Cardiovascular effects of electronic cigarettes.
Cardiovascular safety is an important consideration in the debate on the benefits versus the risks of electronic cigarette (EC) use. EC emissions that might have adverse effects on cardiovascular health include nicotine, oxidants, aldehydes, particulates, and flavourants. To date, most of the cardiovascular effects of ECs demonstrated in humans are consistent with the known effects of nicotine. Pharmacological and toxicological studies support the biological plausibility that nicotine contributes to acute cardiovascular events and accelerated atherogenesis. However, epidemiological studies assessing Swedish smokeless tobacco, which exposes users to nicotine without combustion products, generally have not found an increased risk of myocardial infarction or stroke among users, but suggest that nicotine might contribute to acute cardiovascular events, especially in those with underlying coronary heart disease. The effects of aldehydes, particulates, and flavourants derived from ECs on cardiovascular health have not been determined. Although ECs might pose some cardiovascular risk to users, particularly those with existing cardiovascular disease, the risk is thought to be less than that of cigarette smoking based on qualitative and quantitative comparisons of EC aerosol versus cigarette smoke constituents. The adoption of ECs rather than cigarette smoking might, therefore, result in an overall benefit for public health.
Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, Departments of Medicine and Biopharmaceutical Sciences, University of California, 1001 Potrero Avenue #3316, San Francisco, California 94110, USA.|Center for Tobacco Control Research and Education, University of California, 530 Parnassus Avenue, San Francisco, California 94117, USA.
Neal L
NL
Benowitz
Louisiana State University School of Medicine, Department of Emergency Medicine, Lallie Kemp Regional Medical Center, 52579 US-51, Independence, Louisiana 70443, USA.
Joseph B
JB
Fraiman
D002318:Cardiovascular Diseases / Q000209:etiology*; D002319:Cardiovascular System / Q000187:drug effects; D003257:Consumer Product Safety; D066300:Electronic Nicotine Delivery Systems; D006801:Humans; D009538:Nicotine / Q000009:adverse effects / Q000494:pharmacology; D012907:Smoking / Q000009:adverse effects*; D000073869:Tobacco Smoking / Q000009:adverse effects
D009538:Nicotine