Smoking regular or non-combustible cigarettes while sporting a surgical mask causes a twofold increase in exhaled carbon monoxide and decreased blood vessel function when compared to non-mask times.
This is the finding of a study that was released today in the European Journal of Preventive Cardiology, a publication of the ESC.
The need to wear a mask for extended periods of time during the COVID-19 pandemic, according to study author Professor Ignatios Ikonomidis of the National and Kapodistrian University of Athens, Greece, “suggests that smoking any tobacco product has become even more hazardous during the COVID-19 pandemic.”
Prior research has shown a link between vascular dysfunction, heart disease, and early mortality.
The study’s subjects included conventional (combustible) cigarettes and non-combustible cigarettes, also referred to as “heated” or “heat not burn” tobacco products.
Electronically heating the tobacco to a lower temperature than a combusted cigarette results in an inhalable aerosol of nicotine when smoking non-combustible cigarettes.
E-cigarettes, also known as vaping, which electrically heat a liquid containing nicotine to create an aerosol that is inhaled, were not included in the study.
The levels of carbon monoxide inhaled by smokers who wore masks during work hours and smokers who did not wear masks on off-duty days were compared by the researchers.
The second phase of the study examined whether changes in blood vessel function coincided with changes in carbon monoxide exposure.
In the study, 40 medical professionals of a similar age and gender who did not smoke were compared to 40 conventional cigarette smokers, 40 exclusive heat-not-burn cigarette users, and 40 nonsmokers.
People with known cardiovascular disease, hypertension, diabetes, dyslipidemia, chronic renal disease, or atrial fibrillation were excluded from the study because these conditions may affect vascular function.
The researchers looked at vascular function markers and carbon monoxide exhaled after a deep breath (pulse wave velocity, augmentation index and central systolic blood pressure).
Baseline assessments were finished early in the morning after sleeping without a mask in order to obtain values following a protracted period of quitting smoking.
After either an eight-hour shift wearing a mask or an eight-hour break without one, participants were assigned to a second evaluation.
They then moved on to a third test after either eight hours of rest without a mask or eight hours of work wearing a mask.
The average age of the participants was 45, and 72% of them were female. The same number of cigarettes, whether combustible or not, were smoked during mask and non-mask periods.
Conventional cigarette smokers increased their exhaled carbon monoxide from 8.00 to 12.15 ppm without a mask and from 8.00 to 17.45 ppm with a mask when compared to nonsmokers.
Non-combustible cigarette smokers’ exhaled carbon monoxide was 1.15 ppm at baseline, increasing to 1.43 ppm without a mask and 2.20 ppm with one.
During the baseline, non-mask, and mask periods, the exhaled carbon monoxide in non-smokers remained constant.
Wearing a mask increased all vascular markers in smokers of both combustible and non-combustible cigarettes more than not wearing one. Over the course of the three time periods, non-smokers’ vascular indicators remained constant.
According to Professor Ikonomidis, non-combustible cigarette users showed lower carbon monoxide levels at baseline and smaller increases in vascular damage when wearing a mask compared to combustible cigarette smokers.
However, the findings imply that smoking any tobacco product while donning a mask may worsen blood vessel function when compared to when not donning a mask, at least partially as a result of increased re-inhalation of carbon monoxide and/or nicotine-rich vapour.
The findings provide smokers with even more motivation to stop their habit.
