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Key Points The population risk versus benefit for use of electronic cigarettes (ECs) is strongly influenced by the relative safety of ECs compared with conventional cigarettes The exposure of EC users to potentially toxic chemical emissions is difficult to quantify, given the numerous types of EC devices, different e-liquids, and disparities in individual use patterns EC emissions of concern for cardiovascular health include nicotine, oxidizing chemicals, aldehydes (especially acrolein), and particulates Nicotine might contribute to acute cardiovascular events, particularly in people with underlying cardiovascular disease, primarily by sympathetic neural stimulation and systemic release of catecholamines The cardiovascular risk of EC use is likely to be much less than that of cigarette smoking Abstract Cardiovascular safety is an important consideration in the debate on the benefits versus the risks of electronic cigarette (EC) use