E-Cigarette Flavorings Could Damage the Heart
Nine chemical flavorings used in electronic cigarettes (e-cigarettes) and related tobacco products may be associated with impaired blood vessel function, which could be an early signal of heart damage, according to a new study.1
For their study, Jessica L. Fetterman, PhD, lead study author and assistant professor of medicine at Boston University School of Medicine in Massachusetts, and colleagues investigated the short-term effects of e-cigarette flavorings on endothelial cells.
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Specifically, menthol (mint), acetylpyridine (burnt flavor), vanillin (vanilla), cinnamaldehyde (cinnamon), eugenol (clove), diacetyl (butter), dimethylpyrazine (strawberry), isoamyl acetate (banana) and eucalyptol (spicy cooling) were tested.
Ultimately, results of the study showed that all 9 flavorings impaired nitric oxide production in endothelial cell cultures, and that 5 of the flavorings—menthol, clove, vanillin, cinnamon and burnt flavoring—were associated with increased levels of an inflammatory marker and decreased levels of nitric oxide.
“Increased inflammation and a loss of nitric oxide are some of the first changes to occur leading up to cardiovascular disease and events like heart attacks and stroke, so they are considered early predictors of heart disease,” said Dr Fetterman in a press release.2
The effects of the flavorings were further tested in non-smokers, non-e-cigarette users, non-menthol cigarette smokers, and menthol cigarette smokers from whom endothelial cell samples were collected.
Ultimately, the researchers found that nonsmokers’ endothelial cells that were treated with menthol or a clove flavoring had impaired nitric oxide production similar to that observed in active smokers.
Furthermore, when exposing commercially-available human aortic endothelial cells to the flavorings, all 9 chemicals were found to cause cell death at the highest levels tested. Cinnamon, clove, strawberry, banana, and spicy cooling flavorings caused cell death even at lower levels, and the strawberry flavoring still caused cell death at very low levels.
"Our data suggest that short-term exposure of endothelial cells to flavoring compounds used in tobacco products have adverse effects on endothelial cell phenotype that may have relevance to cardiovascular toxicity," the researchers wrote.1
—Christina Vogt
Reference:
1. Fetterman JL, Weisbrod RM, Feng B, et al. Flavorings in tobacco products induce endothelial cell dysfunction [Published online June 14, 2018]. Arterioscl, Thromb, Vascular Biol. https://doi.org/10.1161/ATVBAHA.118.311156
2. Tobacco aside, e-cigarette flavorings may harm blood vessels [press release] Dallas, TX. American Heart Association/American Stroke Association. June 14, 2018. https://newsroom.heart.org/news/tobacco-aside-e-cigarette-flavorings-may-harm-blood-vessels?preview=fa57 Accessed on June 14, 2018.