The study titled “Longitudinal associations between exclusive and dual use of electronic nicotine delivery systems and cigarettes and self-reported incident diagnosed cardiovascular disease among adults” examined waves 1-5 of the PATH Study (2013-2019). The research team investigated the risk of self-reported incident diagnosed myocardial infarction (MI; 280 incident cases) and stroke (186 incident cases) and any potential associations with the use of electronic nicotine delivery systems (ENDS) and/or cigarettes among adults aged 40 and above.
The analysis of the compiled data revealed that exclusive cigarette use, in comparison to no cigarette or ENDS use, increased the risk of MI and stroke. On the other hand, exclusive ENDS use and even dual use of ENDS and cigarettes did not show a statistically significant increase in risk.
The researchers concluded, “Compared to non-use, exclusive cigarette use was associated with an increased risk of self-reported incident diagnosed cardiovascular disease over a five-year period, while ENDS use was not associated with a statistically significant increase in the outcomes.”
Switching from smoking to smokeless tobacco
Similarly, a recent study published in the journal Nicotine and Tobacco Research highlighted the comparative safety of smokeless tobacco products and their association with lower cardiovascular disease risk in smokers who switch from combustible cigarettes.
The study titled “Associations of Smokeless Tobacco Use With Cardiovascular Disease Risk: Insights From the Population Assessment of Tobacco and Health Study” was conducted by a team of researchers from UCLA, UC San Francisco, Boston University, and the University of Texas at Arlington.
The researchers analyzed data from a nationally representative group of 4,347 adults who provided urine and blood samples as part of the Population Assessment of Tobacco and Health (PATH) Study in 2013-14. Among this group, 3,034 participants exclusively used cigarettes, 338 used only smokeless tobacco, and 975 had never used any tobacco product.
The research team discovered that despite similar nicotine levels, users of smokeless tobacco exhibited significantly lower levels of disease biomarkers. Lead study author Mary Rezk-Hanna, an assistant professor at UCLA School of Nursing, stated, “Our findings demonstrate that exclusive smokeless tobacco users, despite having higher nicotine levels, had significantly lower concentrations of inflammation and oxidative stress biomarkers compared to cigarette smokers. The levels of these biomarkers among smokeless tobacco users were similar to those of individuals who had never used tobacco.”
