Hemodynamic and autonomic effects of smokeless tobacco in healthy young men

Abstract

Objectives: The aim of this study was to investigate the acute hemodynamic and autonomic effects of smokeless tobacco.

Background: Smokeless tobacco use is increasing. Its cardiovascular effects are not well understood.

Methods: Sixteen healthy, male, habitual snuff tobacco users (aged 22 +/- 1 year) were studied, using a randomized, double-blind, placebo-controlled, crossover design with two separate experimental sessions: placebo and tobacco. Muscle sympathetic nerve activity (MSNA), electrocardiogram, blood pressure, calf blood flow, nicotine, and catecholamines were measured.

Results: Snuff tobacco increased plasma nicotine from 2.8 +/- 0.5 ng/ml to 10.4 +/- 1.1 ng/ml. Mean blood pressure increased by 10 +/- 1 mm Hg, and heart rate increased by 16 +/- 2 beats/min. Peripheral vascular resistance, MSNA, and norepinephrine concentration did not change with tobacco, but epinephrine increased by approximately 50%.

Conclusions: Oral snuff tobacco increases heart rate, blood pressure, and epinephrine. Despite the increase in blood pressure, there is no decrease in either MSNA or peripheral vascular resistance. Smokeless tobacco is a powerful autonomic and hemodynamic stimulus. Catecholamine release from the adrenal medulla likely contributes to this response.