Vaping Slows Wound Healing Just as Much as Smoking
Study finds that e-cigarettes significantly impact the body’s ability to heal
“If you’re using electronic cigarettes, or ‘vaping’, instead of smoking cigarettes, you’re fooling yourself if you think it’s a healthier option,” with regard to wound healing, says Jeffrey Spiegel, a Boston University School of Medicine professor of otolaryngology, head and neck surgery, and chief of Facial Plastic and Reconstructive Surgery at Boston Medical Center.
Spiegel is the senior author on a new study, published October 18, 2018, in JAMA Facial Plastic Surgery, that found that electronic cigarettes have virtually the same negative consequences for wound healing as traditional cigarettes. Although electronic cigarettes or “e-cigarettes” have been marketed as a safer alternative to cigarettes, Spiegel says those claims are largely lacking in scientific data.
It’s long been known that traditional cigarettes greatly reduce the body’s ability to repair wounds. Nicotine restricts blood vessels, reducing blood flow to skin and tissues. At the same time, it also increases the degree to which blood platelets, which play a role in clotting, tend to clump together.
“Basically, nicotine makes your blood vessels smaller and your blood stickier,” Spiegel says.
As a result, blood circulation is reduced, especially to small microvessels found in the skin, making it much harder for the body to repair injuries.
Although e-cigarettes don’t contain tobacco, they do contain nicotine and other chemicals. To find out the effects of e-cigarettes on wound healing, Spiegel teamed up with BU School of Medicine otolaryngology resident Chelsea Troiano, who applied for and received funding from the American Academy of Facial Plastic and Reconstructive Surgery. Troiano is the first author on the new paper.
Studying how well skin flaps were able to heal in rodents over the course of one month, Spiegel and Troiano found that 30 minutes a day of exposure to traditional cigarette smoke versus e-cigarette vapors was nearly identical in slowing down wound healing. After 30 days, there was substantially more tissue death in rodents that had been exposed to cigarettes and e-cigarettes when compared with rodents who had been in a smoke-free environment.
Spiegel says the effects of vaping an electronic cigarette cartridge a day is “as bad for wound healing as smoking a pack of cigarettes a day.”
Ordinarily, to protect the body’s ability to recover, surgeons have warned patients to abstain from smoking cigarettes for a month leading up to elective surgeries and to remain smoke-free afterwards. Now, Spiegel’s research shows that surgeons must also carefully discuss e-cigarette use with patients and the impact it can have on wound healing.
What’s more, the study hints at larger implications for how e-cigarettes disrupt the body’s ability to self-repair and stave off disease.
“Wound healing is certainly very important with regard to surgery,” but it’s also very important in “repairing small levels of injury” the body experiences every day, Spiegel warns. Electronic cigarette users are essentially “suffocating the body’s tissues so that they can’t heal well, setting up for a bad situation.”
Having read the article entitled ‘Vaping Slows Wound Healing Just as Much as Smoking.’, I’m now curious to know what effect stopping vaping will have on a Stage 4 Pressure sore that I have on my right buttock.
I vape daily with e-liquid which has 18mg (or 1.8%,) nicotine content and the healing of my wound happens to have plateaued over the last few months. This means that the nurses dressing the wound every day are currently making sure that the wound doesn’t get any worse, rather than watching it improve steadily.
If, as my consultant stronglyrecommends, I stop vaping for the next three months as I await reconstructive surgery (as I fully intend to do), what changes or improvements to wound healing am I most likely to experience during this nicotine-free period?
Although in asking this I should add that I do realize that wounds don’t always heal in a predictable way, and that observing a healing process plateau, and then suddenly start again, is a commonplace phenomenon.
Also; please could you explain to me (preferably in layman’s terms!) what effect vaping nicotine has on the body, quite apart from the issue of how it impacts on wound healing.
I ask this because, strangely, I have had one doctor tell me that nicotine, although highly addictive, is about as harmful as caffeine, whereas another doctor has told me that nicotine is extremely poisonous – which suggests to me that its effects on the body could potentially be far more serious than caffeine!
I look forward to hearing from you shortly.
Mr. C. J. Rasdale.
Hi Mr. Rasdale, Thanks for your comment. Here is a response from Dr. Jeffrey Spiegel:
Thank you for reading our article and for your interest in our work. We found that wound healing is impaired with vaping similar to what occurs with smoking cigarettes. We suggest you discuss your individual health situation with the surgeon with adequate time to make the necessary changes to your behaviors for the best outcome. -JS
Dear Dr. Spiegel
Thank you for responding to my post.
I have now stopped vaping ‘Cold Turkey’ as the saying goes, and so far, after 48hrs, the nicotine withdrawal symptoms seem far less severe than they would be if I’d gone Cold Turkey with cigarettes.
Unsurprisingly I don’t know what to do with my hands and so I’ve tentatively decided that in order to try to emulate my usual vaping experience as closely as possible, I may try vaping with a zero nicotine e-liquid.
The point of this, largely, would be to try to get the same kind of pleasant ‘Throat Hit’ from vaping some flavour of zero-nicotine e-liquid, that I would get from my usual 18mg (or 1.8%) e-liquid.
In doing this I’ll do whatever I can to ensure that whatever zero nicotine e-liquid I use, it WILL GENUINELY BE ZERO NICOTINE. Although there may not be much that I can actually do to really ensure zero nicotine, but one can only do one’s best.
Again Dr. Spiegel, thank you for responding to my posting.
I did not see any mention of 0mg e-juice in the article, was this tested as well? If nicotine is what causes most of the issues, would a 0mg nicotine content still cause the same issues?
Hey dr. Spiegel
I’m recovering from an Achilles’ tendon tear and I use a dab pen almost everyday. Was wondering if you have any information on the affects of that on healing. I don’t believe it has nicotine in it.
Preliminary results demonstrated that e-cigarette use results in reduced cutaneous blood flow when monitored using thermal imaging technology. The authors hypothesize that that e-cigarette use may impair wound healing and have adverse effects on surgical outcomes.