14 Jun Tobacco Flavorings On Their Own May Cause Heart Disease

MedicalResearch.com Interview with:
Jessica L. Fetterman, PhD
Assistant Professor of Medicine
Boston University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In our study, we studied endothelial cells, the cells that line the inside of the blood vessels. We collected endothelial cells from smokers both who use menthol and non-menthol cigarettes are impaired compared to non-smokers and we could make the non-smoker cells look like the endothelial cells of smokers by treating with menthol or eugenol (provides a clove spice-flavoring).

To test a wider variety of commonly used flavoring additives, we treated cultured (outside of the body in a dish) endothelial cells with some of the most commonly used flavoring additives in tobacco products and at different concentrations/doses. We then evaluated the effects of flavoring additives by looking at measures of cell death, oxidative stress, inflammation, and the ability of the cells to produce nitric oxide, a cardio-protective chemical made by endothelial cells that is lost when the cells become damaged.

We found that the flavoring additives used in tobacco products like e-cigarettes are toxic to the cells that line the blood vessels (endothelial cells). Our works suggests that the flavoring additives used in tobacco products may be harmful to the cardiovascular system.

MedicalResearch.com: What should readers take away from your report?

Response: Our study suggests that the flavoring additives, on their own in the absence of the other combustion products or components, may cause cardiovascular injury. Our work suggests that at certain levels, the flavoring additives are toxic to the blood vessels, which could have serious implications as flavored tobacco products are the most popularly used products, especially among youth. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We still don’t know what concentrations of the flavorings make it inside the body with tobacco product use. We know for menthol, that the lower concentrations we tested are similar to the levels obtained smoking a pack of mentholated cigarettes in one day. But how much of the other flavoring additives make it into the blood following vaping is not known. We need to study the effects of these flavoring additives in people directly after they use their tobacco products. We do have on-going studies looking into the health effects in tobacco product users and hopefully we will be able to shed some more light on this topic soon.

MedicalResearch.com: Is there anything else you would like to add?

Response: Our work suggests that at certain levels, the flavoring additives are toxic to the blood vessels which could have serious implications as flavored tobacco products are the most popularly used products, especially among youth. Many studies have already demonstrated that the use of flavorings in tobacco products plays a key role in attracting youth and sustaining tobacco use in smokers. Our study showing that the flavoring additives themselves are toxic to the blood vessels lends additional support for policies that serve to limit access of youth or completely ban the use of flavoring additives in tobacco products. 

We have no disclosures. 

Citations:

Flavorings in Tobacco Products Induce Endothelial Cell Dysfunction
Jessica L. Fetterman, Robert M. Weisbrod, Bihua Feng, Reena Bastin, Shawn T. Tuttle, Monica Holbrook, Gregory Baker, Rose Marie Robertson, Daniel J. Conklin, Aruni Bhatnagar, Naomi M. Hamburg
https://doi.org/10.1161/ATVBAHA.118.311156
Arteriosclerosis, Thrombosis, and Vascular Biology. 2018;ATVBAHA.118.311156
Originally published June 14, 2018

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Last Updated on June 14, 2018 by Marie Benz MD FAAD