Use of e-cigarettes, traditional combustible cigarettes, and high sensitivity C-reactive protein: The Cross Cohort Collaboration

Zhiqi Yao; Erfan Tasdighi; Zeina A Dardari; John Erhabor; Kunal K Jha; Ngozi Osuji; Tanuja Rajan; Ellen Boakye; Carlos J Rodriguez; Joao A C Lima; Suzanne E Judd; Theodore Feldman; Jonathan A Fialkow; Ramachandran S Vasan; Omar El Shahawy; Emelia J Benjamin; Aruni Bhatnagar; Andrew P DeFilippis; Khurram Nasir; Michael J Blaha

doi:10.1016/j.ahj.2024.10.012

Use of e-cigarettes, traditional combustible cigarettes, and high sensitivity C-reactive protein: The Cross Cohort Collaboration

Am Heart J. 2025 Feb:280:1-6. doi: 10.1016/j.ahj.2024.10.012. Epub 2024 Oct 24.

Authors

Zhiqi Yao¹, Erfan Tasdighi¹, Zeina A Dardari¹, John Erhabor², Kunal K Jha¹, Ngozi Osuji¹, Tanuja Rajan¹, Ellen Boakye², Carlos J Rodriguez³, Joao A C Lima⁴, Suzanne E Judd⁵, Theodore Feldman⁶, Jonathan A Fialkow⁶, Ramachandran S Vasan⁷, Omar El Shahawy⁸, Emelia J Benjamin⁹, Aruni Bhatnagar¹⁰, Andrew P DeFilippis¹¹, Khurram Nasir¹², Michael J Blaha¹³

Affiliations

¹ Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD.
² Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD; The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX.
³ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX; Division of Cardiovascular Medicine, Albert Einstein College of Medicine, Bronx, NY.
⁴ Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
⁵ Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL.
⁶ Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL.
⁷ University of Texas School of Public Health, San Antonio, TX.
⁸ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX; Department of Population Health, New York University Grossman School of Medicine, New York, NY.
⁹ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX; Department of Medicine, Boston University, Chobanian & Avedisian, Boston, MA; Department of Epidemiology, School of Public Health, Boston, MD; Boston University and NHLBI's Framingham Heart Study, Framingham, MA.
¹⁰ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX; Department of Environmental Medicine, University of Louisville School of Medicine, Louisville, KY.
¹¹ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
¹² Division of Cardiovascular Medicine, Houston Methodist Hospital, Houston, TX.
¹³ Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD; The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX. Electronic address: mblaha1@jhmi.edu.

PMID: 39461654
DOI: 10.1016/j.ahj.2024.10.012

Abstract

This cross-sectional study included 18,797 participants from 6 longitudinal cohorts (CARDIA, FHS Gen III, HCHS/SOL, MESA, MiHeart, and REGARDS), and 5,806 of them had high-sensitivity C-reactive protein (hs-CRP) measurements. We found that exclusive electronic cigarette (EC) use was associated with significantly lower hs-CRP levels compared to exclusive combustible cigarette use, suggesting a potentially lower inflammatory burden. hs-CRP levels in dual users and former smokers currently using EC were comparable to those observed in exclusive cigarette smokers. Exclusive EC users showed no significant difference in hs-CRP levels compared to never cigarette smokers. These findings have important implications for tobacco regulation, public health, and clinical practice, highlighting the need for continued monitoring of potential EC-related health impacts.

MeSH terms

Adult
Aged
C-Reactive Protein* / analysis
C-Reactive Protein* / metabolism
Cigarette Smoking / blood
Cigarette Smoking / epidemiology
Cohort Studies
Cross-Sectional Studies
Electronic Nicotine Delivery Systems* / statistics & numerical data
Female
Humans
Longitudinal Studies
Male
Middle Aged
Tobacco Products
Vaping / adverse effects
Vaping / blood

Substances

C-Reactive Protein