Abstract

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

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

Results: The e-cigarettes with and without nicotine and the combustible cigarette significantly increase the resistance of the small airways (p<0.05) after the intervention. The chewing bag does 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 significantly increase parameters of haemodynamic and arterial stiffness.

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 small airway function.