Joel L. Nitzkin Published in June 2014, Joel Nitzkin looks at the role electronic cigarettes play in the formation of tobacco harm reduction policy.
Nitzkin believes that tobacco harm reduction is a viable addition to current tobacco control policies and that it’s important for smokers who are unable to quit using traditional methods. Some smokers are also unwilling to quit, but adding electronic cigarettes to the equation creates more opportunities to reduce illness, harm, and death.
Dr. Konstantinos Farsalinos
You’ll see Dr. Farsalinos’ work mentioned several times throughout this blog. Dr. Farsalinos is a cardiac specialist from Greece who has dedicated many hours over the last four years to studies in which e-cig vapour is studied and compared to cigarette smoke.
I have chosen this study, conducted between 2011 and 2012, as the first on my list because it set the groundwork for every subsequent electronic cigarette investigation by Farsalinos and his team. It is the first of its kind that presents clinical evidence regarding e-cigarette use and its effect on the cardiovascular function. The results showed that cardiac functions studied were not affected by the use of electronic cigarettes.
Effects of electronic cigarette use on myocardial function
Our landmark study was performed in 2011-2012 and was presented in oral format and in a press conference during the 2012 annual congress of the European Society of Cardiology. It was one of the 30 studies, out of 4000 in total submitted to the congress, that was presented in both oral form and in press conference.
The study was designed based on the fact smoking has immediate adverse effects on myocardial function. Recently, our research group published a study about this. Therefore, the goal was to determine if similar disturbances can occur after using the electronic cigarette.
Two groups of participants were recruited. Smokers, and electronic cigarette users who had completely substituted smoking with electronic cigarettes. Interestingly, e-cigarette users had higher lifetime smoking exposure compared to current smokers (had smoked more cigarettes per day and for more years).
We asked smokers to smoke 1 cigarette, while e-cigarette users used a device (eGO battery) with liquid containing 11mg nicotine per ml for 7 minutes.
Concerning hemodynamic measurements, smoking caused an acute elevation in systolic and diastolic blood pressure, and in heart rate. In e-cigarette users, only a slight elevation in diastolic blood pressure was observed. Since hemodynamic changes depend solely on nicotine absorption, this study confirms previous observations that nicotine is absorbed at a lower rate from the e-cigarette compared to tobacco cigarette.
Concerning myocardial function, several parameters of diastolic function were adversely affected by smoking, while no parameter was changed after vaping. Diastolic function is a very sensitive measure of subclinical dysfunction. It is the phase during which the heart relaxes and blood is returning from the lungs and the peripheral veins. Almost every clinical disease involves diastolic dysfunction at an early stage.
The results of our study have shown that cardiac function is not affected by e-cigarette use, unlike the adverse effects of tobacco cigarette use. This provides the first clinical evidence about the acute cardiovascular effects of e-cigarettes