Use of E-Cigarette, Traditional Cigarettes, and 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 Judd; Theodore Feldman; Jonathan A Fialkow; Vasan S Ramachandran; 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-Cigarette, Traditional Cigarettes, and C-Reactive Protein: The Cross Cohort Collaboration

Am Heart J. 2024 Oct 24:S0002-8703(24)00275-8. doi: 10.1016/j.ahj.2024.10.012. Online ahead of print.

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 Judd⁵, Theodore Feldman⁶, Jonathan A Fialkow⁶, Vasan S Ramachandran⁷, 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, USA.
² Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA.; The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA.
³ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA.; Division of Cardiovascular Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
⁴ Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁵ Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
⁶ Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL, USA.
⁷ University of Texas School of Public Health, San Antonio, TX, USA.
⁸ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
⁹ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA.; Boston University, Department of Medicine, Chobanian & Avedisian School of Medicine, Department of Epidemiology, School of Public Health, Boston, MA, USA.; Boston University and NHLBI's Framingham Heart Study, Framingham, MA, USA.
¹⁰ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA.; University of Louisville School of Medicine, Louisville, KY, USA.
¹¹ The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA.; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
¹² Division of Cardiovascular Medicine, Houston Methodist Hospital, Houston, TX, USA.
¹³ Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD, USA.; The American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX, USA.. 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 six longitudinal cohorts (CARDIA, FHS Gen III, HCHS/SOL, MESA, MiHeart, and REGARDS). 5,806 of them were with high-sensitivity C-reactive protein (hs-CRP) measurements. We found that among exclusive electronic cigarette (EC) use was associated with significantly lower high-sensitivity C-reactive protein (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. In contrast, individuals who exclusively used ECs showed no significant difference in hs-CRP levels compared to never smokers. These findings have important implications for tobacco regulation, public health, and clinical practice, highlighting the need for continued monitoring of EC-related health impacts.

Keywords: Cross Cohort Collaboration; combustible cigarette; electronic cigarette; hs-CRP; subclinical marker; systematic inflammation.