Users of non-combustible tobacco have biomarkers similar to non-smokers—U.S. study


Tobacco harm reduction advocates in the Philippines have welcomed the results of a landmark study in the U.S. which found that the biomarkers of those who exclusively use non-combustible alternatives to cigarettes have a similar profile to those who do not smoke.

The study entitled “Association of Cigarette and Electronic Cigarette Use Patterns with Levels of Inflammatory and Oxidative Stress Biomarkers among US Adults” and published in the journal Circulation spearheaded by Andrew C. Stokes and other researchers, found that “participants who vaped exclusively showed a similar inflammatory and oxidative stress profile as people who did not smoke cigarettes or use e-cigarettes.”

Peter Paul Dator, president of the consumer group The Vapers Philippines, said that with no less than scientific researchers in the U.S. confirming the almost nil impact of using non-combustible alternatives on health, “adult smokers should be given a choice to switch to these less harmful alternatives so that the almost certain adverse effects of using combustible cigarettes could be avoided.”

The Nicotine Consumers Union of the Philippines said this is why the Philippines Food and Drug Administration should carefully prepare the guidelines to implement Republic Act No. 11467 and Executive Order No. 106 which allow but regulate the sale, distribution, and taxation of vapor and heated tobacco products in the Philippines.

With a sample of more than 7,100 U.S. adults aged 18 and older, the study looked at the association of cigarette smoking and e-cigarette use with inflammation and oxidative stress as biomarkers, which recent literature considers among key contributors to smoking-induced cardiovascular disease.

The data came from the PATH Study (Population Assessment of Tobacco and Health Study) Wave 1, conducted from 2013 to 2014, which included blood and urine sample collection. The data were used to explore the cardiovascular toxicity of e-cigarette use by measuring biomarkers known to predict heart attack, stroke, and other cardiovascular events.

“It is the smoke from cigarettes that kills smokers. If smokers could not give up nicotine, they should be allowed to switch to smoke-free alternatives,” Dator said.

Dator said it was not the first time that scientific studies have found non-combustible alternatives to be better than cigarettes, noting that Public Health England reported as early as 2015 that vaping is 95-percent less harmful than smoking combustible tobacco.

The NUCP said, however, that health organizations like the American Heart Association should interpret the results of the landmark study accurately, without mudding the data.

In a press release on the landmark study, the American Heart Association said “people who smoked traditional cigarettes in addition to using e-cigarettes experienced health effects as harmful as those who smoked cigarettes exclusively; [and] those effects are associated with a higher risk for cardiovascular disease and death.”

“The American Heart Association completely missed the point of the study—that those who vaped exclusively showed a similar inflammatory and oxidative stress profile as people who did not smoke cigarettes or use e-cigarettes.  It is too bad that a scientific body would forget to mention the most important conclusion of the study,” the NUCP said.

The study is among the first nationally representative studies of e-cigarettes to include measurable early indicators of the health impacts of nicotine products, according to Stokes, an assistant professor of global health at Boston University School of Public Health in Boston.

The analysis found that compared to participants who smoked exclusively, those who vaped exclusively had significantly lower levels of almost all inflammatory and oxidative stress biomarkers. 

However, participants who used cigarettes and e-cigarettes at the same time had levels of all inflammatory and oxidative stress biomarkers comparable to those who smoked exclusively.

The authors of the study said the large population sample makes the findings applicable to the U.S. adult population.

The NUCP said this also highlights the importance for Filipino smokers who could not give up nicotine to switch completely to non-combustible products.

It said that in other countries such as the United Kingdom and Japan, millions of former smokers have already switched to e-cigarettes and HTPs.  Nearly a third of Japan’s smokers have already switched to HTPs, the NUCP said.

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