TY - JOUR
T1 - Association Between E-Cigarette Use and Cardiovascular Disease Among Never and Current Combustible-Cigarette Smokers
AU - Osei, Albert D.
AU - Mirbolouk, Mohammadhassan
AU - Orimoloye, Olusola A.
AU - Dzaye, Omar
AU - Uddin, S. M.Iftekhar
AU - Benjamin, Emelia J.
AU - Hall, Michael E.
AU - DeFilippis, Andrew P.
AU - Stokes, Andrew
AU - Bhatnagar, Aruni
AU - Nasir, Khurram
AU - Blaha, Michael J.
N1 - Funding Information:
Funding: American Heart Association Tobacco Regulation and Addiction Center, 2U54HL120163, which is funded by the U.S. Food and Drug Administration and National Heart, Lung, and Blood Institute. Conflict of Interest: EJB has received the following grant: P50 HL120163 (Robertson, Bhatnagar), 09/01/18-06/30/23, American Heart Association (AHA)/National Institutes of Health, AHA Tobacco Regulation and Addiction Center (ATRAC); EJB is the primary investigator on the Training Core (Core D).
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/8
Y1 - 2019/8
N2 - Background: The prevalence of e-cigarette use in the United States has increased rapidly. However, the association between e-cigarette use and cardiovascular disease remains virtually unknown. Therefore, we aimed to examine the association between e-cigarette use and cardiovascular disease among never and current combustible-cigarette smokers. Methods: We pooled 2016 and 2017 data from the Behavioral Risk Factor Surveillance System (BRFSS), a large, nationally representative, cross-sectional telephone survey. We included 449,092 participants with complete self-reported information on all key variables. The main exposure, e-cigarette use, was further divided into daily or occasional use, and stratified by combustible-cigarette use (never and current). Cardiovascular disease, the main outcome, was defined as a composite of self-reported coronary heart disease, myocardial infarction, or stroke. Results: Of 449,092 participants, there were 15,863 (3.5%) current e-cigarette users, 12,908 (2.9%) dual users of e-cigarettes + combustible cigarettes, and 44,852 (10.0%) with cardiovascular disease. We found no significant association between e-cigarette use and cardiovascular disease among never combustible-cigarette smokers. Compared with current combustible-cigarette smokers who never used e-cigarettes, dual use of e-cigarettes + combustible cigarettes was associated with 36% higher odds of cardiovascular disease (odds ratio 1.36; 95% confidence interval, 1.18-1.56); with consistent results in subgroup analyses of premature cardiovascular disease in women < 65 years and men < 55 years old. Conclusion: Our results suggest significantly higher odds of cardiovascular disease among dual users of e-cigarettes + combustible cigarettes compared with smoking alone. These data, although preliminary, support the critical need to conduct longitudinal studies exploring cardiovascular disease risk associated with e-cigarette use, particularly among dual users.
AB - Background: The prevalence of e-cigarette use in the United States has increased rapidly. However, the association between e-cigarette use and cardiovascular disease remains virtually unknown. Therefore, we aimed to examine the association between e-cigarette use and cardiovascular disease among never and current combustible-cigarette smokers. Methods: We pooled 2016 and 2017 data from the Behavioral Risk Factor Surveillance System (BRFSS), a large, nationally representative, cross-sectional telephone survey. We included 449,092 participants with complete self-reported information on all key variables. The main exposure, e-cigarette use, was further divided into daily or occasional use, and stratified by combustible-cigarette use (never and current). Cardiovascular disease, the main outcome, was defined as a composite of self-reported coronary heart disease, myocardial infarction, or stroke. Results: Of 449,092 participants, there were 15,863 (3.5%) current e-cigarette users, 12,908 (2.9%) dual users of e-cigarettes + combustible cigarettes, and 44,852 (10.0%) with cardiovascular disease. We found no significant association between e-cigarette use and cardiovascular disease among never combustible-cigarette smokers. Compared with current combustible-cigarette smokers who never used e-cigarettes, dual use of e-cigarettes + combustible cigarettes was associated with 36% higher odds of cardiovascular disease (odds ratio 1.36; 95% confidence interval, 1.18-1.56); with consistent results in subgroup analyses of premature cardiovascular disease in women < 65 years and men < 55 years old. Conclusion: Our results suggest significantly higher odds of cardiovascular disease among dual users of e-cigarettes + combustible cigarettes compared with smoking alone. These data, although preliminary, support the critical need to conduct longitudinal studies exploring cardiovascular disease risk associated with e-cigarette use, particularly among dual users.
KW - Cardiovascular disease
KW - Combustible cigarettes
KW - Dual use
KW - E-cigarettes
UR - https://www.scopus.com/pages/publications/85066238857
UR - https://www.scopus.com/pages/publications/85066238857#tab=citedBy
U2 - 10.1016/j.amjmed.2019.02.016
DO - 10.1016/j.amjmed.2019.02.016
M3 - Article
C2 - 30853474
AN - SCOPUS:85066238857
SN - 0002-9343
VL - 132
SP - 949-954.e2
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 8
ER -