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Trends Cardiovasc Med. 2019 Apr 25. pii: S1050-1738(19)30051-9. doi: 10.1016/j.tcm.2019.04.006. [Epub ahead of print]

Cardiovascular impact of electronic-cigarette use.

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Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, A2-237 CHS, 650 Charles Young Drive South, Los Angeles, CA 90025, United States. Electronic address:


The majority of premature deaths related to tobacco cigarettes (TCs) are attributable to cardiovascular disease, so it is fitting and timely to review the overall cardiovascular impact of electronic cigarettes (ECs), which have recently exploded onto the tobacco product market. Longitudinal studies of EC users are necessary, but not yet available, to answer the question whether cardiovascular disease is lower in chronic EC users compared to TC smokers, so we must rely on biomarker studies. Several biomarkers that portend increased cardiovascular risk, including markers of increased sympathetic nerve activity, oxidative stress and inflammation, vascular dysfunction, and thrombosis, have been reported to be abnormal after EC use, although often not to the degree found in TC smokers. We conclude that if all FDA-certified strategies for TC smoking cessation have been tried without success, then ECs may be a reasonable strategy for TC smoking cessation, but the message to non-TC smokers must be clear and unwavering: non TC-smokers should not use ECs - they are not harmless.


Cardiovascular disease; Electronic cigarettes; Nicotine

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