Cardiovascular and Pulmonary Reactions in Long-term Users: A Comparison of ENDS and Combustible Cigarettes

The following is a summary of “Cardiovascular and Pulmonary Responses to Acute Use of Electronic Nicotine Delivery Systems and Combustible Cigarettes in Long-Term Users,” published in the  September 2023  issue of Chest by Tattersall, et al.

Long-term users of today’s electronic nicotine delivery systems (ENDS) have not yet been studied for their acute cardiovascular and pulmonary consequences. What are the differences in cardiovascular and pulmonary responses between frequent users of nicotine-containing products and nonusers of tobacco and vaping after an acute 15-minute product usage challenge with ENDS and combustible cigarettes?

The 395 participants included those who used ENDS exclusively (n = 164; exhaled CO level, 5 parts per million [ppm]; positive urine NicCheck I [Mossman Associates] results, 82%; 4th-generation ENDS), those who smoked cigarettes exclusively (n = 117; CO level, > 5 ppm; positive urine NicCheck I results), and controls (n = 114; CO level, 5 ppm; neg. The average cigarette smoker inhaled 14.0 puffs during the 15-minute product test (IQR: 9.3), whereas the average ENDS user inhaled 9.0 puffs (IQR: 7.5); P <.001). Adjusted mean differences in systolic BP (5.6 mm Hg [95% CI, 4.4-6.8 mm Hg] vs 2.0 mm Hg [95% CI, 1.1-3.0 mm Hg]; P =.001), diastolic BP (4.2 mm Hg [95% CI, 3.3-5.0 mm Hg] vs 2.0 mm Hg [95% CI, 1.1-3.0 mm values comparable to those of smokers (vs. nonsmokers: -1.1 [95% CI, -2.7 to 0.6]; P =.005). 

All workout measures were poorer for ENDS users compared to controls, but the most striking differences were shown in metabolic equivalents (adjusted mean difference, 1.28 METs [95% CI, 0.73-1.83 METs]; p< .001) and heart rate recovery after 60 seconds (adjusted mean difference, 2.9 beats/min [95% CI, 0.7-5.0 beats/min]; P =.008). Acute vaping by ENDS users was associated with higher airflow blockage, decreased lung function, increased heart rate, and elevated blood pressure compared to controls.

Source: sciencedirect.com/science/article/abs/pii/S0012369223004944