Effects of Pod-Based Electronic Cigarette Use on Vascular Health and Relation to Volatile Organic Compound Exposure in Young Adults

BackgroundPod-based electronic cigarettes (e-cigarettes) use that contain nicotine salts is frequent among youth and young adults; thus, we compared the vascular health effects of pod-based e-cigarette use to combustible cigarette use. Methods and ResultsWe performed a two center observational, cross-sectional study of healthy adults recruited from the community (aged 18-45, N=106) in 3 groups: pod-based e-cigarette users (N=48); combustible cigarette users (N=21); and tobacco nonusers (N=37) and assessed the acute (following structured use) and chronic (resting state after 6 hour tobacco abstinence) effects of pod-based e-cigarette use on endothelial function (brachial artery flow-mediated dilation), blood pressure, and heart rate. Among the pod-based e-cigarette users, 64% were exclusive users including 37% who had never used combustible cigarettes. Pod-based e-cigarette users and combustible cigarette users had higher systolic blood pressure compared to non-users (121{+/-}11mmHg, 121{+/-}13mmHg, 112{+/-}10 mmHg, P=0.0004). Structured pod-based e-cigarette use acutely decreased flow-mediated dilation (-3.2{+/-}2.7%), raised systolic and diastolic blood pressure (6{+/-}8mmHg, 4{+/-}5mmHg) and heart rate (5{+/-}7bpm), similar to combustible cigarette use (-2.6{+/-}2.6%, 9{+/-}8mmHg, 6{+/-}5mmHg, 6{+/-}6bpm P=0.83, 0.3, 0.4, 0.56 vs pod-based), and to a greater extent than nonuse (0.3{+/-}4.1%, 0.7{+/-}5mmHg, 0.3{+/-}3mmHg, -3{+/-}4bpm, P=1.0x10-7, 0.002, 0.003, 2.6x10-7). Differences remained robust in models adjusted for age, sex, and race. The effect of pod-based cigarette use was similar in adults who had never used combustible cigarettes. Levels of acrolein, acrylamide, acrylonitrile, and crotonaldehyde were associated with the changes in vascular health measures. ConclusionsOverall, our findings suggest that pod-based e-cigarette use has acute and chronic vascular effects in healthy young adults including those who never used combustible cigarettes. Select metabolites derived from volatile organic compounds were associated with the vascular changes suggesting relevance to vascular health.