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Vaping and Smoking May Be Just as Harmful as Smoking Alone

CardioSmart News

Using both cigarettes and electronic cigarettes may be as harmful as smoking traditional cigarettes alone based on elevated levels of biomarkers known to predict future heart disease, heart attack, stroke and other cardiac events, according to a research letter published in Circulation. The study further revealed that levels of these heart risk markers were similar among people who used e-cigarettes exclusively and those who didn’t vape or smoke tobacco.

The study underscores the potential heart risks of dual use—that is using both cigarettes and e-cigarettes. Dual users and exclusive smokers have similar elevations of these biomarkers compared with non-users.

Given that many people turn to vaping as a way to curb their smoking habit, these results suggest that dabbling in both may be just as harmful to the heart and the ultimate goal should be stop use of all tobacco products. The results “highlight the importance of completely replacing cigarette smoking with e-cigarettes or quitting the use of both products for cigarette smokers to derive potential health benefits,” the authors write.

For the analysis, researchers used data from 7,130 adults surveyed in 2013 and 2014 as part of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative sample, to examine the relationship between tobacco use and key biomarkers.

The value of looking at biomarkers of inflammation and oxidative stress, according to the authors, is that they can give an early (subclinical) picture of how likely someone will develop heart disease; whereas, it can take decades for the potential long-term heart effects of tobacco products to show.

Participants were asked about their use of cigarettes, e-cigarettes, or both within the past 30 days. They were divided into one of four categories: non-users of cigarettes and e-cigarettes; exclusive vaping; exclusive cigarette smoking; and using both cigarettes and e-cigarettes. Of the participants, more than half (58.6%) did not use cigarettes or e-cigarettes; nearly 2% only vaped; about 30% only smoked cigarettes; and nearly 10% reported using both e-cigarettes and traditional cigarettes.

Researchers then examined participants’ blood and urine samples, looking specifically at the levels of five biomarkers of inflammation and oxidative stress: high-sensitivity C-reactive protein, interleukin-6, fibrinogen, soluble intercellular adhesion molecule and biomarker urinary 8-isoprostane.

Oxidative stress is caused when there is higher production of free radicals that can damage cells and upend the body’s ability to stabilize harmful effects. Inflammation happens when the body is trying to respond to and fight something it thinks is foreign.

Researchers found that:

  • People who only smoked traditional cigarettes and dual users (both traditional and electronic cigarettes) had significantly higher levels across all biomarkers compared with people who didn’t use any cigarettes.
  • Compared with people who only smoked traditional cigarettes, those who exclusively vaped had significantly lower levels of all inflammatory and oxidative stress biomarkers with the exception of C-reactive protein.
  • People who only vaped had similar rates of inflammatory and oxidative stress as those who didn’t smoke cigarettes or use e-cigarettes.

The study, which was funded by the National Heart, Lung, and Blood Institute, is limited in that it only allows researchers to look at a point in time and can only show a relationship between smoking and these markers. It was also done before some popular vaping devices became available.

For more information, visit CardioSmart.org/StopSmoking

Association of Cigarette and Electronic Cigarette Use Patterns With Levels of Inflammatory and Oxidative Stress Biomarkers Among US Adults,” Circulation, Jan. 4.

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