Five Evidence-Based Takeaways from the Latest AHA Study on Smoking and Cardiovascular Risk

Dubai, UAE – January 28, 2026: A newly published study in the Journal of the American Heart Association examined cardiovascular outcomes among stroke survivors, comparing risks associated with combustible cigarette use, electronic cigarette use, and dual use. Conducted using a large nationwide cohort of Korean men, the study offers timely, evidence-based insights into how different smoking behaviours relate to cardiovascular risk in a high-risk population.
Here are five key takeaways from the research:
1. Combustible smoking remains a major cardiovascular risk after stroke
The study found that continued use of combustible cigarettes was associated with a significantly higher risk of recurrent stroke or myocardial infarction compared with non-use. This reinforces long-established evidence that smoking is a major modifiable risk factor for cardiovascular disease, particularly among stroke survivors.
2. Dual use carries risks comparable to continued smoking
Individuals who used both combustible cigarettes and e-cigarettes (referred to as “dual users”) also showed a significantly increased risk of recurrent cardiovascular events. The findings suggest that adding e-cigarettes without fully quitting smoking does not reduce cardiovascular harm and may expose users to risks associated with both products.
3. Although not risk-free, e-cigarette-exclusive use showed a lower risk than smoking
Among stroke survivors who reported exclusive e-cigarette use, the study observed a numerically higher but statistically non-significant increase in cardiovascular risk compared with nonusers. Importantly, the risk appeared lower than that associated with combustible cigarette use or dual use, although the authors caution that this does not imply that e-cigarettes are completely risk-free.
4. Combustion is the key driver of cardiovascular harm
The findings add to the scientific understanding that many of the most harmful cardiovascular effects of smoking are linked to the combustion process when a cigarette is lit, which produces toxic substances such as carbon monoxide and tar. While e-cigarettes eliminate combustion, they still deliver other substances that may affect cardiovascular health.
5. Complete smoking cessation remains the most appropriate choice
The authors emphasise that full cessation of smoking remains the best option for reducing cardiovascular risk, especially for stroke survivors. While e-cigarettes may present lower cardiovascular risk than continued smoking for some individuals, further research is needed to better understand their long-term impact and role in harm reduction.
As public and policy discussions around smoking, and less harmful alternatives continue, this study underscores the importance of evidence-based dialogue and clear distinctions between nicotine and the harms caused by combustion. For high-risk populations, informed decisions based on scientific evidence remain essential.