Impact of Chewing Bags, Heated Tobacco Products, E-Cigarettes, and Combustible Cigarettes on Small Airways and Central Hemodynamics

Introduction Several substitute products are discussed as a healthier alternative for smoking, thereunder e-cigarettes and chewing bags. Nicotine pouches become more and more popular in this context. Therefore we investigated the acute effects of chewing bags compared head-to-head to e-Cigarettes with and without nicotine and combustible cigarettes on small airways and arterial stiffness.

Methods This single-center four-arm cross-overstudy included 20 healthy occasional smokers (25±0.6 years). On 4 test days participants consumed one product per day. Before, during and after consuming peripheral and central hemodynamic as well as arterial stiffness parameters were measured by Mobil-O-Graph™ (I.E.M., Germany) and resistance of the small airways was measured by tremoFlo​ c-100 (THORASYS Thoracic Medical Systems Inc.).

Results The e-Cigarette with and without nicotine and the combustible cigarette increased significantly the peripheral obstruction (p<0.05) after the intervention, the chewing bag did not show a significant increase. After the intervention all nicotine containing products (e-cigarette with nicotine, combustible cigarette, chewing Bag) as well as the e-cigarette without nicotine increased significantly parameters of hemodynamic and arterial stiffness.

Conclusion In conclusion, changes in blood pressure and arterial stiffness are similar after smoking, vaping and using chewing bags. These changes may be associated with an increased cardiovascular risk compared with no product use. In contrast, chewing bags do not appear to have any harmful effects on peripheral obstruction. However, a long-term follow-up and a larger cohort of chewing bags are still needed.

Publication History

Article published online:
09 March 2023