Measurement of cardiovascular and pulmonary function endpoints and other physiological effects following partial or complete substitution of cigarettes with electronic cigarettes in adult smokers

D’Ruiz, Carl D.; O’Connell, Grant; Graff, Donald W.; Yan, Xiaoli

doi:10.1016/j.yrtph.2017.05.002

Cited by 60 publications

(46 citation statements)

References 55 publications

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“…This is a useful design for assessing the respiratory effects of e-cigarettes; although some studies have found that e-cigarette users experience improvements in lung health, results have not been consistent even when users were able to reduce cigarette consumption 37383940. Studies funded by the tobacco industry have consistently found few adverse respiratory health outcomes in smokers transitioning to e-cigarette use 414243. An important caveat to these studies is that in general they have not looked at whether e-cigarettes have respiratory toxicity but at whether the measured outcomes differ from those of people exposed to ongoing cigarette smoke.…”

Section: Human Studiesmentioning

confidence: 99%

What are the respiratory effects of e-cigarettes?

Gotts

Jordt

McConnell

et al. 2019

BMJ

392

303

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Electronic cigarettes (e-cigarettes) are alternative, non-combustible tobacco products that generate an inhalable aerosol containing nicotine, flavors, propylene glycol, and vegetable glycerin. Vaping is now a multibillion dollar industry that appeals to current smokers, former smokers, and young people who have never smoked. E-cigarettes reached the market without either extensive preclinical toxicology testing or long term safety trials that would be required of conventional therapeutics or medical devices. Their effectiveness as a smoking cessation intervention, their impact at a population level, and whether they are less harmful than combustible tobacco products are highly controversial. Here, we review the evidence on the effects of e-cigarettes on respiratory health. Studies show measurable adverse biologic effects on organ and cellular health in humans, in animals, and in vitro. The effects of e-cigarettes have similarities to and important differences from those of cigarettes. Decades of chronic smoking are needed for development of lung diseases such as lung cancer or chronic obstructive pulmonary disease, so the population effects of e-cigarette use may not be apparent until the middle of this century. We conclude that current knowledge of these effects is insufficient to determine whether the respiratory health effects of e-cigarette are less than those of combustible tobacco products.

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Section: Human Studiesmentioning

confidence: 99%

What are the respiratory effects of e-cigarettes?

Gotts

Jordt

McConnell

et al. 2019

BMJ

392

303

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show abstract

“…These studies reported HR and BP outcomes, summarized in the following paragraph and in ESM Table 3. Only one of these studies was a short-term (5 day) switch study [11] during which the participants were confined and smoking behavior was monitored. In total, 105 chronic TC smokers were randomized to three general groups: (1) TC to EC complete switch; (2) TC to EC switch but TCs were allowed; (3) complete TC and nicotine cessation.…”

Section: Chronic Autonomic Cardiovascular Effects Of Switching From Cmentioning

confidence: 99%

Cardiovascular autonomic effects of electronic cigarette use: a systematic review

2020

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Purpose Electronic cigarettes (ECs) are the fastest growing tobacco product in the USA, and ECs, like tobacco cigarettes (TCs), have effects on the cardiovascular autonomic nervous system, with clinical implications. The purpose of this review was to collect and synthesize available studies that have investigated the autonomic cardiovascular effects of EC use in humans. Special attention is paid to the acute and chronic effects of ECs, the relative contributions of the nicotine versus non-nicotine constituents in EC emissions and the relative effects of ECs compared to TCs. Methods Using the methodology described in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, we conducted a literature search of the Ovid PubMed and Embase databases on 6 December 2019 using keywords in titles and abstracts of published literature. Acute (minutes to hours) and chronic (days or longer) changes in heart rate variability (HRV), heart rate (HR) and blood pressure (BP) were used as estimates of cardiovascular autonomic effects. Results Nineteen studies were included in this systematic review, all of which used earlier generation EC devices. Acute EC vaping increased HR and BP less than acute TC smoking. Nicotine but not non-nicotine constituents in EC aerosol were responsible for the sympathoexcitatory effects. The results of chronic EC vaping studies were consistent with a chronic sympathoexcitatory effect as estimated by HRV, but this did not translate into chronic increases in HR or BP. Conclusions Electronic cigarettes are sympathoexcitatory. Cardiac sympathoexcitatory effects are less when vaping using the earlier generation ECs than when smoking TCs. Additional studies of the latest pod-like EC devices, which deliver nicotine similarly to a TC, are necessary.

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“…In a study of 23 daily e-cigarette users, e-cigarette power output was reported to vary between 5 and 60 W, puff volume varied between 10-251 mL, and puff duration between 1.3 and 5.8 s [19]. Understanding of the relative importance of different parameters affecting e-cigarette emissions is needed for formulating standardized testing protocols and translating laboratory results to real-life exposure.Carbon monoxide (CO) emissions from e-cigarette have been understudied [20,21], because a few studies showed that exhaled CO concentrations among e-cigarette users were significantly lower than conventional tobacco smokers [7,[22][23][24]. However, CO can be formed in e-cigarettes through thermal decomposition of e-liquid base materials (propylene glycol (PG) and vegetable glycerin (VG)) [25] and some flavoring compounds [26].…”

mentioning

confidence: 99%

“…Carbon monoxide (CO) emissions from e-cigarette have been understudied [20,21], because a few studies showed that exhaled CO concentrations among e-cigarette users were significantly lower than conventional tobacco smokers [7,[22][23][24]. However, CO can be formed in e-cigarettes through thermal decomposition of e-liquid base materials (propylene glycol (PG) and vegetable glycerin (VG)) [25] and some flavoring compounds [26].…”

mentioning

confidence: 99%

Carbonyls and Carbon Monoxide Emissions from Electronic Cigarettes Affected by Device Type and Use Patterns

Son

Bhattarai

Samburova

et al. 2020

IJERPH

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Dangerous levels of harmful chemicals in electronic cigarette (e-cigarette) aerosols were reported by several studies, but variability in e-cigarette design and use patterns, and a rapid development of new devices, such as JUUL, hamper efforts to develop standardized testing protocols and understand health risks associated with e-cigarette use. In this study, we investigated the relative importance of e-cigarette design, power output, liquid composition, puff topography on e-cigarette emissions of carbonyl compounds, carbon monoxide (CO), and nicotine. Four popular e-cigarette devices representing the most common e-cigarette types (e.g., cig-a-like, top-coil, ‘mod’, and ‘pod’) were tested. Under the tested vaping conditions, a top-coil device generated the highest amounts of formaldehyde and CO. A ‘pod’ type device (i.e., JUUL) emitted the highest amounts of nicotine, while generating the lowest levels of carbonyl and CO as compared to other tested e-cigarettes. Emissions increased nearly linearly with puff duration, while puff flow had a relatively small effect. Flavored e-liquids generated more carbonyls and CO than unflavored liquids. Carbonyl concentrations and CO in e-cigarette aerosols were found to be well correlated. While e-cigarettes emitted generally less CO and carbonyls than conventional cigarettes, daily carbonyl exposures from e-cigarette use could still exceed acute exposure limits, with the top-coil device potentially posing more harm than conventional cigarettes.

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Measurement of cardiovascular and pulmonary function endpoints and other physiological effects following partial or complete substitution of cigarettes with electronic cigarettes in adult smokers

Cited by 60 publications

References 55 publications

What are the respiratory effects of e-cigarettes?

What are the respiratory effects of e-cigarettes?

Cardiovascular autonomic effects of electronic cigarette use: a systematic review

Carbonyls and Carbon Monoxide Emissions from Electronic Cigarettes Affected by Device Type and Use Patterns

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