Korean J Fam Pract.  2021 Jun;11(3):184-190. 10.21215/kjfp.2021.11.3.184.

Association between Electronic Cigarettes, Conventional Cigarettes, and Dual Use and Inflammation and Oxidative Stress: The Seventh Korean National Health and Nutrition Examination Survey 2016–2018

• Seo Hj
• Kim Jh
• Kim Sa
• Shin Wy
• Lee Jw
• Cho SH

• KMID: 2516842
• DOI: http://doi.org/10.21215/kjfp.2021.11.3.184

Abstract

Background
The rate of e-cigarette use is increasing due to the perception that there is a smoking cessation effect and that there is relatively low harm; most users use e-cigarettes in combination with conventional cigarettes. Therefore, this study compares the systemic inflammation and oxidative stress among groups of people with realistic smoking patterns: conventional smokers (CS), only e-cigarette smokers (ECS), dual users (DS), and nonsmokers (NS).
Methods
Data from the Korean National Health and Nutrition Examination Survey VII (2016–2018) were used. We compared urinary cotinine (Ucot) as a nicotine indicator, uric acid (UA) and high sensitivity C-reactive protein (hsCRP) as inflammation indicators, and folate, vitamin A, and vitamin E, which are antioxidants, as oxidative stress indicators. A complex samples general linear regression was performed.
Results
Altogether, 5,191 participants were divided into 940 CS, 110 DS, 23 ECS, and 4,118 NS. Ucot levels were higher in all smoking groups than in NS, with the highest value in DS (P<0.001). UA levels were higher in all smoking groups and significantly higher in DS than in CS (P<0.01). hsCRP levels were higher in all smoking groups but not at a statistically significant level. Contrary to the expectation that antioxidants would be low in smokers, all oxidative stress indicators were higher in DS than in NS.
Conclusion
Nicotine exposure in dual users was not significantly different from that in conventional smoking, and UA was significantly higher in dual users than in conventional smoking. Therefore, it is necessary to provide adequate smoking cessation education for e-cigarette smokers.

Keyword

Smoking; E-Cigarette; Dual Users; Inflammation; Oxidative Stress