E-Cigarettes Plus Smoking As Harmful as Cigarettes Alone: Analysis

A new analysis has shown that those who use e-cigarettes (vaping) and those who also smoke cigarettes have higher levels of biomarkers for inflammation and oxidative stress.

The study was, according to first author Andrew C. Stokes, PhD, assistant professor of global health at Boston University School of Public Health in Boston, one of the first to use nationally representative data for the study of a link between cigarette and e-cigarette use and biomarkers for inflammatory and oxidative stress.

“Given the lag time between tobacco exposure and disease symptoms and diagnosis, identifying the association between e-cigarette use and sensitive biomarkers of subclinical cardiovascular injury is necessary for understanding the long-term effects of newer tobacco products such as e-cigarettes,” Dr. Stokes said in a press release.

The study included data from the longitudinal Population Assessment of Tobacco and Health (PATH) Study. It included 7,130 participants, 58.6% of whom did not use cigarettes or e-cigarettes. The authors examined five biomarkers of inflammation and oxidative stress and broke participants down into four categories: exclusive vaping, exclusive cigarette use, use of both cigarettes and e-cigarettes, and non-use of both.

According to the analysis, almost 2% of the participants used e-e-cigarettes exclusively, while 30% smoked cigarettes exclusively. About 10% of the participants used both. Those who vaped exclusively had similar inflammatory and oxidative stress profiles to those who did not smoke either. Those who used cigarettes exclusively and who used both together had higher biomarker levels than non-users. Those who vaped exclusively had lower levels of almost all inflammatory and oxidative stress biomarkers. Participants who used both had higher biomarker levels than those who smoked exclusively.

“This study adds to the limited body of research we have on biologic measures in those using e-cigarettes,” said study co-author Rose Marie Robertson, MD, deputy chief science and medical officer of the American Heart Association and co-director of the Association’s National Institutes of Health/Food and Drug Administration-funded Tobacco Center of Regulatory Science, which supported the study. “I believe it has an important message for individuals who may believe using e-cigarettes while continuing to smoke some combustible cigarettes reduces their risk. This commonly-seen pattern of dual use was not associated with lower levels of inflammatory markers, and thus is not likely to offer a reduction in risk in this specific area.”

The research letter was published in Circulation.