Short-term impact of e-cigarrette without nicotine in cardiovascular system in comparison to e-cigarette without nicotine and combustile cigarette

Abstract Background Given the undeniable harmfulness of traditional cigarettes, smoking e-cigarettes, containing or not nicotine, has become increasingly popular in recent years. The impact of such smoking on the cardiovascular system is insufficiently understood. Purpose The aim of the study was to determine the effect of e-cigarette without nicotine, e-cigarette with nicotine, and traditional cigarette on circulatory system parameters during short-term observation. Methods The participants were recruited from among students or hospital workers and consecutive healthy subjects visiting the hospital for routine examinations. We enrolled only active, occasional, and former smokers of traditional or electronic cigarettes. Participants were randomized to an intervention involving smoking a nicotine-containing electronic cigarette, a nicotine-free electronic cigarette, or a traditional cigarette. During a single session, cardiovascular system functioning data were collected before (20 minutes), during (10 minutes), and after the intervention (30 minutes). All parameters were measured on a beat-to-beat basis, using the Task Force Monitor. Results A total of 42 participants (17 women) aged 29±6.2 years with a BMI of 23.8±3.3 kg/m² were included in the study. HR was higher after nicotine-containing e-cigarette use compared to nicotine-free e-cigarette (72.9±11.9 vs. 77.5±11.4 bpm, p=0.015). Traditional cigarette smoking resulted in the highest HR, significantly exceeding nicotine-free e-cigarette (80.4±10.8 vs. 72.9±11.9 bpm, p0.0001). SBP increased significantly after smoking a traditional cigarette compared to nicotine-free e-cigarette (118.6±11.4 vs. 113.7±9.3 mmHg, p0.0001). There was no significant difference between nicotine-containing e-cigarette and combustile cigarette (115.6±11.5 vs. 118.6±11.4 mmHg, NS). DBP was higher after traditional cigarette use compared to both nicotine-free e-cigarette (94.9±8.3 vs. 89.8±6.7 mmHg, p0.0001) and nicotine-containing e-cigarette (92.1±8.9 mmHg, p=0.01). MBP followed a similar pattern, with traditional cigarette smoking resulting in significantly higher values than nicotine-free e-cigarette (94.9±8.3 vs. 89.8±6.7 mmHg, p0.0001) and nicotine-containing e-cigarette (92.1±8.9 mmHg, p=0.01), while nicotine-free and nicotine-containing e-cigarettes did not differ significantly. No significant differences were observed in SV, SI, CO, CI or TPR. Figure 1 presents BP and HR values after each intervention, significantly (all p-values0.05) lower values of BP were observed when nicotine-free e-cigarette was used in comparison to other cigarettes. Conclusion Traditional cigarette smoking had the most pronounced effects on HR and blood pressure parameters, particularly increasing DBP and MBP compared to nicotine-containing e-cigarettes. E-cigarette without nicotine had better impact on cardiovascular parameters than combustile cigarette or e-cigarette with nicotine.