful alternative to smoking — but it is not risk-free.
For help verifying whether your product is FDA-authorized, see our [PMTA verification guide](how-to-check-fda-authorized-vape-2026-guide).
The Heavy Vaper (100+ puffs/day)
Best action: Reduce your vaping intensity. The VapeScan Study found a clear dose-response: more than 100 puffs per day was associated with 4.84 mmHg higher systolic blood pressure compared to fewer than 36 puffs per day. Cutting back on puffs per day may reduce cardiovascular risk.
For alternatives to high-consumption disposables, see our [refillable pod vape comparison](best-refillable-pod-vapes-2026-comparison).
The Healthcare Provider
Best action: Add vaping questions to your intake screening for young adult patients. The VapeScan Study provides the first direct evidence of subclinical cardiovascular risk markers in young adult vapers. Blood pressure screening should include questions about e-cigarette use, puffs per day, and years of vaping.
The Consumer Choosing a Vape Product
Best action: Understand that all vaping carries cardiovascular risk. If you choose to vape, use FDA-authorized products from reputable brands. Check your state's laws — some states ban certain products entirely. See our [state flavor ban guide](vape-flavor-bans-by-state-2026-complete-guide) for what's legal where you live.
US vs UK Comparison
| Dimension | United States | United Kingdom |
|---|---|---|
| Regulator | FDA (CTP) | MHRA (TPD compliance) |
| Product authorization | PMTA (48 products authorized) | TPD notification (no authorization required) |
| Nicotine limit | No federal limit | 20mg/ml max |
| Tank/refill limit | No federal limit | 2ml tank, 10ml refill bottle |
| Health authority stance | AHA calls for more research | PHE/NHS: "less harmful than smoking" for adult smokers |
| Flavor restrictions | 6 states ban flavors, 17 have PMTA directories | Disposable vape ban (June 2025) |
| Blood pressure research | VapeScan Study (2026) | UK studies ongoing; COT scheme monitoring |
The UK takes a more permissive stance on vaping for adult smokers switching from cigarettes, with Public Health England's "less harmful than smoking" position. However, the VapeScan findings about cardiovascular risk in never-smokers raise questions that are relevant to both markets — particularly as the UK disposable ban pushes users toward refillable devices that may deliver higher nicotine doses.
What's Next?
- Longitudinal studies: The VapeScan Study is cross-sectional. Long-term follow-up studies tracking vapers over 10-20 years are needed to determine whether the blood pressure increase leads to clinical cardiovascular disease.
- Product-specific research: The study did not distinguish between FDA-authorized and unauthorized products, or between device types (pod systems, disposables, mods). Future research should examine whether specific device types or nicotine concentrations carry different cardiovascular risks.
- Cooling ingredient studies: The June 2026 study on synthetic cooling agents (WS-23) and arrhythmias suggests that specific vape ingredients may have independent cardiovascular effects. Expect more research on flavor compounds and heart health.
- FDA regulatory response: The FDA may consider cardiovascular risk data in future PMTA decisions. The VapeScan findings could influence the agency's approach to authorizing new products, particularly flavored products that appeal to young adults.
- Nicotine reduction: If nicotine is the primary driver of the blood pressure effect (as the sympathetic nervous system mechanism suggests), FDA-mandated nicotine reduction in vaping products could reduce cardiovascular risk.
What to watch: The VapeScan Study is the first major study to directly measure cardiovascular risk markers in young adult vapers. Expect follow-up studies examining specific device types, nicotine concentrations, and flavor compounds. The American Heart Association has already called for more research, and the FDA will likely consider these findings in future regulatory decisions. If you vape, monitor your blood pressure — it is the most actionable finding from this study.
Frequently Asked Questions
Does vaping raise blood pressure?
Yes. The VapeScan Study found that young adults who vaped for a median of 4 years had systolic blood pressure 4.79 mmHg higher (95% CI: 1.83-7.75) and diastolic blood pressure 2.88 mmHg higher (95% CI: 0.54-5.21) than non-vapers. The effect was strongest in the vaping/never smoking group. The more puffs per day, the higher the blood pressure.
Is vaping bad for your heart?
The VapeScan Study found that long-term vaping is associated with higher blood pressure, a key cardiovascular risk factor. Vaping provided no risk reduction for hypertension compared to not vaping or smoking. However, the study measured early risk markers (subclinical), not clinical heart disease. No study has shown that vaping directly causes heart attacks or stroke in young adults. The findings suggest elevated cardiovascular risk over time, but long-term studies are needed.
How many puffs per day is dangerous for blood pressure?
The VapeScan Study found that vaping more than 100 puffs per day was associated with systolic blood pressure 4.84 mmHg higher (95% CI: 0.94-8.74) and diastolic 3.57 mmHg higher (95% CI: 0.74-6.41) compared to fewer than 36 puffs per day. The dose-response relationship was nonlinear, meaning blood pressure increased more steeply at higher puff counts. There is no established "safe" number of puffs per day.
Does vaping cause heart attacks?
No study has directly linked vaping to heart attacks in young adults. The VapeScan Study measured subclinical risk markers — blood pressure, endothelial function, and coronary artery calcification — not clinical cardiovascular events like heart attacks or stroke. The elevated blood pressure findings suggest increased long-term risk, but clinical events may take decades to develop. The study's median 4-year vaping exposure is too short to detect clinical outcomes.
Is vaping safer than smoking for your heart?
The VapeScan Study did not directly compare vaping to smoking for cardiovascular outcomes. However, it found that dual users (vaping plus smoking) did not show significantly higher blood pressure than the control group, and vaping alone provided no risk reduction compared to never vaping or smoking. The American Heart Association notes that the cardiovascular impact of e-cigarettes may be lower than combustible cigarettes, but the long-term effects remain unknown.
What is the VapeScan Study?
The VapeScan Study is a research study conducted by Columbia University researchers, published in JACC: Advances on September 1, 2026. It recruited 372 cardiovascular disease-free participants aged 18 to 49 in the New York City area between May 2021 and May 2024. The study measured systolic and diastolic blood pressure, endothelial function (Framingham reactive hyperemia index), and coronary artery calcification (spatially weighted CAC score).
Should I stop vaping if I have high blood pressure?
If you have high blood pressure, consult your healthcare provider about vaping. The VapeScan Study found that vaping is associated with higher blood pressure in young adults, particularly in those who vape more than 100 puffs per day. If you started vaping to quit smoking, discuss alternative cessation tools with your doctor. If you never smoked and started vaping for other reasons, the cardiovascular risk-benefit calculation is less favorable.
What did the VapeScan Study find about coronary calcification?
The VapeScan Study found an inverse association between vaping categories and spatially weighted coronary artery calcium (CAC) scores compared to never vaping or smoking. The researchers noted this finding requires further investigation and may reflect the younger age and shorter exposure duration of the vaping groups. Coronary calcification takes decades to develop, and the study's median 4-year vaping exposure may be insufficient to detect this outcome.
We Want to Hear From You
Has this article changed how you think about vaping and heart health? Are you concerned about the blood pressure findings, or do you see vaping as a reduced-harm alternative? Share your perspective to help other readers understand the full picture.
- Vote: Did the VapeScan findings change your view on vaping?
- Have you had your blood pressure checked since you started vaping?
- If you switched from smoking to vaping, did your blood pressure change?
- Do the cardiovascular findings make you more likely to reduce your vaping?
- What questions do you still have about vaping and heart health?
- Leave a comment below with your experience
- Share this article with someone who vapes and might not know about the cardiovascular risk
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FDA Regulatory Notice: As of September 14, 2026, 48 vape products from 5 brands (Vuse, NJOY, Logic, JUUL, and Glas) have received FDA PMTA marketing authorization. FDA authorization means a product is allowed on the market, not that it is safe or risk-free. The VapeScan Study measured vaping behavior in general and did not distinguish between authorized and unauthorized products.
State Law Notice: Six states (CA, MA, NJ, NY, RI, UT) maintain statewide flavor bans. Seventeen states maintain PMTA product directories. Texas maintains an origin ban on Chinese-made vapes. Always verify your state and local regulations before purchasing any vape product.
Sources
- Anderson WA, Levitan SB, Sangapalaarachchi DN, et al. "E-Cigarette Use and Early Cardiovascular Risk in Young Adults: The VapeScan Study." JACC: Advances, September 1, 2026. — JACC.org
- American Heart Association. "Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products: A Scientific Statement From the American Heart Association." Circulation. — AHAjournals.org
- American Heart Association. "Can Cooling Ingredients in E-Cigarettes Cause Irregular Heartbeat or Cardiac Arrest?" June 15, 2026. — Heart.org
- Electronic Cigarette Use and Risk of Hypertension: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). JACC: Advances. — JACC.org
- US Food and Drug Administration. "Tobacco Product Marketing Authorization." FDA.gov, September 2026. — FDA.gov
- For state-specific vape regulations, see our complete state flavor ban guide.
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Subscribe MonthlyAuthor: Vape Insider Editorial Team | Published: September 14, 2026 | Last updated: September 14, 2026 | Information verification date: September 14, 2026
