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Cardiac Autonomic Effects of Secondhand Exposure to Nicotine from Electronic Cigarettes: An Exploratory Study.

ABSTRACT: Background:The rapid increase in prevalence of e-cigarette (EC) use may lead to widespread exposure to secondhand emissions among nonsmokers, but evidence on the potential cardiovascular health risks is limited. We aimed to investigate effect of short-term secondhand exposure to nicotine from e-cigarette (EC) emissions on cardiac autonomic function using heart rate variability (HRV). Methods:A randomized, repeated measures crossover study of healthy nonsmoking volunteers was conducted. Standard deviation of NN intervals (SDNN), average of the standard deviation of NN intervals (ASDNN), root mean square of successive differences (rMSSD), and heart rate-corrected QT interval (QTc) were calculated during one hour of EC exposure session. Results:Nicotine from EC emissions was associated with a 7.8% decrease in SDNN (95% CI, -11.2% to -4.3%), 7.7% decrease in ASDNN (95% CI, -11.0% to -4.2%) and 3.8 msec decrease in QTc (95% CI, -5.8 to -1.9). Compared with a short exposure time period (<15min), greater nicotine associated with reductions in ASDNN (P for interaction = 0.076) with longer exposure time periods. For QTc, greater nicotine associated with reductions were found during 15-30 min exposure time period (P for interaction = 0.04). Conclusion:We present the first evidence of cardiac autonomic effects of short-term secondhand exposure to nicotine from EC emissions among healthy nonsmokers. Further comprehensive research on EC exposure extending to more subjects and flavor compounds is warranted.

SUBMITTER: Lee MS

PROVIDER: S-EPMC6814191 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Cardiac Autonomic Effects of Secondhand Exposure to Nicotine from Electronic Cigarettes: An Exploratory Study.

Lee Mi-Sun MS Rees Vaughan W VW Koutrakis Petros P Wolfson Jack M JM Son Youn-Suk YS Lawrence Joy J Christiani David C DC

Environmental epidemiology (Philadelphia, Pa.) 20190201 1

<h4>Background</h4>The rapid increase in prevalence of e-cigarette (EC) use may lead to widespread exposure to secondhand emissions among nonsmokers, but evidence on the potential cardiovascular health risks is limited. We aimed to investigate effect of short-term secondhand exposure to nicotine from e-cigarette (EC) emissions on cardiac autonomic function using heart rate variability (HRV).<h4>Methods</h4>A randomized, repeated measures crossover study of healthy nonsmoking volunteers was condu ...[more]

PMID: 31656942

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Project description:ImportanceUse of electronic cigarettes (e-cigarettes) is increasing. Measures of exposure to known tobacco-related toxicants among e-cigarette users will inform potential health risks to individual product users.ObjectivesTo estimate concentrations of tobacco-related toxicants among e-cigarette users and compare these biomarker concentrations with those observed in combustible cigarette users, dual users, and never tobacco users.Design, setting, and participantsA population-based, longitudinal cohort study was conducted in the United States in 2013-2014. Cross-sectional analysis was performed between November 4, 2016, and October 5, 2017, of biomarkers of exposure to tobacco-related toxicants collected by the Population Assessment of Tobacco and Health Study. Participants included adults who provided a urine sample and data on tobacco use (N = 5105).ExposuresThe primary exposure was tobacco use, including current exclusive e-cigarette users (n = 247), current exclusive cigarette smokers (n = 2411), and users of both products (dual users) (n = 792) compared with never tobacco users (n = 1655).Main outcomes and measuresGeometric mean concentrations of 50 individual biomarkers from 5 major classes of tobacco product constituents were measured: nicotine, tobacco-specific nitrosamines (TSNAs), metals, polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs).ResultsOf the 5105 participants, most were aged 35 to 54 years (weighted percentage, 38%; 95% CI, 35%-40%), women (60%; 95% CI, 59%-62%), and non-Hispanic white (61%; 95% CI, 58%-64%). Compared with exclusive e-cigarette users, never users had 19% to 81% significantly lower concentrations of biomarkers of exposure to nicotine, TSNAs, some metals (eg, cadmium and lead), and some VOCs (including acrylonitrile). Exclusive e-cigarette users showed 10% to 98% significantly lower concentrations of biomarkers of exposure, including TSNAs, PAHs, most VOCs, and nicotine, compared with exclusive cigarette smokers; concentrations were comparable for metals and 3 VOCs. Exclusive cigarette users showed 10% to 36% lower concentrations of several biomarkers than dual users. Frequency of cigarette use among dual users was positively correlated with nicotine and toxicant exposure.Conclusions and relevanceExclusive use of e-cigarettes appears to result in measurable exposure to known tobacco-related toxicants, generally at lower levels than cigarette smoking. Toxicant exposure is greatest among dual users, and frequency of combustible cigarette use is positively correlated with tobacco toxicant concentration. These findings provide evidence that using combusted tobacco cigarettes alone or in combination with e-cigarettes is associated with higher concentrations of potentially harmful tobacco constituents in comparison with using e-cigarettes alone.

Project description:INTRODUCTION:Dual use of electronic cigarettes (e-cigarettes) and combustible cigarettes is a major public health issue. It is generally accepted that exclusive e-cigarette use is less harmful than exclusive combustible cigarette use, but most e-cigarette users continue to smoke combustible cigarettes as well. To what extent the use of e-cigarettes reduces harm in people who continue to smoke combustible cigarettes has been debated. The aim of this study was to explore the utility of biomarkers as measures of dual use. METHODS:In two human studies of participants who used e-cigarettes only or both combustible cigarettes and e-cigarettes, we measured urine concentrations of the metabolites of nicotine (total nicotine equivalents) as well as two biomarkers of tobacco exposure: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a tobacco-specific carcinogen metabolite, and nicotelline, a tobacco alkaloid not found in significant concentrations in e-cigarette products. RESULTS:The presence of nicotine metabolites indicates either e-cigarette or combustible cigarette use. Nicotelline (half-life of 2-3 hours) indicates recent combustible cigarette use and NNAL (half-life of 10 days or more), indicates combustible cigarette use occurring within several weeks prior to sample collection. CONCLUSIONS:Nicotelline and NNAL are useful biomarkers for combustible tobacco use in users e-cigarettes. The application of these biomarkers provides a tool to help assess whether, or to what extent, dual use of e-cigarettes and combustible cigarettes reduces harm compared to sole use of combustible cigarettes. These biomarkers can also verify exclusive use of e-cigarettes over short (24 hour) or long (several week) time periods. IMPLICATIONS:To what extent dual use of e-cigarettes and combustible cigarettes reduce harm compared to smoking combustible cigarettes only is of considerable public health interest. We show that the levels of the minor tobacco alkaloid nicotelline and the nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) are extremely low in electronic cigarette fluids. The urine biomarkers nicotelline and the NNK metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) are indicative of cigarette smoking and can be used to assess recent and past smoking in dual users.

Dataset Information

Cardiac Autonomic Effects of Secondhand Exposure to Nicotine from Electronic Cigarettes: An Exploratory Study.

Publications

Cardiac Autonomic Effects of Secondhand Exposure to Nicotine from Electronic Cigarettes: An Exploratory Study.

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