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Published in: J Cardiopulm Rehabil Prev. 2016 ; 36(5): 352–357.


Purpose—The use of electronic cigarettes (e-cigarettes) has risen dramatically in recent years. However, there is currently no published data on use of e-cigarettes among cardiac patients. The current study reports on the prevalence, reasons for use, and perceived risks of e-cigarettes among post-Acute Coronary Syndrome (ACS) patients. The relationship between e-cigarette use and post- ACS tobacco smoking cessation is also explored.

Methods—Participants were drawn from a randomized trial of smoking cessation treatments following hospitalization for ACS. The current study focuses on 49 participants that completed e- cigarette questions at 24 weeks post-ACS.

Results—51.0% of participants reported ever use of an e-cigarette and 26.5% reported using an e-cigarette at some time during the 24 weeks post-ACS. Ever use and post-ACS use were both significantly associated with lower rates of abstinence from tobacco cigarettes. Participants

perceived e-cigarettes as less harmful to cardiac health than tobacco use and Chantix, and similarly harmful as nicotine replacement therapy. Participant perceived likelihood of experiencing a heart attack in the next year was 34.6% if they were to regularly use e-cigarettes only, significantly lower than perceived risk of recurrence if they were to regularly smoke only tobacco cigarettes (56.2%) and significantly higher than perceived risk of recurrence if they were to use no nicotine (15.2%).

Conclusions—A significant minority of patients are using e-cigarettes post-ACS. Providers should be prepared to discuss potential discrepancies between patient beliefs about the safety of e- cigarettes and the current state of the science.