Acute Effects of Electronic Cigarette Inhalation on the Vasculature and the Conducting Airways

Abstract

The use of electronic cigarettes has increased exponentially since its introduction onto the global market in 2006. However, short- and long-term health effects remain largely unknown due to the novelty of this product. The present study examines the acute effects of e-cigarette aerosol inhalation, with and without nicotine, on vascular and pulmonary function in healthy volunteers. Seventeen healthy subjects inhaled electronic cigarette aerosol with and without nicotine on two separate occasions in a double-blinded crossover fashion. Blood pressure, heart rate, and arterial stiffness measured by pulse wave velocity and pulse wave analysis were assessed at baseline, and then at 0 h, 2 h, and 4 h following exposure. Dynamic spirometry and impulse oscillometry were measured following vascular assessments at these time points, as well as at 6 h following exposure. e-Cigarette aerosol with nicotine caused a significant increase in heart rate and arterial stiffness. Furthermore, e-cigarette aerosol-containing nicotine caused a sudden increase in flow resistance as measured by impulse oscillometry, indicating obstruction of the conducting airways. Both aerosols caused an increase in blood pressure. The present study indicates that inhaled e-cigarette aerosol with nicotine has an acute impact on vascular and pulmonary function. Thus, chronic usage may lead to long-term adverse health effects. Further investigation is warranted.

Keywords: Arterial stiffness; Augmentation index; ENDS; Electronic cigarettes; IOS; Pulse wave velocity; e-Cig.

Fig. 1

Study design

Fig. 2

Effects on blood pressure and heart rate. Mean change in vascular measurements with standard deviations from baseline following exposure to e-cigarette aerosol with and without nicotine. a systolic and b diastolic blood pressure (SBP, DBP), c heart rate (HR). P-values are presented for multiple measures ANOVA for the interaction variable of ‘time × exposure.’ *Denotes significant change from baseline due to exposure (contrast for ‘time × exposure’)

Fig. 3

Effects on arterial stiffness. Mean change in arterial stiffness with standard deviations from baseline following exposure to e-cigarette aerosol with and without nicotine. a heart-rate corrected augmentation index (AIx75) and b pulse wave velocity (PWV). P-values are presented for multiple measures ANOVA for the interaction variable of ‘time × exposure.’ *Denotes significant change from baseline due to exposure (contrast for ‘time × exposure’)

Fig. 4

Effects on airways measured by impulse oscillometry (IOS). Mean change and standard deviations from baseline in flow resistance at 5, 11, 13, and 19 Hz (R5 Hz, R11 Hz, R13 Hz, R19 Hz). P-values are presented for multiple measures ANOVA for the interaction variable of ‘time × exposure.’ *Denotes significant change from baseline due to exposure (contrast for ‘time × exposure’)