Titled, “Longitudinal associations between exclusive and dual use of electronic nicotine delivery systems and cigarettes and self-reported incident diagnosed cardiovascular disease among adults,” the current study analyzed waves 1-5 of the PATH Study (2013-2019). The research team looked for the risk of self-reported incident diagnosed myocardial infarction (MI; 280 incident cases) and stroke (186 incident cases) and any possible associations with ENDS and/or cigarette use among adults aged 40+.

The compiled data found that compared to no cigarette or ENDS use, exclusive cigarette use increased the risk of MI and stroke, while exclusive ENDS use and even dual use of ENDS and cigarettes was not.

“Compared to non-use, exclusive cigarette use was associated with an increased risk of self-reported incident diagnosed cardiovascular disease over a five-year period, while ENDS use was not associated with a statistically significant increase in the outcomes,” concluded the researchers.

Switching from smoking to smokeless tobacco

Similarly, another recent study in the journal Nicotine and Tobacco Research, highlighted the relative safety of smokeless tobacco products and how switching to the products from combustible cigarettes was associates with lower cardiovascular disease risk in smokers.

The study, “Associations of Smokeless Tobacco Use With Cardiovascular Disease Risk: Insights From the Population Assessment of Tobacco and Health Study” was conducted by a team of researchers from UCLA, UC San Francisco, Boston University and the University of Texas at Arlington.

The researchers analyzed data from a nationally representative group of 4,347 adults who provided urine and blood samples in 2013–14 as part of the Population Assessment of Tobacco and Health (PATH) Study. Among this group, 3,034 participants used cigarettes exclusively, 338 used only smokeless tobacco, and 975 had never used any tobacco product.

The research team found that despite similar nicotine levels, smokeless tobacco users displayed significantly lower biomarkers of disease. “Our findings show that despite having higher levels of nicotine, exclusive smokeless tobacco users had significantly lower concentrations of inflammation and oxidative stress biomarkers than cigarette smokers. Levels of these biomarkers among smokeless tobacco users were similar to those of ‘never’ smokers,” said lead study author Mary Rezk-Hanna, who is an assistant professor at UCLA School of Nursing.

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