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Smoking traditional cigarettes in addition to using e-cigarettes leads to harmful health effects like smoking cigarettes exclusively, according to new research published today in the American Heart Association’s flagship journal Circulation.
Smoking, a well-known link to cardiovascular disease and death, seems to be on the decline. While using e-cigarettes, known as vaping, is increasingly popular, there has been limited research on the impact of vaping within the body.
In a massive data analysis of more than 7,100 U.S. adults ages 18 and older, researchers studied the association of cigarette smoking and e-cigarette use with inflammation and oxidative stress as biomarkers.
Researchers used data from the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal cohort in the U.S..
Five biomarkers of inflammation and oxidative stress have been examined. Participants were piled into four categories depending on the use of classic cigarettes and e-cigarettes within a 30-day period: nonuse of cigarettes and e-cigarettes; exclusive vaping; exclusive cigarette smoking; and dual use of cigarettes and e-cigarettes. To test the robustness of first results, the scientists repeated the analyses in subgroups of respondents, including those with no past 30-day use of any other tobacco products.
Of the study participants, more than half (58.6%) didn’t use cigarettes or e-cigarettes; nearly 2% vaped exclusively; about 30% smoked cigarettes exclusively; and roughly 10% used e-cigarettes and traditional cigarettes.
The analysis found:
1. Participants who vaped exclusively showed a similar inflammatory and oxidative stress profile because people who didn’t smoke cigarettes or use e-cigarettes. 2.Participants who smoked exclusively and people who used cigarettes and e-cigarettes had higher levels across all biomarkers evaluated compared to participants who did not use cigarettes or e-cigarettes. 3.Compared to participants who smoked exclusively, people who vaped exclusively had substantially lower levels of nearly all inflammatory and oxidative stress biomarkers. However, participants who used cigarettes and e-cigarettes had levels of all inflammatory and oxidative stress biomarkers comparable to people who smoked exclusively.
“I think it’s an important message for people who might 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 reduced levels of inflammatory markers, and thus isn’t likely to offer a decrease in risk in this specific area.”
Researchers also conducted extensive analyses to check the results against the influence of related behaviors like the use of other tobacco products and marijuana, and secondhand smoke exposure. The results remained constant across the further analyses.
The large population sample of the study makes the findings applicable to the U.S. adult population. One of the study’s limitations is its cross-sectional method of studying population data at the same point in time, which makes it impossible to establish causality.
Researchers said the study highlights the importance of continuing public education concerning the risks of cigarette smoking and the failure of dual use to reduce risk.
“The results could be used to counsel patients about the potential risk of using both cigarettes and e-cigarettes,” Stokes said. “Some men and women who smoke cigarettes, pick up e-cigarette use to decrease the frequency with which they smoke cigarettes. They frequently become dual users of both products rather than switching entirely from one to the other. If e-cigarettes function as a means to stop smoking, cigarette smoking should be completely replaced and a plan to finally attain freedom from all tobacco products should be advised.”
American Heart Association