Randy Nguyen, Isabelle Ruedisueli, Karishma Lakhani, Joyce Ma, Holly R. Middlekauff

Acute Cardiovascular Effects of 4th Generation Electronic Cigarettes and Combusted Cigarettes: Implications for Harm Reduction

  • Physiology (medical)
  • Physiology

The health consequences associated with using electronic cigarettes (ECs) is of great public interest due to their potential role in smoking cessation. In 110 participants, including 41 nonusers, 34 people who exclusively use ECs, and 35 people who smoke tobacco cigarettes (TCs), heart rate (HR), blood pressure (BP), and heart rate variability (HRV) were compared at baseline. In people who use ECs or TCs, parameters were compared after using a 4th generation EC with or without nicotine, a TC with or without nicotine (smokers only), and a straw-control. Baseline HR, BP and HRV parameters were not different among people who use ECs, people who smoke TCs, and nonusers. In people who exclusively use ECs, acute nicotine-EC use increased HR and BP, and produced changes in HRV patterns associated with increased risk for cardiac events. In people who smoke TCs, BP increased similarly after acutely smoking a nicotine-TC compared to using a nicotine-EC. However, the increase in HR was significantly greater after smoking a TC compared to after using an EC despite similar acute increases in plasma nicotine. Overall, all exposures containing nicotine significantly increased HR and BP in both cohorts when compared to non-nicotine exposures. Since acute EC use 1) produces an abnormal HRV pattern associated with increased cardiac risk in people who chronically use ECs, and 2) similar hemodynamic increases compared to acute TC smoking in people who chronically smoke TCs, the role of ECs as part of a harm reduction strategy is questioned.

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