Dissertation
Associations of electronic cigarette use, menthol cigarette use, and cardiovascular outcomes
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Autumn 2022
DOI: 10.25820/etd.006782
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the United States. Cigarette smoking is one the most significant modifiable risk factors for CVD. Due to the decades of efforts towards tobacco control, there have been significant declines in conventional cigarette smoking. However, the increasing prevalence of electronic cigarettes (e-cigarettes) and menthol cigarettes may have negated the impact of tobacco control on CVD. Emerging evidence, although still sparse and inconsistent, suggests associations between electronic cigarettes, menthol cigarettes and cardiovascular outcomes. The objective of this research was to characterize CVD risk among adults who use e-cigarettes or menthol cigarettes.
First, I examined the association of e-cigarette use with CVD among U.S. adults using prospective data from the Population Assessment of Tobacco and Health (PATH) Study. After adjustment for demographic, socioeconomic, lifestyle factors and other chronic conditions, I found a significant association of e-cigarette use with incident CVD. Second, I examined the association of menthol cigarette use with CVD among U.S. adults using prospective data from the PATH study. After adjustment for demographic, socioeconomic, lifestyle factors and other chronic conditions, smoking menthol cigarettes did not increase CVD risk compared with smoking non-menthol cigarettes. Third, using data from the National Health Interview Survey (NHIS), I examined the association between menthol cigarette use and cardiovascular mortality among U.S. adults. I found that the risks for CVD death were comparable between menthol cigarette smokers and non-menthol cigarette smokers.
In summary, this study indicates that e-cigarette use is a potential risk factor associated with increased CVD risk, relative to not smoking. In addition, the risks of CVD morbidity and mortality were comparable between menthol cigarette smokers and non-menthol cigarette smokers. If these findings are replicated and confirmed in other studies, individuals using e-cigarettes should be considered as a target population to reduce CVD burden, and continued efforts for smoking cessation (menthol and non-menthol cigarettes) are still needed.
Details
- Title: Subtitle
- Associations of electronic cigarette use, menthol cigarette use, and cardiovascular outcomes
- Creators
- Yang Du
- Contributors
- James Torner (Advisor)Wei Bao (Committee Member)Robert Wallace (Committee Member)Linda G. Snetselaar (Committee Member)Sarah Nash (Committee Member)Kai Wang (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Epidemiology
- Date degree season
- Autumn 2022
- DOI
- 10.25820/etd.006782
- Publisher
- University of Iowa
- Number of pages
- xv, 155 pages
- Copyright
- Copyright 2022 Yang Du
- Language
- English
- Description illustrations
- Charts, graphs, tables
- Description bibliographic
- Includes bibliographical references (pages 136-151).
- Public Abstract (ETD)
About 659,000 people in the US die from heart disease each year. Smoking causes approximately one of every four deaths from CVD. Despite success in tobacco control, there is an increasing number of people using electronic cigarettes and menthol cigarettes. Therefore, it is important to know whether using e-cigarettes or menthol cigarettes increase the risk of developing CVD. While accumulating evidence indicates individuals using e-cigarettes or menthol cigarettes are more likely to have CVD than tobacco non-users, the associations remain largely unknown.
In this study, I found a higher risk of CVD among adults who used e-cigarettes, relative to non-smokers, after considering many CVD- and tobacco-related factors. In addition, I found that menthol does not appear to increase a smoker’s risk for CVD or CVD death among adults in the US, compared to smoking non-menthol cigarettes.
In summary, this study indicates that e-cigarette use is a potential risk factor for CVD. Furthermore, the risks of CVD morbidity and mortality were comparable between menthol cigarette smokers and non-menthol cigarette smokers. The results of these studies underline the need for continued efforts towards tobacco control and suggest targeted intervention for individuals using e-cigarettes.
- Academic Unit
- Epidemiology
- Record Identifier
- 9984362557702771
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