Core Tip: According to foreign reports, recent research in the United States that e-cigarettes can cause worrying changes in blood pressure and heart function has attracted criticism from British scientists who believe that current evidence Cigarettes can cause worrying changes in blood pressure and heart function, drawing criticism from British scientists who say current evidence still suggests e-cigarettes are safer than smoking.
The 4.3 million people who use e-cigarettes in the UK are now baffled after reading headlines about how e-cigarettes are causing worrying changes in blood pressure and heart function.
Senior academics in the UK have expressed dismay after a US research team’s recommendation that measuring heart rate and blood pressure question the finding that smoking is more dangerous than vaping.
Scientists at King’s College London, which recently conducted the largest review of e-cigarettes of its kind, have been disappointed by the reporting produced by the US analysis.
The US team compared the cardiovascular function of people who vaped, smoked and did not use any nicotine, and said they found significant negative health effects for the participants after vaping and smoking traditional cigarettes. Those who vaped or smoked were found to have larger increases in heart rate and blood pressure, while those who reported not using nicotine saw no changes. People who used nicotine regularly also had worse measurements of heart rate variability and brachial arteries (the main blood vessels that supply blood to the arms and hands).
“These findings suggest that cardiovascular disease risk factors are more severe after vaping or smoking,” said lead study author MAT thew Tattersall of the University of Wisconsin.
Study participants also underwent an exercise stress test after 90 minutes. Those who smoked or vaped fared significantly worse on all measures, including how quickly heart rate recovered after exercise and how hard the heart was working at peak levels.
The analysis, which will be presented this week at the American Heart Association’s Scientific Sessions, challenges the assumption that e-cigarettes are safer than smoking, the team said. However, British scientists are critical of how the research was introduced at the abstract stage.
Professor Peter Hayek of the Wolfson Institute for Population Health at Queen Mary University of London said US researchers had been irresponsible.
He said: “Like many of the previous reports of this kind, the heart rate part just noted a well-known short-term effect of nicotine that comes with
All types of stimulation. Watching a thriller or a football game or taking an exam can have the same effect. Drinking a cup of coffee actually produced a larger, longer-lasting response.
“The main heart health risk of smoking is not caused by nicotine, but by other chemicals in tobacco smoke that are not present in e-cigarette vapour. Prejudice against this finding is irresponsible because it makes smoking switch to safer alternatives.”
E-cigarette users are often ex-smokers, and other differences between ex-smokers or smokers and non-smokers, including differences in exercise levels, were not controlled for
Alan Boobis, Emeritus Professor of Toxicology at Imperial College London and Chair of the UK Toxicology Committee, said: “Given all the potential health effects, I don’t think there is anything in these summaries that challenges the currently widely accepted view that vaping is less harmful than smoking. However, the summaries do provide further evidence that e-cigarette use by non-smokers is not 100% safe.
The research team from King’s College London found that while vaping is not without risks, especially for people who have never smoked, it poses only a fraction of the health risks of smoking in the short to medium term.
Their report reviewed many aspects of e-cigarettes, including who is vaping and what products, the health effects (in absolute terms and compared to smoking), and public perceptions of the harms.
The authors examined studies of biomarkers of exposure — measuring levels of potentially harmful substances in the body, and biomarkers of potential harm — measuring biological changes in the body — due to vaping or smoking.
The strongest evidence comes from biomarkers of exposure. Significantly lower levels of tobacco-specific nitrosamines (a harmful carcinogenic chemical found in tobacco and tobacco smoke), volatile organic compounds, and other toxicants associated with major diseases caused by smoking were found in e-cigarettes. Among e-cigarette users, overall levels of nicotine were lower or similar to smokers.
Dr Debbie Robson, Senior Lecturer in Tobacco Harm Reduction at King’s College and one of the report’s authors, said: “Compared to smokers, vapers have significantly lower levels of exposure to carcinogens and other toxicants. Helping people switch from smoking to vaping should be a priority if the government is to make England smoke-free by 2030.
While investigators are well aware of the benefits of vaping compared to smoking, they found that public perceptions lag behind.
By 2021, only 34% of adults who smoke vaping accurately believe that vaping is less harmful than smoking, and only 11% of adult smokers know that nicotine is not the main cause of smoking-related health risks. Alarmist headlines like the American analysis behind it do nothing to change those perceptions.
Responding to the criticism, Dr Tattersall said: “We looked at the acute cardiovascular and autonomic effects of e-cigarette use. This study did not examine smoking cessation using ENDS, nor was it to determine which method of nicotine consumption was more risky.
“Our data underscore that e-cigarette use has acute cardiovascular and autonomic effects and that e-cigarette use is not benign. While I appreciate the off-the-cuff comparison to watching horror movies, there is no contemporary reference to overheating chemicals. Long-term study on the safety of e-cigarettes.”
“The effects of frequent and repeated use of e-cigarettes on long-term cardiovascular health are unclear. We agree that nicotine is not the poison in our work. In fact,
The changes we observed were not related to nicotine levels or nicotine elevation following product use. We encourage Dr. Hajek and others to read our entire paper rather than judging the abstract or parts of the new version. “
There is overwhelming evidence that e-cigarettes are far safer than tobacco. While they are not entirely risk-free, e-cigarettes carry a fraction of the risks of cigarettes because they do not produce tar or carbon monoxide, the NHS said.
All of this comes on the one-year anniversary of the Medicines and Healthcare Products Regulatory Agency (MHRA) updating its guidelines, meaning e-cigarette makers can submit their products for the same regulatory approval as all NHS medicines.
As a result, the UK could soon become the first country in the world to use e-cigarettes as a smoking cessation tool.
If the product is approved by MHRA and the National Institute for Health and Care Excellence – launched on the NHS – clinicians can decide on a case-by-case basis whether it is appropriate to prescribe vaping patients to the NHS.
No e-cigarettes are currently licensed as medicinal products, but officials said they will continue to support companies in encouraging vaping products to be licensed as medicines,
To support patient-centred care and access.
Post time: Nov-04-2022