Electronic Nicotine Delivery Systems and Cardiovascular/Cardiometabolic Health

Abstract

The use of electronic nicotine delivery systems, specifically electronic cigarettes (e-cig), has risen dramatically within the last few years; the demographic purchasing these devices is now predominantly adolescents that are not trying to quit the use of traditional combustible cigarettes, but rather are new users. The composition and appearance of these devices has changed since their first entry into the market in the late 2000s, but they remain composed of a battery and aerosol delivery system that is used to deliver breakdown products of propylene glycol/vegetable glycerin, flavorings, and potentially nicotine or other additives. Manufacturers have also adjusted the type of nicotine that is used within the liquid to make the inhalation more palatable for younger users, further affecting the number of youth who use these devices. Although the full spectrum of cardiovascular and cardiometabolic consequences of e-cig use is not fully appreciated, data is beginning to show that e-cigs can cause both short- and long-term issues on cardiac function, vascular integrity and cardiometabolic issues. This review will provide an overview of the cardiovascular, cardiometabolic, and vascular implications of the use of e-cigs, and the potential short- and long-term health effects. A robust understanding of these effects is important in order to inform policy makers on the dangers of e-cigs use.

Beabsichtigte und unbeabsichtigte Wirkungen von E-Zigaretten in klinischen Studien – ein Plädoyer für (mehr) Transparenz

“…Nach bisherigen Untersuchungen verbessert der Wechsel vom Tabakrauchen zur E-Zigarette bei Patienten mit vorbestehenden Lungenerkrankungen die Lungenfunktion nicht [6]. Außerdem zeigten die Daten, dass E-Zigaretten sowohl kurz-als auch langfristig die Herzfunktion, die Gefäßintegrität und kardiometabolische Probleme beeinträchtigen können [6][7][8]. Auch die mögliche Entwicklung von Krebserkrankungen aufgrund des E-Zigarettenkonsums wird derzeit diskutiert [9].…”

Posicionamento da Sociedade Brasileira de Cardiologia sobre o Uso de Dispositivos Eletrônicos para Fumar – 2024

“… 1 Além disso, as substâncias presentes nesses dispositivos estão relacionadas ao desenvolvimento de doenças cardiovasculares, como infarto do miocárdio e acidente vascular cerebral, além de diversos outros efeitos adversos. 2 – 4 …”

“… 1 In addition, substances present in those devices are related to the development of cardiovascular diseases, such as myocardial infarction and stroke, as well as to several other adverse effects. 2 – 4 …”

“…1 Além disso, as substâncias presentes nesses dispositivos estão relacionadas ao desenvolvimento de doenças cardiovasculares, como infarto do miocárdio e acidente vascular cerebral, além de diversos outros efeitos adversos. [2][3][4] Em conformidade com a proibição estabelecida pela ANVISA e pela Organização Mundial da Saúde (OMS), bem como a observação do uso desses dispositivos por jovens e não fumantes associada às evidências de malefícios decorrentes de seu consumo, a SBC considera a liberação desses dispositivos prejudicial à saúde da população. A SBC posiciona-se contrariamente à liberação dos DEFs, fundamentando tal decisão em dez razões que respaldam a manutenção de sua proibição, apresentadas a seguir (Figura Central).…”

Public Health Concerns from Increased Use of Electronic Cigarette Use

“…4 Although the full spectrum of CV/cardiometabolic consequences of e-cigarettes is not yet well-appreciated, there is evidence that e-cigarettes can harm cardiac function, vascular integrity and the CV system. 5,6 It is a matter of utmost public health concern for future studies to define the role of e-cigarette smoking in the pathogenesis of vascular diseases and cancer.…”