Cardiovascular Toxicity of Nicotine: Implications for Electronic Cigarette Use

• Published in: Trends in cardiovascular medicine Vol. 26; no. 6; pp. 515 - 523
• Main Authors: Benowitz, Neal L, Burbank, Andrea D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2016; Elsevier Limited
• Subjects: Administration, Inhalation; Angina pectoris; Animals; Atherosclerosis; Binding sites; Blood; Cardiac arrhythmia; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - chemically induced; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - pathology; Cardiovascular Diseases - physiopathology; Cardiovascular System - drug effects; Cardiovascular System - pathology; Cardiovascular System - physiopathology; Cigarette smoking; Consumer Product Safety; Electronic cigarettes; Electronic Nicotine Delivery Systems - adverse effects; Health risk assessment; Heart attacks; Heart failure; Humans; Hypertension; Morbidity; Mortality; Nicotine; Nicotine - administration & dosage; Nicotine - adverse effects; Nicotine - pharmacokinetics; Nicotinic Agonists - administration & dosage; Nicotinic Agonists - adverse effects; Nicotinic Agonists - pharmacokinetics; Pharmacology; Risk Assessment; Risk Factors; Smoking - adverse effects; Smoking cessation; Smoking Cessation - methods; Smoking Prevention; Thrombosis; Time Factors; Tobacco smoke; Toxicity; Toxicology; Vaping - adverse effects; Veins & arteries; Cardiovascular disease; Cigarette smoking; Electronic cigarettes; Nicotine
• ISSN: 1050-1738; 1873-2615
• DOI: 10.1016/j.tcm.2016.03.001

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.