US Study Says Dual Use is as Harmful to Heart Health as Smoking

According to new research recently published in the American Heart Association's journal Circulation, using traditional cigarettes alongside e-cigarettes, is as harmful to one’s heart as smoking alone.

Diane Caruana

April 26, 2021

The study titled, “Association of Cigarette and Electronic Cigarette Use Patterns With Levels of Inflammatory and Oxidative Stress Biomarkers Among US Adults: Population Assessment of Tobacco and Health Study,” analysed the association between smoking, vaping and heart health, in over 7,100 U.S. adults 18 and above.

Participants who used cigarettes and e-cigarettes had levels of all inflammatory and oxidative stress biomarkers comparable to those who smoked exclusively.

Using data from the Population Assessment of Tobacco and Health (PATH) study, the researchers looked for biomarkers of inflammation and oxidative stress, as these are known to be indicative of heart disease and predictors of cardiovascular events, such as heart attacks and heart failures.

Analyzing five biomarkers of inflammation and oxidative stress, the participants were divided into 4 groups: Exclusive smokers, exclusive vapers, dual users and users of none. The researchers listed the following findings:

Participants who vaped exclusively showed a similar inflammatory and oxidative stress profile as people who did not smoke or vape.
Participants who smoked exclusively and those who used cigarettes and e-cigarettes had higher levels across all biomarkers assessed compared to participants who did not use cigarettes or e-cigarettes.
Compared to participants who smoked exclusively, those who vaped exclusively had significantly lower levels of almost all inflammatory and oxidative stress biomarkers.
However, participants who used cigarettes and e-cigarettes had levels of all inflammatory and oxidative stress biomarkers comparable to those who smoked exclusively.

“This study is among the first to use nationally representative data to examine the association of cigarette and e-cigarette use behaviors with biomarkers of inflammation and oxidative stress. Given the lag time between tobacco exposure and disease symptoms and diagnosis, identifying the association between e-cigarette use and sensitive biomarkers of subclinical cardiovascular injury is necessary for understanding the long-term effects of newer tobacco products such as e-cigarettes,” said lead study author Andrew C. Stokes, Ph.D, Assistant Professor at Global Health, Boston University School of Public Health.

Other research indicates otherwise

On the other hand last year, researchers from Britain’s Dundee University, found that chronic smokers who rapidly switched from smoking to vaping, saw a significant improvement in markers of heart health after just a month.

“By switching from cigarettes to e-cigarettes we found an average percentage point improvement of 1.5 within just one month,” said professor of cardiovascular medicine and therapeutics at Britain’s Dundee University, Jacob George, in a briefing about the study. “And to put that into context, each percentage point improvement in vascular function results in a 13% reduction in cardiovascular event rates, such as heart attack.”

Published in the Journal of the American College of Cardiology, this prior study, took two years to complete and was funded by the British Heart Foundation charity. The Dundee researchers recruited 114 long-term cigarette smokers who had smoked at least 15 cigarettes a day for at least two years. These were placed into one of three groups for a month and had vascular testing before and after. One group stuck to tobacco cigarettes, the second switched to nicotine-containing e-cigarettes, and the third switched to non-nicotine e-cigarettes.

The results indicated that whether or not the e-cigarettes used contained nicotine, the endothelial function (a measure of how easily blood flows around the body) in those who switched from smoking, was significantly improved.

Read Further: News-Medical