Are Electronic Cigarette Users at Increased Risk for Cardiovascular Disease?

Bhatnagar, Aruni

doi:10.1001/jamacardio.2016.5550

Cited by 10 publications

(10 citation statements)

References 14 publications

(28 reference statements)

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“…For example, exposure to secondhand cigarette smoke has nearly as large an effect on many risk factors for cardiovascular disease and the risk of acute myocardial infarction as does being an active smoker ( 13 ). In addition, e-cigarettes expose users to acrolein and other aldehydes ( 17 , 18 ). Like conventional cigarette smokers, e-cigarette users experience increased oxidative stress ( 26 , 92 ) and increases in the release of inflammatory mediators ( 26 , 61 ).…”

Section: Health Effects Of E-cigarettesmentioning

confidence: 99%

E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications

Glantz

Bareham

2024

Annual Review of Public Health

377

302

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Since e-cigarettes appeared in the mid-2000s, some practitioners, researchers, and policy makers have embraced them as a safer alternative to conventional cigarettes and an effective way to stop smoking. While e-cigarettes deliver lower levels of carcinogens than do conventional cigarettes, they still expose users to high levels of ultrafine particles and other toxins that may substantially increase cardiovascular and noncancer lung disease risks, which account for more than half of all smoking-caused deaths, at rates similar to conventional cigarettes. Moreover, rather than stimulating smokers to switch from conventional cigarettes to less dangerous e-cigarettes or quitting altogether, e-cigarettes are reducing smoking cessation rates and expanding the nicotine market by attracting youth.

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Section: Health Effects Of E-cigarettesmentioning

confidence: 99%

E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications

Glantz

Bareham

2024

Annual Review of Public Health

377

302

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“…Two of the central pillars on which the harm reduction argument rests are: (a) use of ENDS is substantially less harmful than smoking cigarettes and (b) their use leads to higher population-level smoking quit rates [ 6 , 13 , 26 – 30 ]. Although more research is necessary before the full extent of the risks from ENDS use are known [ 31 , 32 ], the extant research suggests that use of ENDS is likely substantially less harmful than smoking combustible cigarettes [ 25 , 33 – 37 ], with most debate focusing on how much less harmful [ 28 ]. Reduced risk, however, is insufficient for achieving population-level harm reduction without effecting switching from a higher risk to a lower risk product.…”

Section: Introductionmentioning

confidence: 99%

Are electronic nicotine delivery systems helping cigarette smokers quit? Evidence from a prospective cohort study of U.S. adult smokers, 2015–2016

et al. 2018

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BackgroundThe potential of electronic nicotine delivery systems (ENDS) to reduce the cardiovascular and other disease risks of smoking is of great interest. While many smokers report using ENDS for cessation, their impact under real-world use patterns and conditions on adult smokers’ quitting behavior is uncertain. The objective of this study was to generate more recent and comprehensive evidence on the effect of “real world” ENDS use on the population quit rates of adult smokers while taking account of frequency and duration of use, device type, e-liquid flavor, and reasons for use.Methods and findingsWe conducted a population-based, prospective cohort study of a random probability sample of 1284 U.S. adult smokers recruited in August/September 2015 and re-contacted one-year later (September 2016) from GfK’s KnowledgePanel, a national, probability-based web-panel designed to be representative of non-institutionalized U.S. adults. Among the 1081 baseline smokers who remained members of KnowledgePanel, 858 completed the follow-up survey. The primary outcome was smoking abstinence for at least 30 days prior to follow-up. Secondary outcomes were making a quit attempt during the 12-month study period and number of cigarettes smoked per day at follow-up. The adjusted odds of quitting smoking were lower for those that used ENDS at baseline (9.4%, 95% CI = 5.22%-16.38%; AOR = 0.30, 95% CI = 0.13–0.72) compared to smokers who did not use at ENDS (18.9%, 95% CI = 14.24%-24.68%). Smokers who used ENDS daily at some point during the study period were also less likely to quit smoking than nonusers (AOR = 0.17; 95% CI = 0.04–0.82). Limited ability to draw causal inferences from the observational design and a lack of biochemical verification of quitting smoking or ENDS use are limitations of this study.ConclusionsWe found no evidence that ENDS use, within context of the 2015–2016 US regulatory and tobacco/vaping market landscape, helped adult smokers quit at rates higher than smokers who did not use these products. Absent any meaningful changes, ENDS use among adult smokers is unlikely to be a sufficient solution to obtaining a meaningful increase in population quit rates. Additional research is needed to reconcile the divergent literature and monitor the impact of ENDS in an environment of rapidly evolving markets and regulatory policies.

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“…As noted in the recent Surgeon General’s report on e-cigarettes, nicotine sustains addiction and interferes with typical adolescent brain development (US Department of Health and Human Services, 2016). While there is limited understanding of the health effects of e-liquid constituents, emerging evidence suggests that e-cigarette constituents may pose cardiovascular and respiratory risks (Bhatnagar, 2017; Shields et al, 2017). Further, many recent studies, including our own, have also observed that e-cigarette use progresses to future cigarette use among youth (Bold et al, 2018; Soneji et al, 2017).…”

mentioning

confidence: 99%

Socioeconomic status and adolescent e-cigarette use: The mediating role of e-cigarette advertisement exposure

Simon

Camenga

Morean

et al. 2018

Preventive Medicine

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Among adolescents, low socioeconomic status (SES) is associated with greater exposure to tobacco cigarette advertising and cigarette use. However, associations among SES, e-cigarette advertising and e-cigarette use are not well understood. This study examined exposure to e-cigarette advertisements as a mediator of the relationship between SES and adolescent e-cigarette use. Adolescents (N = 3473; 51% Female) from 8 high schools in Connecticut completed an anonymous survey in Spring 2015. Mediation analysis was used to examine whether the total number of sources of recent e-cigarette advertising exposure (e.g., TV, radio, billboards, magazines, local stores [gas stations, convenience stores], vape shops, mall kiosks, tobacco shops, social media) mediated the association between SES (measured by the Family Affluence Scale) and past-month frequency of e-cigarette use. We clustered for school and controlled for other tobacco product use, age, sex, race/ethnicity and perceived social norms for e-cigarette use in the model. Our sample recently had seen advertisements via 2.1 (SD = 2.8) advertising channels. Mediation was supported (indirect effect: β = 0.01, SE = 0.00, 95% CI [0.001, 0.010], p = 0.02), such that higher SES was associated with greater recent advertising exposure, which, in turn, was associated with greater frequency of e-cigarette use. Our study suggests that regulations to reduce youth exposure to e-cigarette advertisement may be especially relevant to higher SES youth. Future research should examine these associations longitudinally and evaluate which types of advertisements target different SES groups.

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Are Electronic Cigarette Users at Increased Risk for Cardiovascular Disease?

Abstract: Five-year outcome after implantation of zotarolimus-and everolimus-eluting stents in randomized trial participants and nonenrolled eligible patients: a secondary analysis of a randomized clinical trial [published online January 18, 2017]. JAMA Cardiol.

Cited by 10 publications

References 14 publications

E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications

E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications

Are electronic nicotine delivery systems helping cigarette smokers quit? Evidence from a prospective cohort study of U.S. adult smokers, 2015–2016

Socioeconomic status and adolescent e-cigarette use: The mediating role of e-cigarette advertisement exposure

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