Vaping has a built-in illusion.
Unlike cigarette smoke, the aerosol can taste sweet, fruity or minty. And newer ingredients can create an icy-cool sensation that makes each inhale feel surprisingly smooth.
But smoother doesn’t mean safer.
In fact, researchers have discovered that some of the chemicals added specifically to take the harsh edge off vaping may have an unintended target: your heart’s electrical system.
A study published in the American Heart Association journal Circulation: Arrhythmia and Electrophysiology found that menthol and two increasingly popular synthetic cooling agents affected heart rhythm and autonomic function in laboratory models.
And when those cooling chemicals were combined with nicotine, one in particular was linked to a sharp increase in premature heartbeats.
Here’s what researchers found — and why that “cooling” sensation may deserve a second thought.
‘Cooling’ chemicals affect heart rhythm
Menthol isn’t the only ingredient manufacturers can use to create a cooling sensation.
Synthetic compounds called WS-3 and WS-23 can provide that icy feeling without producing a strong identifying flavor. They also help reduce the harshness of inhaled aerosol, making vaping feel smoother.
Researchers wanted to know what these cooling agents might be doing to the cardiovascular system.
They conducted two types of laboratory tests. In the first, mice inhaled e-cigarette aerosols containing nicotine with or without cooling agents while researchers monitored heart rhythms and electrical conduction.
They found:
- All three cooling agents affected heart rate variability, a measure influenced by the autonomic nervous system.
- Adding synthetic coolants to aerosol containing nicotine and solvents increased premature heartbeats.
- WS-23 had the strongest effect, tripling premature beats compared with aerosol containing nicotine and solvents alone.
- Coolant exposure was also associated with a faster heart rate and changes in the heart’s electrical recovery between beats.
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The researchers then exposed lab-grown human heart cells to the cooling agents while using noradrenaline to mimic the stress effects associated with nicotine.
The coolants had little effect while the cells were at rest. But under hormonal stress, they altered the cells’ beating and electrical recovery.
Together, the findings suggest these cooling chemicals could contribute to abnormal heart rhythms — and potentially increase vulnerability to more serious rhythm disturbances.
Study investigator Dr. Alex Carll says the findings also raise questions about how these additives are regulated.
“Coolants are added to e-cigarettes at very high levels, often more than nicotine or any other flavoring,” he says.
Researchers emphasize that these were laboratory and animal experiments. More research in people is needed to determine whether the short-term electrical effects translate into long-term arrhythmia or cardiac-arrest risk.
The dangers go beyond coolants
Cooling agents are only one concern.
E-cigarette aerosol can expose users to nicotine along with toxic compounds such as formaldehyde and heavy metals. Research has linked vaping with oxidative stress, inflammation, blood-vessel dysfunction and other changes associated with cardiovascular disease.
Then there’s nicotine itself.
Some vape cartridges can contain as much nicotine as an entire pack of cigarettes. Nicotine can raise heart rate and blood pressure, constrict blood vessels and increase the workload on the heart.
That makes the new findings especially concerning: The cooling agents appeared to cause stronger disturbances when the heart was already experiencing nicotine-like stress.
And there’s another problem.
A smoother, cooler inhale may make vaping feel less irritating — while potentially allowing users to tolerate greater exposure to nicotine and aerosol chemicals.
So if you vape, especially products advertised as cool, ice, chill, frost or menthol, don’t mistake that smoother sensation for safety.
Quitting remains the best way to eliminate the cardiovascular risks associated with vaping. If you’re ready to stop, cardiologist Dr. Elizabeth Klodas has some helpful suggestions to kick the smoking habit without vaping.
Sources:
Growing scientific evidence links e-cigarette chemicals to heart health risks — American Heart Association
Can cooling ingredients in e-cigarettes cause irregular heartbeat or cardiac arrest? — American Heart Association
Influence of Cooling Agents on the Arrhythmogenic and Autonomic Effects of Electronic Cigarettes in an in vivo Model — Circulation: Arrhythmia and Electrophysiology
FAQ: Vaping and Heart Rhythm
Research suggests vaping can influence heart rate, heart rate variability and the autonomic nervous system, all of which play roles in maintaining normal heart rhythm. A recent laboratory study found that menthol and synthetic cooling chemicals in e-cigarettes increased rhythm disturbances in mice under certain conditions. More research is needed to determine how strongly these findings translate to people.
WS-3 and WS-23 are synthetic cooling agents added to some vaping products to create a cold or icy sensation without necessarily adding a recognizable flavor. They can make inhalation feel smoother and less harsh. New research suggests these compounds may also influence heart rhythm and electrical activity.
Menthol was one of the cooling agents found to affect cardiovascular measurements in laboratory research. However, synthetic coolants such as WS-23 also produced effects, meaning the potential concern isn’t limited to products labeled “menthol.”
Nicotine stimulates the cardiovascular system. It can increase heart rate and blood pressure, narrow blood vessels and make the heart work harder. Researchers found that cooling chemicals produced more concerning effects when combined with conditions mimicking nicotine-related stress.
E-cigarettes don’t produce the combustion products created by burning cigarettes, but that doesn’t make them harmless. E-cigarette aerosol can contain nicotine and other potentially harmful chemicals, and research continues to identify cardiovascular effects associated with vaping. People who don’t currently use tobacco products should not start vaping.
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