The health risks of dual use of electronic and combustible cigarettes: exposure to acrylamide and glycidamide.

Abstract

INTRODUCTION\nThe combustible cigarette is a significant source of acrylamide, which cause many health hazards. Electronic cigarettes are an emerging smoking device with uncertain health effects.\n\n\nOBJECTIVES\nTo explore the exposure risks of acrylamide (AA) with serum sample and measurable biomarkers hemoglobin-adducted acrylamide (HbAA) and hemoglobin-adducted glycidamide (HbGA) in the general adult smoking population with different smoking conditions.\n\n\nPATIENTS AND METHODS\nA cross-sectional study of 1657 participants ≥ 18 years old from the U.S. National Health and Nutrition Examination Survey (2015-2016) with recorded smoking conditions and HbAA and HbGA concentrations was utilized. Multivariable linear regression models were used to analyze HbAA and HbGA in different smoking groups (non-smokers, cigarettes smoking only, e-cigarettes smoking only and dual users).\n\n\nRESULTS\nDual users had the highest HbAA and HbGA concentrations (pmol/gHb) (medians (IQR)) (HbAA: 83.75 (53.28-128.25); HbGA: 61.20 (40.73-89.78)). A positive association between usage of e-cigarette and HbAA concentration was noted. The standardized β coefficients of HbAA and HbGA between the C-smoker and non-smokers in the fully adjusted model were 0.312 and 0.255 (both P < 0.001) and those between the dual-users and non-smokers in the fully adjusted model were 0.396 and 0.342 (both P < 0.001), respectively.\n\n\nCONCLUSIONS\nThis study indicates the exposure of AA using e-cigarettes and highlights the harmful results of dual users. Aside from the adverse effects caused by e-cigarette smoking, co-exposure risks of combustible cigarettes and e-cigarettes need to be delivered to the public. Further studies are encouraged to aid in health promotion.