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...
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BMJ Publishing Group
2023-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/4/e062297.full |
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| 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 |
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