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.

FDA Grants PMTA Authorization to 11 ZYN ULTRA Nicotine Pouches, Bringing Total Authorized Pouches to 43
FDA Grants PMTA Authorization to 11 ZYN ULTRA Nicotine Pouches, Bringing Total Authorized Pouches to 43
The U.S. Food and Drug Administration authorized 11 ZYN ULTRA nicotine pouch products made by Swedish Match USA through the premarket tobacco product application pathway on August 21, 2026. Ten of the authorized products have a labeled nicotine content of 9 mg, while ZYN ULTRA Smooth was authorized at 11 mg. The reviews were conducted through FDA’s nicotine pouch PMTA pilot program. FDA has now authorized 43 nicotine pouch products, including 23 through the pilot.
Aug.24
UK HMRC Urges Public to Report Suspicious Vape Shops in Crackdown on Tax Fraud, Money Laundering and Illicit Tobacco Sales
UK HMRC Urges Public to Report Suspicious Vape Shops in Crackdown on Tax Fraud, Money Laundering and Illicit Tobacco Sales
HM Revenue & Customs is urging members of the public to report vape shops, barber shops and other high-street businesses suspected of tax fraud, money laundering or other illegal activity, with informants not required to provide personal details. HMRC plans more than 30,000 interventions in 2026-27 targeting tax fraud, organised crime and illicit activity, including the sale of illegal vapes and tobacco. The push forms part of a broader UK effort to tackle organised crime on high streets, backed by a £30 million government enforcement programme.
Regulations
Aug.17 by 2Firsts Perspectives
Gallery | InterTabac 2026 Opens as VAPORESSO, SKE, GREENTANK, GEEK BAR and Other Brands Take the Floor
Gallery | InterTabac 2026 Opens as VAPORESSO, SKE, GREENTANK, GEEK BAR and Other Brands Take the Floor
InterTabac 2026 opened in Dortmund, Germany, on September 15 alongside NUBIZ and InterSupply. According to the latest figures released by the organizer, the three trade shows bring together around 750 exhibitors from 64 countries. On site, 2Firsts observed vaping and related brands including VAPORESSO, DOJO, SKE, GREENTANK, GEEK BAR, HQD and ELUX.
Special Report
Sep.15
Malaysia Liquid Nicotine Returns to Poisons List, Leaving Vape Retail and RM354 Million Tax Collection in Legal Uncertainty
Malaysia Liquid Nicotine Returns to Poisons List, Leaving Vape Retail and RM354 Million Tax Collection in Legal Uncertainty
Malaysia’s withdrawal of its appeal in a landmark liquid-nicotine case has left a High Court ruling that struck down the 2023 nicotine exemption in force, bringing liquid and gel nicotine used in vaping products back under the Poisons Act 1952. At the same time, the Control of Smoking Products for Public Health Act 2024 continues to provide a regulatory framework for vaping products, creating uncertainty over retail sales, taxation and existing inventory. MPs are calling for nicotine vape sales and excise collection to stop, including refunds of more than RM354 million collected since 2023, while industry and consumer groups are asking the government to clarify the current legal position.
Sep.04
China’s Zhengzhou Tobacco Research Institute develops end-to-end heated tobacco analysis to trace aerosol compound origins
China’s Zhengzhou Tobacco Research Institute develops end-to-end heated tobacco analysis to trace aerosol compound origins
The Zhengzhou Tobacco Research Institute of China National Tobacco Corporation has filed a patent application for an end-to-end method to analyze the migration and transformation of chemical compounds in heated tobacco products. Using GC-Orbitrap/MS non-targeted analysis, the method compares tobacco substrate and aerosol samples to distinguish compounds transferred directly from the substrate from those newly formed during heating, while also calculating transfer rates. In an example involving nine heated tobacco products, the patent identified 17 newly formed thermal decomposition compounds and 38 transferred compounds.
Aug.13
UK HMRC Unveils Red and Yellow Transitional Vape Duty Stamps Ahead of October Tax Launch
UK HMRC Unveils Red and Yellow Transitional Vape Duty Stamps Ahead of October Tax Launch
HM Revenue & Customs (HMRC) has released sample images of the UK’s transitional vaping duty stamps, showing red and yellow versions ahead of the new Vaping Products Duty and Vaping Duty Stamps Scheme starting on October 1, 2026. Transitional stamps contain physical security features but no digital scanning function. Approved businesses may purchase them through November 30 and affix them through December 31. HMRC has not stated that the red and yellow samples represent different product categories or tax statuses.
Regulations
Sep.02