Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study

Abstract

ObjectiveElectronic nicotine delivery systems (ENDS) products have emerged as the most popular alternative to combustible cigarettes. However, ENDS products contain potentially dangerous toxicants and chemical compounds, and little is known about their health effects. The aim of the present study was to examine the prospective association between cigarette and ENDS use on self-reported incident hypertension.DesignLongitudinal cohort study.SettingNationally representative sample of the civilian, non-institutionalised population in the USA.Participants17 539 adults aged 18 or older who participated at follow-up and had no self-reported heart condition or previous diagnosis of hypertension or high cholesterol at baseline.MeasuresWe constructed a time-varying tobacco exposure, lagged by one wave, defined as no use, exclusive established use (every day or some days) of ENDS or cigarettes, and dual use. We controlled for demographics (age, sex, race/ethnicity and household income), clinical risk factors (family history of heart attack, obesity, diabetes and binge drinking) and smoking history (cigarette pack-years).OutcomesSelf-reported incident hypertension diagnosis.ResultsThe self-reported incidence of hypertension was 3.7% between wave 2 and wave 5. At baseline, 18.0% (n=5570) of respondents exclusively smoked cigarettes; 1.1% (n=336) exclusively used ENDS; and 1.7% (n=570) were dual users. In adjusted models, exclusive cigarette use was associated with an increased risk of self-reported incident hypertension compared with non-use (adjusted HR (aHR) 1.21, 95% CI 1.06 to 1.38), while exclusive ENDS use (aHR 1.00, 95% CI 0.68 to 1.47) and dual use (aHR 1.15, 95% CI 0.87 to 1.52) were not.ConclusionsWe found that smoking increased the risk of self-reported hypertension, but ENDS use did not. These results highlight the importance of using prospective longitudinal data to examine the health effects of ENDS use.

Association between cigar use, with and without cigarettes, and incident diagnosed COPD: a longitudinal cohort study

“…Discrete-time survival models were used to examine the prospective association between exclusive and dual use of cigars and cigarettes and incident self-reported diagnosis of COPD at follow-up (Wave 2-Wave 5). These models provide the discrete-time equivalent to continuous time survival models [ 25 ], and we have used this methodological framework in previous health effects research [ 21 , 26 , 27 ]. Hazard ratios (HRs) and 95% confidence intervals (CIs) were fit using a general linear modeling (GLM) approach with a binomial distribution and a complementary log-log link function.…”

O Uso De Cigarro Eletrônico Como Fator Predisponente Para Hipertensão Arterial Sistêmica: Uma Revisão Narrativa

“…Todas essas características estão correlacionadas com menor risco de hipertensão. Estudos com maior número de usuários de SEAN são necessários para melhor compreender o risco de hipertensão incidente entre usuários duplos (Cook et al, 2023).…”

“…Outrossim, alguns estudos demonstraram pontos contrastantes com os já apresentados. Segundo Cook et al (2023), em comparação com o não uso, o uso exclusivo de SEAN e o uso duplo não foram associados ao aumento do risco de (2024), os quais demonstraram, por meio de uma revisão sistemática, que o uso exclusivo do cigarro eletrônico proporciona menos danos do que o uso exclusivo do cigarro convencional, pois há um aumento menor na PA. No entanto, este estudo é limitado porque o período de medição para aquisição da doença é limitado a um ano (dados transversais). Em contraste, a incidência de doenças devido ao tabagismo tende a ser crônica, ou a manifestação da doença desenvolve-se durante um período relativamente longo, isto é, a curta duração da exposição ao cigarro eletrônico pode ser insuficiente para que um jovem vaper exclusivo desenvolva hipertensão, ou para que um vaper mais velho que era ex-fumante tenha um efeito cumulativo significativo sobre a exposição ao fumo a longo prazo (Moeis et al, 2024;Cook et al, 2023;La Rosa et al, 2023).…”