But there is another important factor that Glantz is forgetting. In the existing studies, the smokers examined had simply cut down on the amount they smoked without substituting another source of nicotine. Therefore, they were highly likely to be compensating by inhaling much more heavily on the cigarettes that they smoked. In contrast, when dual users of e-cigarettes and cigarettes cut down substantially on their smoking, they are doing so by substituting non-tobacco, nicotine cigarettes. One would expect much less, if any, compensation. Thus, the studies that Glantz cites are not quite as relevant as they would otherwise be.

In the study, investigators examined measures of acute heart function using echocardiography among 36 smokers and 40 vapers, before and after using either a cigarette or e-cigarette. The researchers found that cigarette smoking adversely affected acute heart function. Electronic cigarette use had no effect on any of the measures examined.

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