Electronic Cigarette Smoking Increases Arterial Stiffness and Oxidative Stress to a Lesser Extent Than a Single Conventional Cigarette

Ikonomidis, Ignatios; Vlastos, Dimitrios; Kourea, Kallirrhoe; Kostelli, G; Varoudi, Maria; Pavlidis, George; Efentakis, Panagiotis; Triantafyllidi, Helen; Parissis, John; Andreadou, Ioanna; Iliodromitis, Efstathios K.; Lekakis, John

doi:10.1161/circulationaha.117.029153

Cited by 93 publications

(71 citation statements)

References 5 publications

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“…2, where the vertical dashed line represents no effect and plots to the right of the vertical dashed line indicate that the TC effect is greater than the EC effect. The results of most studies [5,15,26,44,52], but not of all studies [16,25,47], are consistent with the concept that the effects of TC smoking on acute cardiovascular autonomic functions are greater than those of EC vaping. The overall mean differences between TC smoking and EC vaping across all studies was 1.58 mmHg (95% confidence interval [CI] 0.20-2.97; p = 0.025) for SBP, 1.57 mmHg (95% CI 0.37-2.78; p = 0.01) for DBP and 3.06 bpm (95% CI 2.01-4.10; p = 0.00001) for HR.…”

Section: Acute Autonomic Cardiovascular Effects Of Tc Smoking Versus supporting

confidence: 57%

“…At 3 months, similar to the the results of the George et al [18] switch study, there was no decrease in HR or BP. In summary, most [14,25,39], but not all [18,45] of the TC to EC switch studies involving chronic TC smokers tended to show a small decrease in BP, but not HR, over time.…”

Section: Chronic Autonomic Cardiovascular Effects Of Switching From Cmentioning

confidence: 82%

“…In the same study, a different cohort of 35 chronic TC smokers first vaped an EC without nicotine for 7 min; then, after a 60-min washout period, they smoked a TC. The results showed that HR and brachial SBP and DBP were unchanged after acute use of the TC or EC with and without nicotine compared to baseline [25]. Plasma nicotine levels following smoking the TC or vaping the EC were not measured.…”

Section: Acute Autonomic Cardiovascular Effects Of Tc Smoking Versus mentioning

confidence: 85%

“…The study of Ikonomidis et al [25] was the only study that had two phases: an acute phase, which we discuss in this section, and a chronic phase, which we discuss in section Chronic autonomic cardiovascular effects of switching from chronic TC smoking to EC vaping. In the crossover study on acute effects [25], 35 chronic TC smokers were asked to first vape an EC with nicotine (eGo e-cigarette, 1.2% nicotine) for 7 min; then, after a 60-min washout period, they smoked a TC. In the same study, a different cohort of 35 chronic TC smokers first vaped an EC without nicotine for 7 min; then, after a 60-min washout period, they smoked a TC.…”

Section: Acute Autonomic Cardiovascular Effects Of Tc Smoking Versus mentioning

confidence: 99%

“…There was no change in BP in the chronic TC control group. Ikonomidis et al [25] enrolled 70 TC smokers in an EC switch study, confirming TC cessation by periodic monitoring of exhaled carbon monoxide (CO). Twenty age-matched TC smokers served as a time control.…”

Section: Chronic Autonomic Cardiovascular Effects Of Switching From Cmentioning

confidence: 99%

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Cardiovascular autonomic effects of electronic cigarette use: a systematic review

2020

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Purpose Electronic cigarettes (ECs) are the fastest growing tobacco product in the USA, and ECs, like tobacco cigarettes (TCs), have effects on the cardiovascular autonomic nervous system, with clinical implications. The purpose of this review was to collect and synthesize available studies that have investigated the autonomic cardiovascular effects of EC use in humans. Special attention is paid to the acute and chronic effects of ECs, the relative contributions of the nicotine versus non-nicotine constituents in EC emissions and the relative effects of ECs compared to TCs. Methods Using the methodology described in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, we conducted a literature search of the Ovid PubMed and Embase databases on 6 December 2019 using keywords in titles and abstracts of published literature. Acute (minutes to hours) and chronic (days or longer) changes in heart rate variability (HRV), heart rate (HR) and blood pressure (BP) were used as estimates of cardiovascular autonomic effects. Results Nineteen studies were included in this systematic review, all of which used earlier generation EC devices. Acute EC vaping increased HR and BP less than acute TC smoking. Nicotine but not non-nicotine constituents in EC aerosol were responsible for the sympathoexcitatory effects. The results of chronic EC vaping studies were consistent with a chronic sympathoexcitatory effect as estimated by HRV, but this did not translate into chronic increases in HR or BP. Conclusions Electronic cigarettes are sympathoexcitatory. Cardiac sympathoexcitatory effects are less when vaping using the earlier generation ECs than when smoking TCs. Additional studies of the latest pod-like EC devices, which deliver nicotine similarly to a TC, are necessary.

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Section: Acute Autonomic Cardiovascular Effects Of Tc Smoking Versus supporting

confidence: 57%

Section: Chronic Autonomic Cardiovascular Effects Of Switching From Cmentioning

confidence: 82%

Section: Acute Autonomic Cardiovascular Effects Of Tc Smoking Versus mentioning

confidence: 85%

Section: Acute Autonomic Cardiovascular Effects Of Tc Smoking Versus mentioning

confidence: 99%

Section: Chronic Autonomic Cardiovascular Effects Of Switching From Cmentioning

confidence: 99%

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Cardiovascular autonomic effects of electronic cigarette use: a systematic review

2020

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Electronic cigarettes for smoking cessation

Huhndorf¹,

Curtis²,

Neher³

et al. 2020

Cochrane Database of Systematic Reviews

261

196

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Background Electronic cigarettes (ECs) are electronic devices that heat a liquid into an aerosol for inhalation. The liquid usually comprises propylene glycol and glycerol, with or without nicotine and flavours, and stored in disposable or refillable cartridges or a reservoir. Since ECs appeared on the market in 2006 there has been a steady growth in sales. Smokers report using ECs to reduce risks of smoking, but some healthcare organizations, tobacco control advocacy groups and policy makers have been reluctant to encourage smokers to switch to ECs, citing lack of evidence of efficacy and safety. Smokers, healthcare providers and regulators are interested to know if these devices can help smokers quit and if they are safe to use for this purpose. This review is an update of a review first published in 2014. Objectives To evaluate the safety and effect of using ECs to help people who smoke achieve long-term smoking abstinence. Search methods We searched the Cochrane Tobacco Addiction Group's Specialized Register, the Cochrane Central Register of Controlled Trials (CEN-TRAL), MEDLINE, Embase, and PsycINFO for relevant records from 2004 to January 2016, together with reference checking and contact with study authors. Selection criteria We included randomized controlled trials (RCTs) in which current smokers (motivated or unmotivated to quit) were randomized to EC or a control condition, and which measured abstinence rates at six months or longer. As the field of EC research is new, we also included cohort follow-up studies with at least six months follow-up. We included randomized cross-over trials, RCTs and cohort follow-up studies that included at least one week of EC use for assessment of adverse events (AEs). Data collection and analysis We followed standard Cochrane methods for screening and data extraction. Our main outcome measure was abstinence from smoking after at least six months follow-up, and we used the most rigorous definition available (continuous, biochemically validated, longest follow-up). We used a fixed-effect Mantel-Haenszel model to calculate the risk ratio (RR) with a 95% confidence interval (CI) for each study, and where appropriate we pooled data from these studies in meta-analyses.

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Electronic cigarettes for smoking cessation

Hartmann‐Boyce

McRobbie

Butler

et al. 2021

Cochrane Database of Systematic Reviews

147

102

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BackgroundElectronic cigarettes (ECs) are electronic devices that heat a liquid into an aerosol for inhalation. The liquid usually comprises propylene glycol and glycerol, with or without nicotine and flavours, and stored in disposable or refillable cartridges or a reservoir. Since ECs appeared on the market in 2006 there has been a steady growth in sales. Smokers report using ECs to reduce risks of smoking, but some healthcare organizations, tobacco control advocacy groups and policy makers have been reluctant to encourage smokers to switch to ECs, citing lack of evidence of efficacy and safety. Smokers, healthcare providers and regulators are interested to know if these devices can help smokers quit and if they are safe to use for this purpose. This review is an update of a review first published in 2014. ObjectivesTo evaluate the safety and effect of using ECs to help people who smoke achieve long-term smoking abstinence. Search methodsWe searched the Cochrane Tobacco Addiction Group's Specialized Register, the Cochrane Central Register of Controlled Trials (CEN-TRAL), MEDLINE, Embase, and PsycINFO for relevant records from 2004 to January 2016, together with reference checking and contact with study authors. Selection criteriaWe included randomized controlled trials (RCTs) in which current smokers (motivated or unmotivated to quit) were randomized to EC or a control condition, and which measured abstinence rates at six months or longer. As the field of EC research is new, we also included cohort follow-up studies with at least six months follow-up. We included randomized cross-over trials, RCTs and cohort follow-up studies that included at least one week of EC use for assessment of adverse events (AEs). Data collection and analysisWe followed standard Cochrane methods for screening and data extraction. Our main outcome measure was abstinence from smoking after at least six months follow-up, and we used the most rigorous definition available (continuous, biochemically validated, longest follow-up). We used a fixed-effect Mantel-Haenszel model to calculate the risk ratio (RR) with a 95% confidence interval (CI) for each study, and where appropriate we pooled data from these studies in meta-analyses.

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Electronic Cigarette Smoking Increases Arterial Stiffness and Oxidative Stress to a Lesser Extent Than a Single Conventional Cigarette

Cited by 93 publications

References 5 publications

Cardiovascular autonomic effects of electronic cigarette use: a systematic review

Cardiovascular autonomic effects of electronic cigarette use: a systematic review

Electronic cigarettes for smoking cessation

Electronic cigarettes for smoking cessation

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