Why the study?
Widespread use of the JUUL device sparked debate regarding harm reduction, prompting a direct comparison of its acute effects on arterial stiffness against other smoking devices.
Does the use of the JUUL e-cigarette worsen arterial stiffness and endothelial function compared to traditional cigarettes, heated tobacco products, and nicotine-free e-cigarettes?
RCT (n=20)
Randomized for each participant by drawing lots
No
Does the use of the JUUL e-cigarette worsen arterial stiffness and endothelial function compared to traditional cigarettes, heated tobacco products, and nicotine-free e-cigarettes?
Absolute Event Rate: -22% vs -21%
p-value: p=<0.01
Acute JUUL use leads to similar increases in arterial stiffness and endothelial dysfunction as conventional cigarettes and heated tobacco products.
Background: The widespread use of the JUUL™ device ignited a discussion about the effects these products have on harm reduction. Therefore, we conducted a study directly comparing the JUUL™ device with a cigarette, a heated tobacco product, and a nicotine-free e-cigarette to examine the acute effects on arterial stiffness. Methods: This crossover-designed study examines 20 occasional smokers (age 25.2 ± 2.5 years). Study participants used each of the four smoking devices for a duration of 5 min following a protocol. Peripheral blood pressure and parameters of arterial stiffness and endothelial vasodilator function such as the reactive hyperemia index and the augmentation index were measured using the EndoPAT™2000 before and after. Results: In addition to significant peripheral hemodynamic changes after 5 and 10 min (p < 0.05), the reactive hyperemia index showed a significant decrease for all devices 15 min after consumption and remained significantly decreased after 60 min (p < 0.01). The augmentation index adjusted for a heart rate of 75 bpm increased significantly for all devices 15 and 60 min after consumption (p < 0.01). Conclusions: In conclusion, the increases in blood pressure and arterial stiffness are similar after smoking, JUUL™ing, heating, and vaping. These changes may be associated with an increase in cardiovascular risks; however, an evaluation of the long-term effects of JUUL™ing, vaping and heating is needed.
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Benthien et al. (2022) conducted an RCT in Occasional smokers or e-cigarette users (n=20). JUUL e-cigarette vs. Combustible cigarette, heated tobacco product, and nicotine-free e-cigarette was evaluated on Reactive hyperemia index at 15 minutes (p=<0.01).
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