The Impact of Long‐Term Electronic Cigarette Vaping on Cerebrovascular Function

Introduction Despite the rapidly increasing prevalence of electronic cigarette (EC) use, its effects on cerebrovascular health remain unclear. This study is the first to explore the impact of chronic EC vaping on human cerebral vascular function. Methods This cross‐sectional study included 60 participants: 30 long‐term EC users, and 30 age‐ and sex‐matched controls with no history of EC use. Cerebrovascular function was assessed using the breath‐holding index (BHI), a transcranial Doppler‐based measure of cerebral vasomotor reactivity, and a preclinical marker associated with increased risk of cerebrovascular disease, neurocognitive decline, and mortality. Cumulative EC exposure was quantified using “EC burden,” a composite measure derived from the product of average daily puffs and duration of use. Results Long‐term EC vapers exhibited significantly lower BHI values compared to controls ( p < 0.001), with long‐term EC use found to be independently associated with impaired BHI {adjusted odds ratio (OR) 1.21 [95% CI 1.03–3.21]; p = 0.039}. Subjects with impaired BHI had significantly greater EC burden ( p < 0.001) and longer duration of EC use (minimum 4 years; p < 0.001) compared to long‐term EC users with normal BHI. EC burden was independently associated with impaired BHI (adjusted OR 1.35 [95% CI 1.02–2.41]; p = 0.022), demonstrating a strong inverse linear relationship ( R 2 = 0.78; p < 0.001). Conclusions Our findings provide preliminary evidence suggesting an association between long‐term EC vaping and impaired cerebrovascular function, as assessed by BHI. Confirmation through larger prospective studies using more definitive measures of cerebral vasomotor reactivity is warranted.