association between electronic cigarette and combustible cigarette use with cardiometabolic risk biomarkers among U.S. adults.

Introduction:
This text is a scientific article published in the annals of Epidemiology, which examines the association between cigarette use (never-use, exclusive e-cigarette users, exclusive cigarette smoking, and dual use of both products) with cardiometabolic risk biomarkers in a US representative sample of adults. The study aims to determine the relationship between cigarette use and risk factors for cardiovascular disease (CVD), such as reduced high-density lipoprotein cholesterol (hDL-C), elevated low-density lipoprotein cholesterol (LDL-C), elevated triglycerides (TG), elevated fasting blood glucose (FBG), and high blood pressure (hBP).

Key Points:

* The study used data from the National health and Nutrition Examination Survey (NhaNES) across two survey cycles conducted between 2015-2016 and 2017-2018.
* Participants were grouped into four mutually exclusive categories: never used combustible or e-cigarettes (reference group), exclusive e-cigarette use, exclusive combustible cigarette smoking, and dual use of both products.
* Covariates included age, sex, race/ethnicity status, education, income, alcohol use, other tobacco product use, physical activity level, and body mass index.
* The study found that exclusive e-cigarette use was significantly associated with increased odds of hBP (aOR = 2.05, 95% CI = 1.03, 4.08), while dual use was associated with increased odds of reduced hDL-C (aOR = 1.64, 95% CI = 1.01, 2.70).
* Exclusive cigarette smoking was significantly associated with reduced hDL-C (aOR = 1.80, 95% CI = 1.45, 2.23) and elevated TG (aOR = 1.59, 95% CI = 1.01, 2.52).
* The study adjusted for age, sex, race/ethnicity status, education, income, alcohol use, other tobacco product use, physical activity level, and body mass index.
* The study excluded former cigarette smokers and participants with a history of cardiovascular disease, stroke, or diabetes to minimize confounding and potential reverse causality.

Main Message:
The study suggests that exclusive e-cigarette use is associated with increased odds of hBP, while dual use of e-cigarettes and combustible cigarettes is associated with increased odds of reduced hDL-C. Exclusive cigarette smoking is significantly associated with reduced hDL-C and elevated TG. These findings highlight the potential cardiovascular risks associated with e-cigarette and combustible cigarette use, and the importance of continued research in this area to inform regulatory decisions and public health interventions.

Okafor CN, Okafor N, Kaliszewski C, Wang L. association between electronic cigarette and combustible cigarette use with cardiometabolic risk biomarkers among U.S. adults. annals of epidemiology. 2022;71:44-50. doi:10.1016/j.annepidem.2022.02.002