Key result
Pod-based e-cigarettes acutely reduce FMD by ~3% and raise BP and HR like combustible cigarettes.
Why the study?
Pod-based e-cigarette use containing nicotine salts is frequent among youth and young adults, prompting a comparison of their vascular health effects to combustible cigarette use.
Does pod-based electronic cigarette use impair vascular health compared to combustible cigarette use or nonuse in healthy young adults?
Cross-Sectional (n=106)
Single-blind
Yes
Does pod-based electronic cigarette use impair vascular health compared to combustible cigarette use or nonuse in healthy young adults?
Absolute Event Rate: -3.2% vs 0.3%
p-value: p=1.0x10-7
Pod-based e-cigarettes induce acute endothelial dysfunction and hemodynamic changes similar in magnitude to combustible cigarettes, highlighting their potential cardiovascular risks.
Pod-based e-cigarette use acutely impairs endothelial function similarly to smoking in young adults; hypothesis-generating for cardiovascular risk and should not yet change practice.
Background Pod-based electronic cigarettes (e-cigarettes) use that contain nicotine salts is frequent among youth and young adults; thus, we compared the vascular health effects of pod-based e-cigarette use to combustible cigarette use. Methods and Results We performed a two center observational, cross-sectional study of healthy adults recruited from the community (aged 18-45, N=106) in 3 groups: pod-based e-cigarette users (N=48); combustible cigarette users (N=21); and tobacco nonusers (N=37) and assessed the acute (following structured use) and chronic (resting state after 6 hour tobacco abstinence) effects of pod-based e-cigarette use on endothelial function (brachial artery flow-mediated dilation), blood pressure, and heart rate. Among the pod-based e-cigarette users, 64% were exclusive users including 37% who had never used combustible cigarettes. Pod-based e-cigarette users and combustible cigarette users had higher systolic blood pressure compared to non-users (121±11mmHg, 121±13mmHg, 112±10 mmHg, P=0.0004). Structured pod-based e-cigarette use acutely decreased flow-mediated dilation (−3.2±2.7%), raised systolic and diastolic blood pressure (6±8mmHg, 4±5mmHg) and heart rate (5±7bpm), similar to combustible cigarette use (−2.6±2.6%, 9±8mmHg, 6±5mmHg, 6±6bpm P=0.83, 0.3, 0.4, 0.56 vs pod-based), and to a greater extent than nonuse (0.3±4.1%, 0.7±5mmHg, 0.3±3mmHg, -3±4bpm, P=1.0x10 −7 , 0.002, 0.003, 2.6x10 −7 ). Differences remained robust in models adjusted for age, sex, and race. The effect of pod-based cigarette use was similar in adults who had never used combustible cigarettes. Levels of acrolein, acrylamide, acrylonitrile, and crotonaldehyde were associated with the changes in vascular health measures. Conclusions Overall, our findings suggest that pod-based e-cigarette use has acute and chronic vascular effects in healthy young adults including those who never used combustible cigarettes. Select metabolites derived from volatile organic compounds were associated with the vascular changes suggesting relevance to vascular health.
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Majid et al. (2022) conducted a cross-sectional in Healthy adults (n=106). Pod-based e-cigarette use vs. Nonuse and combustible cigarette use was evaluated on Acute change in flow-mediated dilation (p=1.0x10-7). Pod-based e-cigarette use acutely decreased flow-mediated dilation by 3.2% and increased blood pressure and heart rate to a similar extent as combustible cigarette use, and more than nonuse.
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