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.

Special Report | Russia, Ukraine and Belarus Launch Fresh Push to Rein in Vaping
Special Report | Russia, Ukraine and Belarus Launch Fresh Push to Rein in Vaping
Russia, Ukraine and Belarus are tightening vape regulation through different tools, from Ukraine’s stronger enforcement push and Belarus’s proposed advertising restrictions to Russia’s new GOST standard and regional sales-ban mechanism. As black-market concerns persist, some Russian experts argue that China’s tightly controlled but legalised model — built around licensing, traceability and taxation — may offer a more effective alternative to blanket prohibition.
Jul.15
New Zealand Associate Health Minister Casey Costello Warns on Illicit Cigarettes as Legal Tobacco Sales Halve Over Decade
New Zealand Associate Health Minister Casey Costello Warns on Illicit Cigarettes as Legal Tobacco Sales Halve Over Decade
New Zealand Associate Health Minister Casey Costello said legal tobacco sales in the country have fallen by more than half over the past decade, with sales declining more than 20% in 2025 compared with the previous year. She warned that the decline may not fully reflect lower smoking rates, as increased availability of illicit cigarettes could also be contributing. The government said it would continue strengthening tobacco and vape retail enforcement while monitoring the impact of illicit tobacco on public health and tax revenue.
Aug.26
UK PM Andy Burnham Shifts Business Rates Policy, Supporting Hospitality While Raising Pressure on Vape Shops
UK PM Andy Burnham Shifts Business Rates Policy, Supporting Hospitality While Raising Pressure on Vape Shops
UK Prime Minister Andy Burnham’s government is adjusting business rates policy to support hospitality businesses while some other sectors, including vape retailers, face higher operating cost pressures. According to Streamline Feed, AJ Bell and other reports, the policy shift reflects a redistribution of business rate burdens as the government seeks to support sectors facing economic pressure. For UK vape shops, the change comes amid a broader regulatory environment shaped by the disposable vape ban, the upcoming Vaping Products Duty and increased compliance requirements.
News
Jul.24
French Vape Market Under Pressure as Europe’s First Listed Vape Company Kumulus Vape Reports 7.8% H1 Revenue Decline, Retail Sales Rise 41.5%
French Vape Market Under Pressure as Europe’s First Listed Vape Company Kumulus Vape Reports 7.8% H1 Revenue Decline, Retail Sales Rise 41.5%
Kumulus Vape, Europe’s first publicly listed vape company, reported a 7.8% year-on-year decline in first-half 2026 revenue. Amid changing conditions in France’s vape market, the company said channel diversification helped offset pressure, with physical store sales increasing 41.5% year on year. Listed on Euronext Access Paris in 2019 and later transferred to Euronext Growth Paris, Kumulus Vape is viewed as a representative company of Europe’s vape sector. Its performance highlights the industry’s shift from rapid expansion toward more operationally focused growth.
Jul.27
UK Sets Oct. 29 Start for New Vape Retail Rules Covering Age Checks, Giveaways and Discounts
UK Sets Oct. 29 Start for New Vape Retail Rules Covering Age Checks, Giveaways and Discounts
The UK Department of Health and Social Care published new guidance on Aug. 11 outlining the next phase of retail rules under the Tobacco and Vapes Act 2026, which will take effect on Oct. 29, 2026. The measures extend the minimum age of sale of 18 to all vaping and consumer nicotine products and restrict proxy purchasing, promotional giveaways and substantial discounts. Relevant offences in England, Wales and Scotland may carry a £200 fixed penalty notice, while persistent offenders can face temporary sales bans.
Aug.12
EU ‘TPD3’ Enters Next Phase on Aug. 14 as Fragmented Vape and Nicotine Pouch Rules Push the Single Market Toward Regulatory Overhaul
EU ‘TPD3’ Enters Next Phase on Aug. 14 as Fragmented Vape and Nicotine Pouch Rules Push the Single Market Toward Regulatory Overhaul
A 12-week European Commission consultation on revising the Tobacco Products Directive and Tobacco Advertising Directive is due to close on Aug. 14, 2026. The Commission has identified e-cigarette flavours, disposable vapes, tobacco heating devices, nicotine pouches, nicotine-free e-cigarettes, packaging and digital marketing among areas for possible new EU rules. National regulations already vary significantly across the bloc, a fragmentation the Commission says creates internal-market barriers and distorts competition. No formal revised TPD/TAD legislative text has yet been published, with the Commission currently indicating December 2026 for the legislative initiative.
Aug.14