Do E-Cigarettes Impact CV Biomarkers as Much as Combustible Cigarettes?

There is no difference in levels of inflammatory and oxidative stress biomarkers among individuals who do not use cigarettes and those who exclusively use e-cigarettes, according to the results of recent study.

To examine the association between cigarette and/or  e-cigarette use and cardiovascular biomarker levels, the researchers conducted the Population Assessment of Tobacco and Health (PATH) study, during which a survey was administered to 7130 US adults aged 18 years or older. All participants provided their smoking history, as well as blood and urine samples.   

Based on responses to the survey, the participants were categorized into 1 of 4 groups: nonuse, exclusive e-cigarette, exclusive cigarette, and dual use (both cigarette and e-cigarette use). The classifications were based on behaviors in the 30 days prior to the survey.

Dependent variables for this study included high-sensitivity C-reactive protein, interleukin-6, fibrinogen, and soluble intercellular adhesion molecule for biomarkers of inflammation, as well as urinary 8-isoprostane for oxidative stress.

Race/ethnicity, sex, age, education, poverty status based on household income, body mass index, diabetes, myocardial infarction or heart failure, stroke, second-hand smoke exposure, pack-year of cigarette smoke and its squared term, and the use of tobacco products, marijuana, recreational drugs and prescription drugs were covariates the researchers adjusted for.

The majority of participants (58.6%) did not use cigarettes or e-cigarettes. It was found that 1.9% of participants used e-cigarettes exclusively, 29.6% used cigarettes exclusively, and 9.9% used both.

Compared with nonusers, both exclusive cigarette smokers and dual users had higher levels of all biomarkers. However, it was found that exclusive e-cigarette users had significantly lower levels of all inflammatory and oxidative stress biomarkers (except high-sensitivity C-reactive protein) than exclusive smokers.

“In this nationally representative population study of adults, we observed no difference in inflammatory and oxidative stress biomarkers between exclusive e-cigarette users and nonusers (no cigarettes or vaping), and levels were lower in exclusive e-cigarette users relative to exclusive smokers,” the researchers concluded.

“These findings are consistent with recent population studies of inflammatory biomarker and toxicant exposure in users of e-cigarettes and cigarettes and highlight the importance of completely replacing cigarette smoking with e-cigarettes or quitting the use of both products for cigarette smokers to derive potential health benefits.”

—Leigh Precopio

Reference:

Stokes AC, Xie W, Wilson AE, et al. Association of cigarette and electronic cigarette use patterns with levels of inflammatory and oxidative stress biomarkers among US adults: Population Assessment of Tobacco and Health Study. Circulation. Published online January 4, 2020 doi:10.1161/CIRCULATIONAHA.120.051551