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• Posted December 18, 2025

Vapes Or Cigs, Doesn't Matter — Nicotine Is Toxic To Heart Health, Experts Say

It’s beside the point to debate whether vaping or nicotine pouches can be more healthy than smoking a cigarette, a major new report argues.

Nicotine is toxic to the heart and blood vessels regardless of how it’s consumed, according to an expert consensus report published today in the European Heart Journal.

“Nicotine is not a harmless stimulant; it is a direct cardiovascular toxin,” said lead researcher Dr. Thomas Münzel, a senior professor of cardiology at University Medical Center at Johannes Gutenberg University in Mainz, Germany.

“Across cigarettes, vapes, heated tobacco and nicotine pouches, we consistently see increased blood pressure, damage to blood vessels and a higher risk of heart disease,” Münzel said in a news release. “No product that delivers nicotine is safe for the heart.”

For the paper, researchers focused specifically on the medical evidence related to nicotine’s effect on heart health.

”Our findings show that nicotine by itself, even without the multitude of toxic combustion products, tar, or free radicals present in cigarette smoke, drives cardiovascular damage,” Münzel said.

Toxic effects of nicotine include:

• Triggering acute increases in heart rate and blood pressure

• Impairing the ability of blood vessels to expand and contract as needed

• Promoting blood clots, which increases risk of heart attack and stroke

• Causing scarring to the heart

• Promoting growth of new blood vessels, which can feed cancers

The highly addictive nature of nicotine ensures that all of these toxic effects will be endured repeatedly and over the long term, researchers concluded.

“The narrative of ‘safer nicotine’ must end,” Münzel said. “The next heart attack, the next stroke, the next cardiovascular death may not come from a cigarette, but from a flavored pod, a nicotine pouch or a waterpipe in a café.”

Senior researcher Thomas Lüscher, a consultant cardiologist with the Royal Brompton & Harefield Hospitals in London, called the new report “a wake-up call for regulators.”

“The shift from cigarettes to e-cigarettes and flavored pouches is no effective harm reduction; it is rather a transformation of addiction strategies,” Luscher said.

The report calls for a wide variety of regulatory actions aimed at reducing nicotine exposure.

“We need political action,” Lüscher continued. “Flavor bans, effective taxation, comprehensive advertising restrictions and the inclusion of vaping and heated tobacco in all smoke-free laws are no longer optional – these are essential measures to prevent cardiovascular disease.”

He concluded with this: “Science is clear: the cardiovascular toxicity of nicotine is evidence-based by now. The duty now lies with legislators to protect the public, especially children, from a new epidemic of addiction and disease.”

More information

The U.S. Food and Drug Administration has more on the addictive nature of nicotine.

SOURCE: European Society of Cardiology, news release, Dec. 18, 2025