A new study finds that users of e-cigarettes are more at risk of heart failure.

The study, published by the American College of Cardiology, used data from All of Us, a National Institute of Health research program that seeks to build one of the most diverse health databases in history using 1 million volunteers.

Researchers analyzed associations between e-cigarette use and new diagnoses of heart failure in 175,667 study participants, who were an average of 52 years old and 60% female. Of the sample studied, 3,242 participants developed heart failure within a median follow-up time of 45 months.

Those who used e-cigarettes were 19% more likely to develop heart failure in comparison to those who had never used e-cigarettes.

Heart failure is a condition that occurs when a person’s heart does not pump enough blood for his body. About 6.2 million adults in the United States have heart failure, according to the CDC.

“More and more studies are linking e-cigarettes to harmful effects and finding that it might not be as safe as previously thought,” Dr. Yakubu Bene-Alhasan, a resident physician at MedStar Health in Baltimore and the study’s lead author, said in a press release. “The difference we saw was substantial. It’s worth considering the consequences to your health, especially with regard to heart health.”

The study found that there was no evidence that age, sex, or smoking status impacted the relationship between e-cigarettes and heart failure.

According to the CDC, e-cigarettes are the most commonly used tobacco product among youth. In 2023, 2.13 million U.S. middle and high school students had used e-cigarettes in the past 30 days, slightly down from 2022, when there were 2.55 million.

In January, HB 4758 went into effect in Texas, which prohibits businesses from marketing, advertising, selling, or causing to be sold any e-cigarette products that:

  • Depict a cartoon-like fictional character that mimics a character primarily aimed at entertaining minors;
  • Imitate or mimic trademarks or trade dress of products that are or have been primarily marketed to minors;
  • Include a symbol or celebrity image that is primarily used to market products to minors;
  • Resemble a food product, including candy or juice.