On 2016 Aug 31, Clive Bates commented:

May I suggest that readers first read Professor Polosa's review below, and then turn to Benowitz NL, 2016 for a more credible and complete account of the cardiovascular effects of nicotine as they relate to e-cigarettes. Benowitz and Burbank review the relevant evidence and summarise the current state of knowledge as follows:

The cardiovascular safety of nicotine is an important question in the current debate on the benefits vs. risks of electronic cigarettes and related public health policy. Nicotine exerts pharmacologic effects that could contribute to acute cardiovascular events and accelerated atherogenesis experienced by cigarette smokers. Studies of nicotine medications and smokeless tobacco indicate that the risks of nicotine without tobacco combustion products (cigarette smoke) are low compared to cigarette smoking, but are still of concern in people with cardiovascular disease. Electronic cigarettes deliver nicotine without combustion of tobacco and appear to pose low-cardiovascular risk, at least with short-term use, in healthy users.

This should be a basis for reassuring and encouraging smokers considering switching to vaping.

As happens too often in this field, an author makes claims that go well beyond the scope of their scientific study or their field of expertise. Remarks made to media by the lead author at a cardiology conference in Rome caused a news storm in Britain, and will have increased interest in this paper. My examination of the basis for the claims made and reported is available on my blog > here.

On 2016 Aug 31, Riccardo Polosa commented:

The scientific letter lacks of many important details about participants' previous smoking history, type of device and e-liquid used in the study sessions.

Nonetheless, this is essentially an acute study showing what it is already know about the acute effect of nicotine on arterial stiffness. Besides, comparable acute changes in stiffness would also occur after drinking coffee (caffeine is not a risk factor for cardiovascular disease), exercising (exercise is beneficial for cardiovascular health), being exposed to emotional stress, and after taking nicotine replacement therapies.

Most of the observed changes in arterial stiffness after e-cigarette use were induced by asking participants to vape continuously for 30 min (!!!) (and only then the effect was similar to puffing a single conventional cigarette). Obviously, vaping continuously for 30 min is NOT a realistic conditions of use.

Besides, there are already two large clinical studies (one acute and the other chronic) that contradict the negative take of this research letter in relation to cardiovascular health:

http://www.ncbi.nlm.nih.gov/pubmed/24958250

http://www.ncbi.nlm.nih.gov/pubmed/26749533

Last but not least, measurement of arterial stiffness after acute exposure to active stimuli has no prognostic value whatsoever. That is why current guidelines on arterial stiffness measurements clearly state that before the measurements subjects should abstain from the use of any stimulants (like nicotine, caffeine and alcohol) for at least 4-6 hours.

On 2016 Jun 18, Zvi Herzig commented:

Drinking coffee also acutely increases aortic stiffness and blood pressure Vlachopoulos C, 2003. It is thus surprising that these transient effects are suggested as possible predictors of harm.

On 2016 Jun 18, Zvi Herzig commented:

Drinking coffee also acutely increases aortic stiffness and blood pressure Vlachopoulos C, 2003. It is thus surprising that these transient effects are suggested as possible predictors of harm.

On 2016 Aug 31, Riccardo Polosa commented:

The scientific letter lacks of many important details about participants' previous smoking history, type of device and e-liquid used in the study sessions.

Nonetheless, this is essentially an acute study showing what it is already know about the acute effect of nicotine on arterial stiffness. Besides, comparable acute changes in stiffness would also occur after drinking coffee (caffeine is not a risk factor for cardiovascular disease), exercising (exercise is beneficial for cardiovascular health), being exposed to emotional stress, and after taking nicotine replacement therapies.

Most of the observed changes in arterial stiffness after e-cigarette use were induced by asking participants to vape continuously for 30 min (!!!) (and only then the effect was similar to puffing a single conventional cigarette). Obviously, vaping continuously for 30 min is NOT a realistic conditions of use.

Besides, there are already two large clinical studies (one acute and the other chronic) that contradict the negative take of this research letter in relation to cardiovascular health:

http://www.ncbi.nlm.nih.gov/pubmed/24958250

http://www.ncbi.nlm.nih.gov/pubmed/26749533

Last but not least, measurement of arterial stiffness after acute exposure to active stimuli has no prognostic value whatsoever. That is why current guidelines on arterial stiffness measurements clearly state that before the measurements subjects should abstain from the use of any stimulants (like nicotine, caffeine and alcohol) for at least 4-6 hours.

On 2016 Aug 31, Clive Bates commented:

May I suggest that readers first read Professor Polosa's review below, and then turn to Benowitz NL, 2016 for a more credible and complete account of the cardiovascular effects of nicotine as they relate to e-cigarettes. Benowitz and Burbank review the relevant evidence and summarise the current state of knowledge as follows:

The cardiovascular safety of nicotine is an important question in the current debate on the benefits vs. risks of electronic cigarettes and related public health policy. Nicotine exerts pharmacologic effects that could contribute to acute cardiovascular events and accelerated atherogenesis experienced by cigarette smokers. Studies of nicotine medications and smokeless tobacco indicate that the risks of nicotine without tobacco combustion products (cigarette smoke) are low compared to cigarette smoking, but are still of concern in people with cardiovascular disease. Electronic cigarettes deliver nicotine without combustion of tobacco and appear to pose low-cardiovascular risk, at least with short-term use, in healthy users.

This should be a basis for reassuring and encouraging smokers considering switching to vaping.

As happens too often in this field, an author makes claims that go well beyond the scope of their scientific study or their field of expertise. Remarks made to media by the lead author at a cardiology conference in Rome caused a news storm in Britain, and will have increased interest in this paper. My examination of the basis for the claims made and reported is available on my blog > here.