The Potential Hazards of E-Cigarette and Dual Use: a Cochrane Systematic Review and Secondary Analysis

Dec.01.2022
The Potential Hazards of E-Cigarette and Dual Use: a Cochrane Systematic Review and Secondary Analysis
A study on Cochrane's systematic review found that switching from smoking to e-cigarettes significantly reduces potential harm biomarkers. However, a separate study found that using both traditional and e-cigarettes has the same harmful effect on the heart as smoking alone.

Title: Biomarkers of potential harm from switching from tobacco smoking to e-cigarette use, dual use or cessation: a Cochrane systematic review and meta-analysis of secondary analysis of data from randomized controlled trials of electronic cigarettes for smoking cessation. In this study, researchers conducted a secondary analysis of data from randomized controlled trials of electronic cigarettes for smoking cessation in Greece, Italy, Poland, the United Kingdom, and the United States. The conclusion drawn was that switching from tobacco smoking to e-cigarette use significantly lowered potential harmful biomarkers.


At the same time, according to a recent study published in the American Heart Association journal "Circulation," using both traditional cigarettes and e-cigarettes poses the same risk to the heart as smoking alone.


A study titled "Association Between Patterns of Cigarette and E-Cigarette Use and Inflammatory and Oxidative Stress Biomarker Levels in U.S. Adults: A Population Assessment of Tobacco and Health Study" analyzed more than 7,100 U.S. adults aged 18 and over to explore the connection between smoking, vaping, and heart health.


Researchers used data from the Population Assessment of Tobacco and Health (PATH) study to search for biomarkers of inflammation and oxidative stress, as these biomarkers are known to indicate predictive factors for heart disease and cardiovascular events, such as heart attacks and heart failure.


After analyzing five biomarkers of inflammation and oxidative stress, participants were divided into four groups: exclusive smokers, exclusive e-cigarette users, dual users, and non-users of e-cigarettes. Researchers listed the following findings:


Participants who only use electronic cigarettes showed similar levels of inflammation and oxidative stress as those who do not use electronic cigarettes or smoke at all. However, compared to participants who do not use cigarettes or electronic cigarettes, those who smoke exclusively or use both cigarettes and electronic cigarettes had higher levels of all evaluated biomarkers. Participants who only use electronic cigarettes had significantly lower levels of nearly all inflammation and oxidative stress biomarkers compared to those who only smoke. However, participants who use both cigarettes and electronic cigarettes had biomarker levels similar to those who exclusively smoke. 2FIRSTS will continue to report on this issue, with updates available on the "2FIRSTSAPP". Scan the QR code below to download the app.



Disclaimer

This article is provided solely for professional research, industry discussion, and informational purposes. Any references to brands, companies, products, technologies, or policies are made for factual reporting and analytical purposes only, and do not constitute endorsement, recommendation, promotion, or advertising by 2Firsts.

Nicotine-containing products, including but not limited to cigarettes, e-cigarettes, heated tobacco products, and nicotine pouches, carry significant health risks. Readers are responsible for complying with all applicable laws and regulations in their respective jurisdictions, including age restrictions and access limitations.

The information contained in this article should not be regarded as investment, legal, medical, regulatory, or commercial advice. While 2Firsts strives to ensure the accuracy and reliability of its content, it does not assume liability for any direct or indirect loss arising from errors, omissions, inaccuracies, or reliance on the information contained herein.

This article is not intended for individuals below the legal age for accessing tobacco or nicotine-related information in their jurisdiction.

 

Copyright Notice

This article is either original content produced by 2Firsts or content reproduced, translated, summarized, or adapted from third-party sources with attribution where applicable. The intellectual property rights of the original content remain with 2Firsts or the respective original rights holders.

No individual or organization may copy, reproduce, distribute, republish, modify, translate, or otherwise use this content without prior authorization. Any unauthorized use may result in legal action.

For copyright-related inquiries, corrections, or removal requests, please contact: info@2firsts.com.

 

AI-Assisted Translation and Editing Notice

Portions of this article may have been translated, edited, or reviewed with the assistance of artificial intelligence tools to improve efficiency and readability. Due to the limitations of AI-assisted translation and editing, discrepancies, omissions, or inaccuracies may exist when compared with the original source.

Where applicable, readers are advised to refer to the original source for the most complete and accurate information. If you identify any errors or believe that any content infringes upon your rights, please contact us at info@2firsts.com, and we will review and address the matter promptly.

Seita’s Julia Neumaier Says France Should Target Vape Access, Not Plain Packaging
Seita’s Julia Neumaier Says France Should Target Vape Access, Not Plain Packaging
Julia Neumaier, general manager of Seita, Imperial Brands’ French subsidiary, said France should focus vaping regulation on access control, age verification, online sales and distribution channels, rather than applying tobacco-style plain packaging to vaping products.
Jul.15
Vietnam’s Vape Crackdown Expands From Ban Proposal to Grassroots Enforcement
Vietnam’s Vape Crackdown Expands From Ban Proposal to Grassroots Enforcement
Vietnam tightens e-cigarette rules. Health Ministry proposes banning production, trade, transport, storage, ads, promotion, sponsorship, and use of e-cigarettes, heated tobacco, and new products. Hanoi also urges residents to report illegal activities, showing enforcement moves from lawmaking to local action.
Jul.08
2Firsts Data | China’s Vape-Related Exports Rise 16.5% in July 2026 as U.S.-Bound Shipments Jump 53.5%
2Firsts Data | China’s Vape-Related Exports Rise 16.5% in July 2026 as U.S.-Bound Shipments Jump 53.5%
China’s vape-related exports reached $1.047 billion in July 2026, up 16.5% year on year and the highest monthly total of the year. Growth was heavily concentrated in the U.S., where exports jumped 53.5% to $404 million and accounted for 94.9% of the overall increase. Exports to all other markets rose just 1.2%. By category, nicotine-containing non-combustible products—primarily vapes—under HS24041200 rose 24.7% and generated 95.5% of the total increase. Vape-device exports under HS85434000 fell 0.4%, while other nicotine-substitute products under HS24041990 grew 88.9% but remained comparatively small.
DATA
Aug.24
UK PM Andy Burnham Reshapes Vape Retail Rules as Licensing Could Raise Barriers for New Shops
UK PM Andy Burnham Reshapes Vape Retail Rules as Licensing Could Raise Barriers for New Shops
UK Prime Minister Andy Burnham is pushing a high street reform agenda that could give local authorities greater powers over commercial activity, including vape retail. The reforms could involve expanded planning powers and a potential vape retail licensing system, allowing councils to play a larger role in store locations and market access. The measures are part of the UK’s broader shift toward tighter vape regulation, although no nationwide vape retail restrictions have yet been implemented.
Aug.11
Product | ZAR Launches Coffee AirPouch, Expanding Pouch Format Into Caffeine Products
Product | ZAR Launches Coffee AirPouch, Expanding Pouch Format Into Caffeine Products
ZAR has introduced Coffee AirPouch, a nicotine-free caffeine pouch product that extends the brand’s AirPouch format into the functional consumer category. Each pouch contains 50mg of natural caffeine and features a coffee flavor, highlighting how pouch-based products are expanding beyond traditional nicotine applications into broader lifestyle and energy-use scenarios.
Market
Jul.13 by 2Firsts Perspectives
Product | Republic Technologies Launches ZIG Nicotine Pouches, Expanding Beyond Traditional Tobacco Accessories
Product | Republic Technologies Launches ZIG Nicotine Pouches, Expanding Beyond Traditional Tobacco Accessories
Republic Technologies UK has entered the nicotine pouch market with ZIG Nicotine Pouches, marking the company’s expansion beyond traditional tobacco-related accessories into smoke-free nicotine products. The product is expected to enter UK retail channels from August 2026, including convenience stores, supermarkets and tobacco retailers. The launch includes six flavors and three nicotine strengths: 8mg, 12mg and 17mg.
Market
Jul.21 by 2Firsts Perspectives