Comparable impairment of vascular endothelial function by a wide range of electronic nicotine delivery devices

Introduction  Electronic nicotine delivery systems (ENDS; i.e.,
vaping devices) such as e-cigarettes, heated tobacco products, and newer
coil-less ultrasonic vaping devices are promoted as less harmful
alternatives to combustible cigarettes. However, their cardiovascular
effects are understudied. We investigated whether exposure to aerosol from
a wide range of ENDS devices, including a new ultrasonic vaping device,
impairs endothelial function. Methods  We measured arterial
flow-mediated dilation (FMD) in rats (n=8/group) exposed to single session
of 10 cycles of pulsatile 5s exposure over 5 minutes to aerosol from
e-liquids with and without nicotine generated from a USONICIG ultrasonic
vaping device, previous generation e-cigarettes, 5% nicotine JUUL pods
(Virginia Tobacco, Mango, Menthol), and an IQOS heated tobacco product;
with Marlboro Red cigarette smoke and clean air as controls.  We
evaluated nicotine absorption and serum nitric oxide levels after
exposure, and effects of different nicotine acidifiers on platelet
aggregation. Results  Aerosol/smoke from all conditions except
air significantly impaired FMD. Serum nicotine varied widely from highest
in the IQOS group to lowest in USONICIG and previous generation e-cig
groups. NO levels were not affected by exposure. Exposure to JUUL and
similarly acidified nicotine salt e-liquids did not affect platelet
aggregation rate. Despite lack of heating coil, the USONICIG under airflow
conditions heated e-liquid to ~77˚C.   Conclusions  A
wide range of ENDS, including multiple types of e-cigarettes with and
without nicotine, a heated tobacco product, and an ultrasonic vaping
device devoid of heating coil, all impair FMD after a single vaping
session comparably to combusted cigarettes.