Adverse Effects of Cigarette and Noncigarette Smoke Exposure on the Autonomic Nervous System

• Published in: Journal of the American College of Cardiology Vol. 64; no. 16; pp. 1740 - 1750
• Main Authors: Middlekauff, Holly R., MD, Park, Jeanie, MD, Moheimani, Roya S., BS
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 21-10-2014; Elsevier Limited
• Subjects: afferent neurons; autonomic nervous system; Blood pressure; Cardiology; Cardiovascular; Electronic cigarettes; Feedback; Heart attacks; Heart failure; Heart rate; inflammation; Internal Medicine; Marijuana; Mortality; Nervous system; Nicotine; Outdoor air quality; Oxidative stress; reactive oxygen species; Rodents; Smoking; Tobacco smoke; United States > US; sympathetic nerve activity; blood pressure; heart rate; autonomic nervous system; transient receptor potential ankyrin 1; TRPA1; electronic cigarette; afferent neurons; cannabinoid; PM 2.5; SNA; transient receptor potential vanilloid 1; TRPV1; HRV; inflammation; heart rate variability; reactive oxygen species; e-cigarette; fine particulate matter <2.5 μm in hydrodynamic diameter; oxidative stress; CB; PM2.5
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2014.06.1201

Abstract This review summarizes the detrimental effects of cigarette and noncigarette emission exposure on autonomic function, with particular emphasis on the mechanisms of acute and chronic modulation of the sympathetic nervous system. We propose that the nicotine and fine particulate matter in tobacco smoke lead to increased sympathetic nerve activity, which becomes persistent via a positive feedback loop between sympathetic nerve activity and reactive oxidative species. Furthermore, we propose that baroreflex suppression of sympathetic activation is attenuated in habitual smokers; that is, the baroreflex plays a permissive role, allowing sympathoexcitation to occur without restraint in the setting of increased pressor response. This model is also applicable to other nontobacco cigarette emission exposures (e.g., marijuana, waterpipes [hookahs], electronic cigarettes, and even air pollution). Fortunately, emerging data suggest that baroreflex sensitivity and autonomic function may be restored after smoking cessation, providing further evidence in support of the health benefits of smoking cessation.