Effects of using electronic cigarettes on nicotine delivery and cardiovascular function in comparison with regular cigarettes

Regul Toxicol Pharmacol. 2015 Feb;71(1):24-34. doi: 10.1016/j.yrtph.2014.11.004. Epub 2014 Nov 22.


The development of electronic cigarettes (e-cigs) has the potential to offer a less harmful alternative for tobacco users. This clinical study was designed to characterize e-cig users' exposure to nicotine, and to investigate the acute effects of e-cigs on the hemodynamic measurements (blood pressure and heart rate) in comparison with the effects of regular smoking. Five e-cigs and one Marlboro® cigarette were randomized for twenty-three participants under two exposure scenarios from Day 1 to Day 11: half-hour controlled administration and one hour ad lib use. The nicotine plasma concentrations after 1.5h of product use (C90) were significantly lower in the users of e-cigs than of Marlboro® cigarettes. The combination of glycerin and propylene glycol as the vehicle facilitated delivery of more nicotine than glycerin alone. The heart rate, systolic and diastolic blood pressure were significantly elevated after use of Marlboro® cigarettes, but the elevation was less after use of most of the e-cigs. Use of e-cigs had no impact on the exhaled CO levels, whereas the Marlboro® cigarette significantly increased the exhaled CO more than 8 times above the baseline. In conclusion, e-cigs could be a less harmful alternative for tobacco users.

Keywords: Carbon monoxide; Cardiovascular function; Electronic cigarette; Nicotine; Smoking.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure / drug effects
  • Carbon Monoxide / metabolism
  • Cross-Over Studies
  • Electronic Nicotine Delivery Systems*
  • Female
  • Heart Rate / drug effects
  • Humans
  • Male
  • Middle Aged
  • Nicotine / blood
  • Single-Blind Method
  • Tobacco Products / toxicity*
  • Young Adult


  • Nicotine
  • Carbon Monoxide