Pod-based e-cigarettes like Juuls may be just as negatively impactful on the cardiovascular system as regular cigarettes, a study released Monday suggests.

The small study, which will be presented at the American Heart Association’s Scientific Sessions 2022 next month, examined how volatile organic compounds (VOCs) that may be found in e-cigarettes can affect heart health.

Researchers compared people who were exposed to VOCs to those exposed to regular cigarettes, as well as to people who didn’t use tobacco or nicotine. Among the 106 adults aged 18 to 45 included in the study, none had cardiovascular disease or risk factors.

They found that people who used pod-based e-cigarettes had 8% higher blood pressure compared to people who didn’t use any form of cigarettes – a similar rate to people who smoked regular cigarettes. E-cigarette and cigarette users also had higher heart rates and experienced some changes in vascular health, such as lower artery dilation.

“Our findings demonstrate that pod-based e-cigarette use had long- and short-term effects on the vascular system in healthy young adults, including in those who have only smoked e-cigarettes and have never smoked combustible cigarettes,” Sana Majid, lead study author and postdoctoral fellow at Boston University School of Medicine, said in a press release.

The research emerges as the rates of young people using vapes or e-cigarettes continue to remain high. One in 10 middle and high school students – about 2.5 million young people – use e-cigarettes, according to recent data from the Centers for Disease Control and Prevention (CDC). That’s about 14% of high school students who reported using e-cigarettes in 2022. A majority, 85%, use flavored products.

That same report examined how conflicting public health messages and ads around e-cigarettes were affecting young people. It found that while 75% of young people have seen anti-tobacco ad campaigns in the last year – and most recognized the FDA’s The Real Cost ad campaign – a large number of the same students are also being exposed to tobacco marketing.

Three quarters of respondents said they were exposed to tobacco product marketing at a variety of different places – including convenience stores, television or on the Internet.

Additionally, there is an ongoing battle between public health messaging from the Food and Drug Administration and e-cigarette companies like Juul.

Evidence around the toxic effects of e-cigarettes and vaping has historically been lacking, but more studies are beginning to connect the dots. Another recent study, funded by the National Institutes of Health, found that long-term vaping could have a damaging effect on blood vessels.

Questions about the safety of e-cigarettes led to the FDA’s decision to order Juul products off the market in June. The agency argued that the company’s tobacco applications “lacked sufficient evidence regarding the toxicological profile of the products to demonstrate that marketing of the products would be appropriate for the protection of the public health.”

Still, Juul has stated that it plans to continue the fight to keep its products on the market. 

“We strongly believe that we have a future and in that future there will be Juul products available to millions of adult smokers across the world,” Juul Labs CEO K.C. Crosthwaite said, according to The Wall Street Journal.Last month, Juul sued the FDA over documents supporting its market ban before subsequently canceling its overseas expansion plans as the company considers filing for bankruptcy.