The Impact of Heat-Not-Burn, E-Cigarettes, and Cigarettes on Small Airway Function

• Published in: Tobacco use insights Vol. 17; p. 1179173X241271551
• Main Authors: Jung, L., Buchwald, I. C., Hauck, A., Lüthgen, M., Jagomast, T., Weckmann, M., Drömann, D., Franzen, K. F.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.07.2024; Sage Publications Ltd; SAGE Publishing
• Subjects: Electronic cigarettes; Hemodynamics; Nicotine; Original; Vaping; heat-not-burn; cigarette; electronic cigarette; smoking; chronic lung disease; EVALI; small airways; small airway function; tremoflo
• ISSN: 1179-173X; 1179-173X
• DOI: 10.1177/1179173X241271551

Introduction E-cigarettes and heated tobacco products (HTPs) are gaining worldwide significance. The tobacco industry is promoting these products as healthier alternatives to conventional cigarettes. Methods In this four-arm crossover study, we examined the acute effects of cigarette smoking, vaping IQOS, or vaping e-cigarettes (with or without nicotine) on hemodynamics, arterial stiffness, and small airways. Twenty subjects (10 male, 10 female), all occasional smokers, completed each study arm. There was at least a 48 h washout period before each test day. Arterial stiffness and peripheral and central hemodynamics were assessed using Mobil-O-Graph™ (I.E.M., Germany), whereas tremoFlo® c-100 (Thoracic Medical Systems Inc) was used to evaluate the effects on the small airways and resistance. Results Cigarettes, IQOS, e-cigarettes containing nicotine, and nicotine-free e-cigarettes had similar effects on peripheral and central hemodynamics as well as on arterial stiffness. We observed a significant increase in all parameters. However, only nicotine-containing products lead to increased bronchial obstruction, higher reactance, and a higher tidal volume. Conclusion Therefore, we concluded that cigarettes, IQOS, and e-cigarettes have similar effects on hemodynamics. No differences were observed between the nicotine-containing and nicotine-free e-cigarettes. All nicotine-containing products also influence small airways. These findings suggest that e-cigarettes and HTPs are not healthier alternatives than conventional cigarettes.