JUUL and Combusted Cigarettes Comparably Impair Endothelial Function

Abstract

Objectives JUUL and earlier generation electronic cigarettes (e-cigs) are promoted as being less hazardous than cigarettes. While JUUL Labs, in particular, claims that switching from smoking to vaping has beneficial impacts, the health effects of such products are not well understood. We investigated whether exposure to JUUL and previous generation e-cig aerosol impairs endothelial function comparably to cigarette smoke. Methods We exposed rats to aerosol from Virginia Tobacco flavor JUUL, an e-cig tank system using unflavored freebase nicotine e-liquid, Marlboro Red combustible tobacco cigarettes, or clean air for 10 cycles of 2 second inhalation over 5 minutes. Endothelial function (FMD) was measured pre-and post-exposure. Blood was collected 20 mins postexposure for serum nicotine analysis.Results Aerosol/smoke from JUUL, previous generation e-cigs, and cigarettes all impaired FMD. The extent of impairment ranged from 34%-58%, although the differences between groups were insignificant. Nicotine was highest in serum from the JUUL group; for the other e-cig and cigarette groups, nicotine levels were lower and comparable to each other. ConclusionsAerosol from JUUL and previous generation e-cigs impairs endothelial function in rats, comparable to impairment by cigarette smoke.

Oral and periodontal implications of tobacco and nicotine products

“…133 E-cigarettes are sometimes presented as a less-harmful alternative for nicotine-dependent tobacco smokers unwilling or unable to cease nicotine use, because the products deliver much lower levels of toxicants relative to cigarette smoke. 134,135 However, important concerns surrounding e-cigarettes include rising use prevalence among youth and young adults, 136 potential risks for cardiovascular and lung health, [137][138][139] and questions about cessation effectiveness outside clinical trials. The uncertainty and complexity of what impact widespread e-cigarette availability has had, and will have, on public health has spurred much controversy and policy debate.…”

Cellular effects of nicotine salt‐containing e‐liquids

“…Previous studies identified several known flavor chemicals in JUUL e‐liquids that were potentially cytotoxic, including isopulegol, ethyl maltol, benzaldehyde, vanillin, benzyl alcohol, and pulegone (Omaiye, McWhirter, Luo, Pankow, & Talbot, 2019; Talih et al, 2019). Impaired endothelial function in rats following JUUL vape exposure has also been reported (Rao, Liu, & Springer, 2020). Here, we evaluated the effects of JUUL e‐liquids on two human cell lines, namely, HEK293T cells and M0 THP‐1 macrophage‐like cells.…”

Extracorporeal support to treat E-cigarette or vaping product use-associated lung injury (EVALI) during the coronavirus disease 2019 (COVID-19) pandemic

“…7 As such, vaping during pregnancy may have a profound impact on vascular health and function and should not be considered "safe" or "risk-free." 8,9 In the weeks preceding this admission, the ECMO team had conducted a series of preparedness drills and drafted a checklist for managing suspected COVID-19 (Appendix 1). The drills involved multidisciplinary providers, nurses, perfusionists, respiratory therapists, security, and housekeeping in high-fidelity scenarios using mock pumps and mannequins in simulating transport, cannulation, and containment (Figure 2).…”