Smoking traditional cigarettes with e-cigarettes has harmful health effects

According to a new study published today in the American Heart Association’s flagship journal, smoking traditional cigarettes in addition to using e-cigarettes leads to similar adverse health effects as smoking exclusively cigarettes. Traffic.

Smoking, a well-known link to cardiovascular disease and death, appears to be on the decline. Although the use of e-cigarettes, known as vaping, is growing in popularity, there has been little research on the impact of vaping on the body.

In a large data analysis of more than 7,100 American adults aged 18 and older, researchers investigated the association of smoking and e-cigarette use with inflammation and oxidative stress as biomarkers. Inflammation and oxidative stress are key factors in smoking-induced cardiovascular disease and their biomarkers have been shown to be predictors of cardiovascular events, including heart attack and heart failure.

This study is among the first to use nationally representative data to examine the association of cigarette and e-cigarette use behaviors with biomarkers of inflammation and oxidative stress. Given the lag between tobacco exposure and disease symptoms and diagnosis, identifying the association between e-cigarette use and sensitive biomarkers of subclinical cardiovascular injury is necessary to understand the effects at term of new tobacco products such as electronic cigarettes.

Andrew C. Stokes, Ph.D, Assistant Professor, First Author, Global Health, Boston University School of Public Health, Boston

The researchers used data from the Population Assessment of Tobacco and Health (PATH) study, a nationally representative longitudinal cohort in the United States. included the collection of blood and urine samples.

Five biomarkers of inflammation and oxidative stress were analyzed. Participants were divided into four categories based on traditional cigarette and e-cigarette use over a 30-day period: non-use of cigarettes and e-cigarettes; exclusive vaping; exclusive smoking; and the dual use of cigarettes and e-cigarettes. To test the robustness of the initial results, the scientists repeated the analyzes in subgroups of respondents, including those who had not used any other tobacco product in the past 30 days.

Of the study participants, more than half (58.6%) did not use cigarettes or e-cigarettes; nearly 2% vaped exclusively; about 30% smoked cigarettes exclusively; and about 10% used e-cigarettes and traditional cigarettes.

The analysis found:

  • Participants who vaped exclusively had a similar inflammatory and oxidative stress profile as people who did not smoke cigarettes or use e-cigarettes.
  • Participants who smoked exclusively and those who used cigarettes and e-cigarettes had higher levels for all biomarkers assessed compared to participants who did not use cigarettes or e-cigarettes.
  • Compared to participants who smoked exclusively, those who vaped exclusively had significantly lower levels of almost all inflammatory and oxidative stress biomarkers. However, participants who used cigarettes and e-cigarettes had comparable levels of all inflammatory and oxidative stress biomarkers to those who smoked exclusively.

“This study adds to the limited body of research we have on biological measures in those who use e-cigarettes,” said study co-author Rose Marie Robertson, MD, FAHA, deputy scientific director and American Heart Association physician and co-director of the Association’s National Institutes of Health/Food and Drug Administration-funded Tobacco Regulatory Science Center, who supported the study. “I think it contains an important message for people who may believe that using e-cigarettes while continuing to smoke combustible cigarettes reduces their risk. This commonly observed dual-use pattern was not associated with levels lower inflammatory markers, and therefore is not likely to offer a reduction in risk in this specific area.

The researchers also performed extensive analyzes to test the results against the influence of related behaviors such as the use of other tobacco and marijuana products, and exposure to secondhand smoke. The results remained consistent in additional analyses.

The large sample population of this study makes the results applicable to the US adult population. One limitation of the study is its cross-sectional approach of looking at population data at one point in time, which makes it impossible to establish causality.

The researchers said the study highlights the importance of continued public education about the risks of smoking and the failure of dual use to reduce risk.

“The results could be used to counsel patients about the potential risk of using both cigarettes and e-cigarettes,” Stokes said. “Some people who smoke cigarettes start using the e-cigarette to reduce how often they smoke cigarettes. They often become dual users of both products rather than switching from one to the other entirely. If e-cigarettes are used as a means to quit smoking, smoking should be completely replaced and a plan to achieve freedom from all tobacco products should be advised.”


American Heart Association

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