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Vaping increases health risks, especially from Covid-19 - new analysis

Friday June 26th 2020

Smoking and vaping may increase the risk of people being infected by Covid-19, suffering worse symptoms and dying from it, according to research published today.

The study, in the European Heart Journal, also reports that smoking and vaping stiffens the arteries, causes inflammation and damages DNA.

It is the first study to compare the effects of the three forms of smoking and vaping on human health and the endothelium and provides an overview of the available evidence about the harmful chemicals produced and the mechanisms by which smoking and vaping affect the body.

The researchers also looked at the effects of each on a range of medical conditions, including stroke, heart attack and lung cancer.

They reviewed a range of studies, which they graded as providing strong, good or medium levels of evidence on the harmfulness of three types of smoking – tobacco cigarettes, e-cigarettes and waterpipe.

They found that compared to non-smokers, tobacco cigarettes increased the risk of chronic obstructive pulmonary disease (COPD) by 704%, waterpipes by 218% and e-cigarettes by 194%.

Tobacco cigarettes and waterpipes increased the risk of lung cancer by 1210% and 122% respectively. However, the level of evidence for e-cigarettes was not sufficient to be able to make reliable conclusions.

They also examined how much the three smoking techniques stiffened the arteries, finding that compared to non-smokers, tobacco cigarettes increased arterial stiffness by 10%, waterpipes by 9% and e-cigarettes by 7%.

First author Professor Thomas Münzel, of the Department of Cardiology of the University Medical Centre Mainz in Mainz, Germany, said: “Our review focuses primarily on the adverse effects of these three smoking and vaping techniques on endothelial dysfunction and the relation to oxidative stress and, secondly, on clinical disease.

“All three forms of smoking and vaping lead to increased production of oxygen-derived free radicals in blood vessel tissue, such as superoxide. This breaks down nitric oxide, which is released by the endothelium, and is important for helping blood vessels to dilate and for protecting against inflammation and clogging of the arteries.”

The main toxic chemicals in e-cigarette vapour include formaldehyde and acrolein, as well as traces of transition metals and volatile organic compounds (VOCs), while tobacco cigarettes and waterpipe smoke contain a more complex mixture of harmful chemicals and other substances.

Nicotine is present in all three tobacco products, is addictive and is responsible for harmful biological effects as well as, to a minor extent, some beneficial effects.

Looking at the effects of smoking and vaping on Covid-19 infections, the authors write: “As outlined by the WHO, tobacco cigarette and waterpipe smoking may contribute to increased burden of symptoms due to Covid-19 compared to non-smoking, including being admitted to intensive care, requiring mechanical ventilation, and suffering severe health consequences.

“There is no doubt…that smoking cessation is and will remain the most powerful approach to prevent smoking-induced cardiovascular and respiratory disease. This may be even more important in light of the…Covid-19 pandemic as the use of tobacco products likely increases the risk for Covid-19 associated cardiovascular and other severe complications in smokers and vapers.”

Münzel T, Hahad O, Kuntic M et al. Effects of tobacco cigarettes, e-cigarettes and waterpipe smoking on endothelial function and clinical outcome. European Heart Journal 26 June 2020

https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehaa460

Tags: Cancer | Drug & Alcohol Abuse | Europe | Flu & Viruses | Heart Health

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