TY - JOUR
T1 - Is e-cigarette use associated with coronary heart disease and myocardial infarction? Insights from the 2016 and 2017 National Health Interview Surveys
AU - Farsalinos, Konstantinos E.
AU - Polosa, Riccardo
AU - Cibella, Fabio
AU - Niaura, Raymond
N1 - Funding Information:
The author(s) declared following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Riccardo Polosa has received lecture fees and research funding from Pfizer, GlaxoSmithKline, CV Therapeutics, NeuroSearch A/S, Sandoz, MSD, Boehringer Ingelheim, Novartis, Duska Therapeutics, and Forest Laboratories. He has also served as a consultant for Pfizer, Global Health Alliance for Treatment of Tobacco Dependence, CV Therapeutics, NeuroSearch A/S, Boehringer Ingelheim, Duska Therapeutics, Forest Laboratories, ECITA (Electronic Cigarette Industry Trade Association, in the UK), and Health Diplomat (consulting company that delivers solutions to global health problems with special emphasis on harm minimization). Lecture fees from a number of European e-cigarette industry and trade associations (including FIVAPE in France and FIESEL in Italy) were directly donated to vaper advocacy no-profit organizations on the behalf of RP. RP is also currently a scientific advisor for LIAF, Lega Italiana Anti-Fumo (Italian acronym for Italian Anti-Smoking League) and Head of the European Technical Committee for Standardization on ‘Requirements and test methods for emissions of electronic cigarettes’ (CEN/TC 437; WG4). Konstantinos Farsalinos and Raymond Niaura have no conflicts of interest to report over the past 3 years. Over the past 5 years, Konstantinos Farsalinos has published two studies funded by the non-profit association AEMSA and one study funded by the non-profit association Tennessee Smoke-Free Association.
Publisher Copyright:
© The Author(s), 2019.
PY - 2019
Y1 - 2019
N2 - Background: This study analyzed the National Health Interview Surveys (NHIS) of 2016 (n = 33,028) and 2017 (n = 26,742) to examine whether e-cigarette use is consistently associated with myocardial infarction (MI) and coronary heart disease (CHD). Methods: Surveys were examined separately and pooled. Logistic regression analysis was used, with demographics, e-cigarette use, smoking and risk factors for CHD (hypertension, hypercholesterolemia, and diabetes) being independent variables. Former smokers were subclassified according to quit duration (⩽ 6 and > 6 years). Results: For MI, an association was observed with some days e-cigarette (but not daily) use in the 2017 survey (OR: 2.11, 95% CI: 1.14–3.88, p = 0.017). No statistically significant association was observed in the pooled analysis (daily e-cigarette use: OR: 1.35, 95% CI: 0.80–2.27, p = 0.267). For CHD, an association was observed with daily e-cigarette use in the 2016 survey (OR: 1.89, 95% CI: 1.01–3.53, p = 0.047). From the pooled analysis, no association was found between any pattern of e-cigarette use and CHD. In single-year and pooled analysis, both MI and CHD were strongly associated with all patterns of smoking, hypertension, hypercholesterolemia, diabetes, and age. Conclusions: The pooled analysis of the 2016 and 2017 NHIS showed no association between e-cigarette use and MI or CHD. The associations between established risk factors, including smoking, and both conditions were remarkably consistent. The inconsistent associations observed in single-year surveys and the cross-sectional design of the NHIS cannot substantiate any link between e-cigarette use and an elevated risk for MI or CHD. Longitudinal studies are needed to explore the effects of e-cigarette use on cardiovascular disease.
AB - Background: This study analyzed the National Health Interview Surveys (NHIS) of 2016 (n = 33,028) and 2017 (n = 26,742) to examine whether e-cigarette use is consistently associated with myocardial infarction (MI) and coronary heart disease (CHD). Methods: Surveys were examined separately and pooled. Logistic regression analysis was used, with demographics, e-cigarette use, smoking and risk factors for CHD (hypertension, hypercholesterolemia, and diabetes) being independent variables. Former smokers were subclassified according to quit duration (⩽ 6 and > 6 years). Results: For MI, an association was observed with some days e-cigarette (but not daily) use in the 2017 survey (OR: 2.11, 95% CI: 1.14–3.88, p = 0.017). No statistically significant association was observed in the pooled analysis (daily e-cigarette use: OR: 1.35, 95% CI: 0.80–2.27, p = 0.267). For CHD, an association was observed with daily e-cigarette use in the 2016 survey (OR: 1.89, 95% CI: 1.01–3.53, p = 0.047). From the pooled analysis, no association was found between any pattern of e-cigarette use and CHD. In single-year and pooled analysis, both MI and CHD were strongly associated with all patterns of smoking, hypertension, hypercholesterolemia, diabetes, and age. Conclusions: The pooled analysis of the 2016 and 2017 NHIS showed no association between e-cigarette use and MI or CHD. The associations between established risk factors, including smoking, and both conditions were remarkably consistent. The inconsistent associations observed in single-year surveys and the cross-sectional design of the NHIS cannot substantiate any link between e-cigarette use and an elevated risk for MI or CHD. Longitudinal studies are needed to explore the effects of e-cigarette use on cardiovascular disease.
KW - National Health Interview Survey
KW - coronary heart disease
KW - electronic cigarettes
KW - myocardial infarction
KW - smoking
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U2 - 10.1177/2040622319877741
DO - 10.1177/2040622319877741
M3 - Article
AN - SCOPUS:85073227086
SN - 2040-6223
VL - 10
JO - Therapeutic Advances in Chronic Disease
JF - Therapeutic Advances in Chronic Disease
ER -