Smoking and smoking as harmful as smoking alone

Adults using e-cigarettes and smoking cigarettes had levels of inflammation and oxidative stress predicting cardiovascular disease similar to those of exclusive cigarette smokers in the analysis of data from. Tobacco and Health Population Assessment (PATH) Research.

According to Andrew C. Stokes, PhD, after adjusting for multiple covariates, the risk markers for dual-user and exclusive smokers are significantly higher compared to participants who did not use either form of tobacco. (Up to 41%). , Boston University School of Public Health, and colleagues.

An analysis of data on 7,100 PATH study participants surveyed in 2013 and 2014 by measuring biomarkers known to predict heart attack, stroke, and other cardiovascular events. It is one of the first nationally representative analyzes investigating the cardiovascular toxicity of electronic tobacco use.

the study Published in the journal of the American Heart Association circulation As a research letter.

Stokes said Today’s MedPage That is, early asymptomatic measures are needed as it takes decades to identify the long-term health effects of the use of tobacco products.

Inflammation and oxidative stress have been identified as the leading causes of smoking-related cardiovascular disease, and associated biomarkers have been shown to predict heart attacks and strokes.

“Since e-cigarettes appeared on the U.S. market around 2007 and weren’t used in large numbers until 2010, there is currently no clear way to assess the long-term effects of e-cigarette use on humans,” he said. I am. .. “These asymptomatic measurements of cardiovascular injury are really important for detecting early harm.”

The analysis included data from an adult PATH Wave 1 survey conducted between 2013 and 2014, and included blood and urine sample collection.

Participants were asked about the use of e-cigarettes and flammable cigarettes within the last 30 days and classified as either non-users, exclusive e-cigarette users, exclusive combustible cigarette users, or dual users of any product. it was done.

Biomarkers of inflammation included sensitive C-reactive protein, interleukin-6, fibrinogen, and soluble intercellular adhesion molecules. Evaluating the biomarker urinary 8-isoprostan as a measure of oxidative stress, researchers adjusted covariates associated with smoking behavior.

Of the 7,130 participants in the survey, 58.6% were classified as non-users, 1.9% used only e-cigarettes, 29.6% were smoke-only, and 9.9% were double-users.

Multivariate modeling showed no difference in biomarker levels of inflammatory or oxidative stress between participants and non-users who used e-cigarettes. Exclusive smokers and dual users showed higher levels at all biomarkers compared to non-users.

“Compared to exclusive smokers, users of exclusive e-cigarettes had significantly lower levels of almost all inflammatory and oxidative stress biomarkers,” the researchers write. The exception was sensitive C-reactive protein.

No differences in inflammatory and oxidative stress biomarkers were observed between exclusive e-cigarette users and non-users, and the levels of exclusive e-cigarette users were lower compared to exclusive smokers.

Given the high prevalence of dual-use among adults who use e-cigarettes, Stokes said the findings have significant public health implications.

“The main use of e-cigarettes is in combination with cigarettes, and this usage pattern does not appear to reduce risk compared to the exclusive use of flammable cigarettes,” he said. ..

“These results suggest that if smokers really want to reduce their risk, they should avoid flammable cigarettes altogether. Using e-cigarettes as a way to smoke and mitigate risk. If so, it may not work. “

He showed similar risks for cardiovascular biomarkers in study participants who did not smoke or smoke with vaporizers, but the study found that exclusive use of e-cigarettes was more or less harmful than non-use. He added that he did not have the power to show.

“Most adults who use e-cigarettes also smoke, so investigating this would require a very large amount of research,” he said.

The limitation of the study cited by Stokes was the use of data from studies conducted before cartridge vapor-breathing products such as JUUL entered the market. The data were adjusted to the smoking history of the pack year, but researchers lacked data on recent smoking / vaping intensity.