Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study

Objective Electronic nicotine delivery systems (ENDS) products have emerged as the most popular alternative to combustible cigarettes. However, ENDS products contain potentially dangerous toxicants and chemical compounds, and little is known about their health effects. The aim of the present study w...

Full description

Saved in:
Bibliographic Details
Main Authors: Nancy L Fleischer, David Levy, Geoffrey Barnes, Rafael Meza, Jihyoun Jeon, Jana L Hirschtick, Akash Patel, Steven Cook, Douglas Arenberg, Irina Bondarenko, Evelyn Jiminez Mendoza
Format: Article
Language:English
Published: BMJ Publishing Group 2023-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/4/e062297.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850199122871582720
author Nancy L Fleischer
David Levy
Geoffrey Barnes
Rafael Meza
Jihyoun Jeon
Jana L Hirschtick
Akash Patel
Steven Cook
Douglas Arenberg
Irina Bondarenko
Evelyn Jiminez Mendoza
author_facet Nancy L Fleischer
David Levy
Geoffrey Barnes
Rafael Meza
Jihyoun Jeon
Jana L Hirschtick
Akash Patel
Steven Cook
Douglas Arenberg
Irina Bondarenko
Evelyn Jiminez Mendoza
author_sort Nancy L Fleischer
collection DOAJ
description Objective Electronic nicotine delivery systems (ENDS) products have emerged as the most popular alternative to combustible cigarettes. However, ENDS products contain potentially dangerous toxicants and chemical compounds, and little is known about their health effects. The aim of the present study was to examine the prospective association between cigarette and ENDS use on self-reported incident hypertension.Design Longitudinal cohort study.Setting Nationally representative sample of the civilian, non-institutionalised population in the USA.Participants 17 539 adults aged 18 or older who participated at follow-up and had no self-reported heart condition or previous diagnosis of hypertension or high cholesterol at baseline.Measures We constructed a time-varying tobacco exposure, lagged by one wave, defined as no use, exclusive established use (every day or some days) of ENDS or cigarettes, and dual use. We controlled for demographics (age, sex, race/ethnicity and household income), clinical risk factors (family history of heart attack, obesity, diabetes and binge drinking) and smoking history (cigarette pack-years).Outcomes Self-reported incident hypertension diagnosis.Results The self-reported incidence of hypertension was 3.7% between wave 2 and wave 5. At baseline, 18.0% (n=5570) of respondents exclusively smoked cigarettes; 1.1% (n=336) exclusively used ENDS; and 1.7% (n=570) were dual users. In adjusted models, exclusive cigarette use was associated with an increased risk of self-reported incident hypertension compared with non-use (adjusted HR (aHR) 1.21, 95% CI 1.06 to 1.38), while exclusive ENDS use (aHR 1.00, 95% CI 0.68 to 1.47) and dual use (aHR 1.15, 95% CI 0.87 to 1.52) were not.Conclusions We found that smoking increased the risk of self-reported hypertension, but ENDS use did not. These results highlight the importance of using prospective longitudinal data to examine the health effects of ENDS use.
format Article
id doaj-art-be00e15524dd4f149f5a95b596d2b674
institution OA Journals
issn 2044-6055
language English
publishDate 2023-04-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-be00e15524dd4f149f5a95b596d2b6742025-08-20T02:12:42ZengBMJ Publishing GroupBMJ Open2044-60552023-04-0113410.1136/bmjopen-2022-062297Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal studyNancy L Fleischer0David Levy1Geoffrey Barnes2Rafael Meza3Jihyoun Jeon4Jana L Hirschtick5Akash Patel6Steven Cook7Douglas Arenberg8Irina Bondarenko9Evelyn Jiminez Mendoza101 Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA6 Georgetown University, Washington, DC, USA2 Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, Michigan, USADepartment of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada2 Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA2 Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA1 Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA1 Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA4 Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, USA5 Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA1 Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USAObjective Electronic nicotine delivery systems (ENDS) products have emerged as the most popular alternative to combustible cigarettes. However, ENDS products contain potentially dangerous toxicants and chemical compounds, and little is known about their health effects. The aim of the present study was to examine the prospective association between cigarette and ENDS use on self-reported incident hypertension.Design Longitudinal cohort study.Setting Nationally representative sample of the civilian, non-institutionalised population in the USA.Participants 17 539 adults aged 18 or older who participated at follow-up and had no self-reported heart condition or previous diagnosis of hypertension or high cholesterol at baseline.Measures We constructed a time-varying tobacco exposure, lagged by one wave, defined as no use, exclusive established use (every day or some days) of ENDS or cigarettes, and dual use. We controlled for demographics (age, sex, race/ethnicity and household income), clinical risk factors (family history of heart attack, obesity, diabetes and binge drinking) and smoking history (cigarette pack-years).Outcomes Self-reported incident hypertension diagnosis.Results The self-reported incidence of hypertension was 3.7% between wave 2 and wave 5. At baseline, 18.0% (n=5570) of respondents exclusively smoked cigarettes; 1.1% (n=336) exclusively used ENDS; and 1.7% (n=570) were dual users. In adjusted models, exclusive cigarette use was associated with an increased risk of self-reported incident hypertension compared with non-use (adjusted HR (aHR) 1.21, 95% CI 1.06 to 1.38), while exclusive ENDS use (aHR 1.00, 95% CI 0.68 to 1.47) and dual use (aHR 1.15, 95% CI 0.87 to 1.52) were not.Conclusions We found that smoking increased the risk of self-reported hypertension, but ENDS use did not. These results highlight the importance of using prospective longitudinal data to examine the health effects of ENDS use.https://bmjopen.bmj.com/content/13/4/e062297.full
spellingShingle Nancy L Fleischer
David Levy
Geoffrey Barnes
Rafael Meza
Jihyoun Jeon
Jana L Hirschtick
Akash Patel
Steven Cook
Douglas Arenberg
Irina Bondarenko
Evelyn Jiminez Mendoza
Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study
BMJ Open
title Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study
title_full Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study
title_fullStr Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study
title_full_unstemmed Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study
title_short Time-varying association between cigarette and ENDS use on incident hypertension among US adults: a prospective longitudinal study
title_sort time varying association between cigarette and ends use on incident hypertension among us adults a prospective longitudinal study
url https://bmjopen.bmj.com/content/13/4/e062297.full
work_keys_str_mv AT nancylfleischer timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT davidlevy timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT geoffreybarnes timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT rafaelmeza timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT jihyounjeon timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT janalhirschtick timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT akashpatel timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT stevencook timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT douglasarenberg timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT irinabondarenko timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy
AT evelynjiminezmendoza timevaryingassociationbetweencigaretteandendsuseonincidenthypertensionamongusadultsaprospectivelongitudinalstudy