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| ID | Type | Description | Link |
|---|---|---|---|
| 1R01HL139331-01 | U.S. NIH Grant/Contract | View source | |
| Protocol Version 4/26/2021 | Other Identifier | UW Madison | |
| A534225 | Other Identifier | UW Madison | |
| SMPH\MEDICINE\CARDIOLOGY | Other Identifier | UW Madison |
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| Name | Class |
|---|---|
| National Institutes of Health (NIH) | NIH |
| National Heart, Lung, and Blood Institute (NHLBI) | NIH |
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This study is designed to enhance the understanding of the possible health effects of e-cigarette use by relating the acute and long-term use of e-cigarettes and conventional cigarettes ("products") to well-validated cardiovascular and pulmonary disease biomarkers. Participants will be enrolled in 3 groups: exclusive e-cigarette users, exclusive cigarette smokers, and a control group of never-users. Participants can expect up to 4 weeks of study participation.
E-cigarette use is increasing rapidly in the United States, especially amongst youth, underscoring the vital need to improve understanding of its health risks. Relevant data could inform policy, guide public health and clinical intervention efforts, and inform individuals who might use or who are using this product. This research will significantly enhance the understanding of the possible health effects of e-cigarette use by relating the acute and long-term use of e-cigarettes and conventional cigarettes ("products") to well-validated cardiovascular and pulmonary disease biomarkers. 3 different "use-groups" of participants will be enrolled: exclusive e-cigarette users (n=165), exclusive cigarette smokers (n=165), and a "control" group of never-users (n=110). These groups reflect the primary decisions that people can make regarding their future tobacco use: to continue to smoke cigarettes, to switch to e-cigarettes, or to avoid tobacco use entirely. It is essential that smokers and health care providers have accurate information on the health effect of these choices.
[Additionally, 100 participants will be invited to be part of an epigenetics sub-study (50 E-cig users, 25 smokers and 25 controls), prior to smoking, an additional 16 ml of blood will be collected in Vacutainer cell separation tubes for peripheral blood monocyte (PBMC) Isolation containing sodium citrate.]
Product use will be related to well-validated biomarkers that sensitively and reproducibly reflect mechanisms, injury, and/or future risk related to cardiovascular or pulmonary disease. Biomarkers will be related to: 1) acute product use in the laboratory (exposure challenges), 2) lifetime history of product use, and/or 3) real-time measures of product use in participants' daily lives. The primary cardiovascular biomarkers are brachial artery flow-mediated dilation (a measure of endothelial function) and carotid intima-media thickness, a measure of subclinical arterial injury and atherosclerosis. The primary pulmonary disease biomarkers will be measures of lung volumes and flow rates (Forced Expiatory Volume exhaled in the first second (FEV1), Forced vital capacity (FVC), FEV1/FVC) obtained by spirometry. Treadmill exercise stress testing will be performed (to assess aerobic fitness), electrocardiography (to measure heart rate variability, HRV), and measure heart rate, blood pressure, lipids, HgbA1c, and inflammation/oxidation markers (leukocyte count, C-reactive protein, urinary F2 isoprostanes and exhaled nitric oxide). This research will show how product use-groups differ in response to acute product use and long-term use as they are related to key cardiovascular and pulmonary biomarkers. Objective measures of product use include exhaled CO and plasma nicotine/cotinine and urinary nicotine/cotinine concentrations. History of product use within use-groups will be related to biomarker status.
The proposed research will yield vital and comprehensive data regarding product use, subclinical arterial injury, atherosclerosis burden, arterial and pulmonary function, cardiac and aerobic fitness, cardiac autonomic regulation, systemic and pulmonary inflammation, and oxidative stress, as well as other key outcomes. These data will serve as a foundation for future longitudinal investigations of e-cigarette health effects and will inform public policy decisions, clinical intervention, and patient guidance regarding e-cigarettes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exclusive Smokers | Smokes Daily; >/= 5 cigarettes/day for last 6 months |
| |
| Exclusive E-Cig users | E-cig usage >/= 5 days/week for last 3 months |
| |
| Never users | < 100 cigarettes in lifetime, none for > 5 years; < 3 E-cig usage in lifetime |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cigarettes | Behavioral | smokes daily |
| |
| E-Cigarettes |
| Measure | Description | Time Frame |
|---|---|---|
| Brachial Artery Flow-Mediated Dilation (FMD)- Pre Challenge | Brachial Artery Flow-Mediated Dilation is a primary cardiovascular biomarker and a measure of endothelial function that will be assessed before and after an acute exposure challenge. These are pre-challenge values. Ultrasound based changes in brachial artery diameter after a forearm cuff occlusion (250mmHg) for 5 minutes. FMD is the percent change in brachial diameter measured 60 to 90 seconds post cuff release compared to its resting diameter. A higher % dilation is an indication of better endothelial function. | V2 up to 4 weeks from enrollment visit, fasting |
| Forced Expiratory Volume (FEV1)- Pre Challenge | FEV1 is a primary measure of pulmonary disease obtained by spirometry that will be assessed before and after an acute exposure challenge. These are per-challenge values | V2 up to 4 weeks from enrollment visit , fasting, pre challenge session |
| Carotid Intima-Media Thickness (IMT) | Carotid Intima-Media Thickness is a cardiovascular biomarker and a measure of sub-clinical arterial injury and atherosclerosis as a result of chronic exposure. IMT will be measured via ultrasonography. | V2 up to 4 weeks from enrollment visit, only done pre-challenge |
| Changes in Systolic Blood Pressure Pre- and Post-challenge. | Visit 2 was scheduled up to 4 weeks from enrollment visit, fasting.. They came in the morning after 8 hours of fasting and refraining from nicotine products. Systolic blood pressure (left brachial artery using an oscillometric method) was measured supine, after 10 minutes rest ("Pre") and repeated after they underwent smoking or vaping changes. The "post challenge" blood pressures were recorded 15-20 minutes post end of exposure. For controls, all measurements were repeated in the same order after a 10 minute break. | During Visit 2 (1 - 4 weeks post enrollment) before and after smoking/vaping challenge and for controls after a 10 minute break |
| Measure | Description | Time Frame |
|---|---|---|
| Heart Rate (HR) | Heart Rate pre-acute exposure challenge was obtained after resting supine for 10 minutes during V2 in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. | Participants attended V2 generally 1-4 weeks after enrollment with a window that allowed up to 4 weeks after enrollment |
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Inclusion Criteria:
able to read and write English
no plans to quit smoking and/or e-cig use in the next month
not using cigars/smokeless/snus tobacco >/= 1 time per week
having a stable pattern of current product use
able to walk at least 2 blocks without assistance or stopping
Specific to Exclusive Smokers:
Specific to Exclusive E-cig users:
Specific to Never-users
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165 exclusive E-cig users, 165 exclusive cigarette smokers, and 110 never-users will be enrolled. Tobacco product use will be examined via time-line follow-back use-history measures, real-time measures, and lab measures. Potential participants will be assessed for eligibility via a phone screen. Because biomarker status may be affected by age and sex, groups will be stratified equally for gender (48/52 male/female) and age (≤35/>35 years).
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| Name | Affiliation | Role |
|---|---|---|
| James H Stein, MD | University of Wisconsin, Madison | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Wisconsin | Madison | Wisconsin | 53792 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37044158 | Result | Tattersall MC, Hughey CM, Piasecki TM, Korcarz CE, Hansen KM, Ott NR, Sandbo N, Fiore MC, Baker TB, Stein JH. Cardiovascular and Pulmonary Responses to Acute Use of Electronic Nicotine Delivery Systems and Combustible Cigarettes in Long-Term Users. Chest. 2023 Sep;164(3):757-769. doi: 10.1016/j.chest.2023.03.047. Epub 2023 Apr 10. |
| Label | URL |
|---|---|
| link to full manuscript with published results for this trial | View source |
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Our plan includes the creation of a data archive with coded information in computer-readable form for distribution to the scientific community using the procedures outlined below. The information will include a codebook with definitions of variables, variable field locations, summary statistics and any standard scoring. Final data sets will be stripped of identifiers prior to release for sharing (the release of a limited data set containing one or more specific identifiers would be considered if absolutely required by the researcher and if the request meets all University of Wisconsin -Institutional Review Board and Office of Human Research Protections policies. We will make all key variables available via posting of final data codebook and dataset in suitable archives. All shared variables and datasets will be de-identified and approved for sharing by the University of Wisconsin and Institutional Review Board
After data has been collected and analyzed.
In accord with an Institutional Review Board-approved study consent that will permit sharing of study data sets under University of Wisconsin and Institutional Review Board policies, University of Wisconsin Center for Tobacco Research and Intervention will act under its own auspices as the hub for making data related to these topics available. We will make the final de-identified study dataset available by request from other researchers in accord with NHLBI policy.
Participants tested for Exhaled CO and urinary nicotine to determine if they qualified for either arm of the study. E-cigarette vapers exclusively (exhaled CO less than 5 ppm and nicotine in urine), cigarettes exclusively (CO more or equal 5 ppm, positive urine nicotine), and controls (CO less than 5 ppm, and negative nicotine in urine). NOTE: one participant was enrolled twice completing all study visits. Later, when this was noticed, we amended procedures, only his initial data was used.
March 5 2019 started enrollment, ended last visit March 9th 2022. Studies were conducted at the University of Wisconsin Hospital and Clinics and the Center for Tobacco Research and Intervention (CTRI) in Madison, WI and for a short period we also at CTRI location in Milwaukee,WI.
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| ID | Title | Description |
|---|---|---|
| FG000 | Exclusive Smokers | Smokes Daily; >/= 5 cigarettes/day for last 6 months Cigarettes: smokes daily |
| FG001 | Exclusive E-Cig Users | E-cig usage >/= 5 days/week for last 3 months E-Cigarettes: E-cigarette usage >/= 5 days/week |
| FG002 | Never Users | < 100 cigarettes in lifetime, none for > 5 years; < 3 E-cig usage in lifetime |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
results are reported for only those participants who completed the final study visit, when outcome data was collected.
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| ID | Title | Description |
|---|---|---|
| BG000 | Exclusive Smokers | Smokes Daily; >/= 5 cigarettes/day for last 6 months Cigarettes: smokes daily |
| BG001 | Exclusive E-Cig Users | E-cig usage >/= 5 days/week for last 3 months E-Cigarettes: E-cigarette usage >/= 5 days/week |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Brachial Artery Flow-Mediated Dilation (FMD)- Pre Challenge | Brachial Artery Flow-Mediated Dilation is a primary cardiovascular biomarker and a measure of endothelial function that will be assessed before and after an acute exposure challenge. These are pre-challenge values. Ultrasound based changes in brachial artery diameter after a forearm cuff occlusion (250mmHg) for 5 minutes. FMD is the percent change in brachial diameter measured 60 to 90 seconds post cuff release compared to its resting diameter. A higher % dilation is an indication of better endothelial function. | % FMD pre-challenge after 8 hours refraining from nicotine exposure. A higher % dilation is an indication of better endothelial function. | Posted | Mean | Standard Deviation | Percent change from resting diameter | V2 up to 4 weeks from enrollment visit, fasting |
|
2 years
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Exclusive Smokers | Smokes Daily; >/= 5 cigarettes/day for last 6 months Cigarettes: smokes daily |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | Non-systematic Assessment | one e-cigarette user felt transient nausea after vaping |
Observational study, changes observed with product challenge are not proof of the causal effects.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr James H. Stein | University of Wisconsin-Madison | 608-262-2075 | jhs@medicine.wisc.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 26, 2021 | Apr 28, 2023 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | May 5, 2021 | Apr 26, 2023 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D064424 | Tobacco Use |
| D000072137 | Vaping |
| D002318 | Cardiovascular Diseases |
| D008171 | Lung Diseases |
| ID | Term |
|---|---|
| D001519 | Behavior |
| D012907 | Smoking |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D062789 | Tobacco Products |
| D066300 | Electronic Nicotine Delivery Systems |
| ID | Term |
|---|---|
| D000074602 | Smoking Devices |
| D008420 | Manufactured Materials |
| D013676 | Technology, Industry, and Agriculture |
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| Behavioral |
E-cigarette usage >/= 5 days/week |
|
|
| Changes in Diastolic Blood Pressure Pre- and Post-challenge. | Participants returned for V2 up to 4 weeks from enrollment visit, fasting. They came in the morning after 8 hours of fasting and refraining from nicotine products. Diastolic blood pressure (left brachial artery using an oscillometric method) was measured supine, after 10 minutes rest ("Pre") and repeated after they underwent smoking or vaping changes. The "post challenge" blood pressures were recorded 15-20 minutes post end of exposure. For controls, all measurements were repeated in the same order after a 10 minute break. | before and after smoking/vaping challenge during Visit 2 (up to 4 weeks from enrollment) |
| Changes in Heart Rate Pre- and Post-challenge. | Visit 2 was scheduled up to 4 weeks from enrollment visit, fasting. Participants attended fasting and refraining from nicotine products for at least 8 hours prior. All visits were in the morning. Pre-challenge heart rate measured supine, after 10 minutes rest from blood pressure monitor (dinamap). The post challenge heart rates were recorded 15-20 minutes post end of exposure to smoking or vaping challenge completion or in the case of controls after a 10 minute break. | Before and after smoking/vaping challenge during Visit 2 (up to 4 weeks from enrollment) |
| Changes in Brachial Artery Diameter Pre- and Post-challenge | Visit 2 was scheduled up to 4 weeks from enrollment visit. Participants attended fasting and refraining from nicotine products for at least 8 hours prior. All visits were in the morning. Pre-challenge brachial artery diameter imaged with ultrasound after resting supine for 10 minutes before and repeated 15-20 minutes after smoking/vaping challenge ended. or in the case of controls after a 10 minute break. | before and after smoking/vaping challenge during Visit 2 (up to 4 weeks from enrollment) |
| Changes in Brachial Artery Flow Mediated Dilation (FMD) Pre- and Post-challenge | Visit 2 was scheduled up to 4 weeks from enrollment visit. Participants attended fasting and refraining from nicotine products for at least 8 hours prior. All visits were in the morning. Pre-challenge ultrasound of brachial artery diameter imaged with ultrasound after resting supine for 10 minutes before and repeated 15-20 minutes after smoking/vaping challenge ended. or in the case of controls after a 10 minute break. The FMD protocol includes measuring % change in resting diameter after 60-90 seconds post fore-arm cuff occlusion release. | Testing was done after 10 minutes rest and fasting for pre- and post-challenge. The post challenge FMD were recorded 15-20 minuted after end of exposure (up to 4 weeks from enrollment) |
| Changes in Percent of Sequential Heart Cycles That Differ by More Than 50 ms From Each Other in Length (PNN50, %) Pre- and Post-challenge | Expressed as a percentage of beats (supine recordings had be 5 minutes or longer to be valid). We used the SphygmoCor system for these recordings (Atcor medical). Participants attended V2 1-2 weeks after enrollment visit. They came in the morning fasting and refraining from nicotine for at least 8 hours. Heart rate variability was recorded supine for 10 minutes or more, pre and post smoking/vaping challenge. For controls is was repeated after a 10-minute break. | During V2 (scheduled up to 4 weeks from enrollment) and obtained after 10 minutes of supine rest, before and after smoking/vaping challenge |
| Changes in Root Mean Square of Successive Differences Between Normal Heart Beats (RMSSD, ms) Pre- and Post-challenge | Participants attended V2 up to 4 weeks after enrollment visit. They came in the morning fasting and refraining from nicotine for at least 8 hours. Heart rate variability was recorded supine for 10 minutes or more, pre and post smoking/vaping challenge. For controls it was repeated after a 10 minute break. | heart rate variability recordings of at least 10 minutes per-challenge and 15 minutes post-challenge (up to 4 weeks from enrollment) |
| Changes in Heart Rate Variability Standing Ratio Pre- and Postchallenge | We used the SphygmoCor system for these recordings (Atcor medical). Participants attended V2 up to 4 weeks after enrollment visit. They came in the morning fasting and refraining from nicotine for at least 8 hours. Heart rate variability standing ratio was assessed pre and post smoking/vaping challenge. For controls is was repeated after a 10-minute break. Ratio between maximal heart rate after abrupt standing from a supine position and the subsequent lowest heart rate value within 40 seconds of peak. | Ratio was measured pre- and post- smoking/vaping challenge after completion of the 10 minutes of heart rate variability measures (up to 4 weeks from enrollment) |
| Changes in Predicted Forced Expiatory Volume in 1 Second (FEV1, %) Pre- and Post-challenge | maximum amount of air that the subject can forcibly expel during the first second following maximal inhalation, expressed as a percentage of the predicted normal values in the population. Participants attended V2 1-4 weeks after enrollment. They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge spirometry was performed sitting before all other tests and repeated within 15 minutes after smoking/vaping challenge. | before and after smoking/vaping challenge during Visit 2 (1-4 weeks after enrollment visit) |
| Changes in Forced Vital Capacity (FVC, %) Pre- and Post-Challenge. | Amount of air that can be forcibly exhaled after taking the deepest breath possible expressed as a predicted percentage from the normal population. Participants attended V2 1-4 weeks after enrollment. They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge spirometry was performed sitting before all other tests and repeated within 15 minutes after smoking/vaping challenge. | before and after smoking/vaping challenge during Visit 2 Visit 2 which was scheduled 1 to 4 weeks from enrollment visit, fasting |
| Changes in Ratio Between Predicted Forced Expiatory Volume in First Second and Predicted Total Vital Capacity (FEV1/FVC Ratio) Pre- and Post-challenge | The post challenge spirometry was recorded <15 minutes post end of exposure. Participants attended V2 1-4 weeks after enrollment. They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge spirometry was performed sitting before all other tests and repeated within 15 minutes after smoking/vaping challenge. | before and after smoking/vaping challenge during Visit 2 (1-4 weeks after enrollment visit) |
| Changes in Percent Predicted Forced Expiratory Flow at 25 and 75% of the Pulmonary Volume (FEF 25-75, %) Pre and Pos-challenge | Participants attended Visit 2 (1-4 weeks after enrollment visit). They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge spirometry was performed sitting before all other tests and repeated within 15 minutes after smoking/vaping challenge. | Spirometry performed pre-challenge and within 15 minutes post-challenge (up to 4 weeks from enrollment) |
| Changes in Fractional Exhaled Nitric Oxide (FeNO, Ppb) Pre- and Post-challenge | Participants attended V2 1-4 weeks after enrollment. They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge FeNO was obtained sitting and repeated within 15 minutes after smoking/vaping challenge. | before and after less than 15 minutes from smoking/ vaping product (up to 4 weeks from enrollment) |
| Heart Rate Variability (HRV) - Pre Product Use Challenge |
Heart Rate Variability PNN50(%) measured before an exposure challenge. Participants attended visit 2 fasting and refraining from nicotine for at least 8 hours. |
| V2 two was generally scheduled 1-4 weeks after enrollment visit with a window up to 4 weeks. HRV measures obtained after resting supine for 10 minutes |
| Systolic Blood Pressure (BP) | Blood Pressure measured using the oscillometric technique before an acute exposure challenge following standardized protocol. After resting supine for 10 minutes blood pressure was measured on both arms and the average of the last two values was used. | V2 was up to 4 weeks from enrollment visit, after resting supine for 10 minutes |
| Forced Vital Capacity (FVC) | Forced Vital Capacity is a measure of how much air can be exhaled forcefully obtained by spirometry pre acute exposure challenge. | recordings obtained during V2 in the morning, fasting and refraining from nicotine for at least 8 hours. This visit was generally 1-2 weeks after enrollment date with a window up to 4 weeks |
| Fractional Exhaled Nitric Oxide (FeNO) | Fractional Exhaled Nitric Oxide is a measure of airway inflammation measured before an acute exposure challenge. | recordings obtained during V2 in the morning, fasting and refraining from nicotine for at least 8 hours. This visit was generally 1-2 weeks after enrollment date with a window up to 4 weeks |
| Autonomic Measures - RMSSD | Root mean square of standard deviation of rr intervals. Obtained fasting and refraining from nicotine exposure using the Sphymocor system. We used 10 or more minutes of supine data to derive heart rate variability measures. | v2 was generally 1-2 weeks after enrollment visit, with a window up to 4 weeks from V1 |
| Arterial Pulse Wave Analysis (PWA), Augmentation Index (at 75 Bpm, %) | Analysis of radial pressure wave forms allows for non-invasive estimation of central aortic pressures, accounting for pressure amplification and the amplitude of the arterial pulse wave as it moves through arteries away from the heart. The Atcor Sphygmacor system can derive central aortic pressures from radial tracings using a validated transfer function. This computation is performed using the pulse wave analysis (PWA) mode. Pulse Wave Analysis via radial tonometry was obtained as a measure of chronic exposure. | v2 was generally 1-2 weeks after enrollment visit, with a window up to 4 weeks from V1 |
| Exercise Treadmill Stress Test (ETT)-Peak METS | An ETT to determine exercise capacity will be completed as a measure of chronic exposure. Peak metabolic equivalents (METs, 1 MET=3.5 ml O2 uptake/kg body weight/minute) were determined at all exercise stages, peak exercise, and 1-minute post-exercise. | Treadmill test done only once at the end of v2 after completion of all other post-challenge assessment tests. V2 was scheduled 1-4 weeks from enrollment vist |
| Diastolic Blood Pressure (DBP) | During V2, Diastolic Blood Pressure was measured using the oscillometric technique before an acute exposure challenge following a standardized protocol. After resting supine for 10 minutes blood pressure was measured on both arms and the average of the last two values was used. Participants attended v2 in the morning, fasting and refraining from nicotine products for at least 8 hours. | V2 was generally 1-2 weeks after enrollment with a window up to 4 weeks from V1, recorded after resting supine for 10 minutes |
| Peak Rate Pressure Product (RPP, Peak Heart Rate Multiplied by Peak Systolic Blood Pressure) | Peak RPP was calculated by multiplying maximun heart rate during exercise by systolic blood pressure as a reliable assessment of cardiac workload | During V2 (1-4 weeks after enrollment visit) the treadmill stress test was done last, following Nicotine-containing product challenge (users) or pretend 10 minute exposure for controls |
| Heart Rate Reserve (%) | Measure of maximal exercise capacity adjusted for age, calculated as max heart rate during treadmill divided by (220 minus the participant's age in yrs) | During V2 (1-4 weeks after enrollment visit) the treadmill stress test was done last, following Nicotine-containing product challenge (users) or 10 minute pretend exposure for never-users |
| 60 Seconds Heart Rate Recovery (Beats Per Minute) | Difference in heart rate 60 seconds post treadmill minus maximal heart rate during treadmill.. | During V2 (1-4 weeks after enrollment visit) the treadmill stress test was done last, following Nicotine-containing product challenge (users) or pretend 10 minute exposure for controls |
| Lost to Follow-up |
|
| Did not qualify due to comorbidities, positive COVID-9, high CO, Low CO, Negative nicotine in urine |
|
| While cleaning datasets, we realized one participant was enrolled twice. |
|
| BG002 | Never Users | < 100 cigarettes in lifetime, none for > 5 years; < 3 E-cig usage in lifetime |
| BG003 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | 392 from Madison and 3 from Milwaukee, Wisconsin, USA | Number | participants |
|
| Exhaled CO | Exhaled CO concentration at final visit after 8 hours refraining from smoking or vaping | Mean | Standard Deviation | ppm |
|
| Serum Nicotine (ng/ml) | Serum Nicotine concentration at V2 after 8 hours of refraining from use of nicotine products. For these assays, the minimum value was coded as 1.99 when the concentration was below the threshold of detection (<2 ng/ml). | Mean | Standard Deviation | ng/ml |
|
| Serum Cotinine (ng/ml) | Serum Cotinine concentration at V2 after 8 hours of refraining from use of nicotine products. For these assays, the minimum value was coded as 1.99 when the concentration was below the threshold of detection (<2 ng/ml). | Mean | Standard Deviation | ng/ml |
|
| OG001 | Exclusive E-Cig Users | E-cig usage >/= 5 days/week for last 3 months E-Cigarettes: E-cigarette usage >/= 5 days/week |
| OG002 | Never Users | < 100 cigarettes in lifetime, none for > 5 years; < 3 E-cig usage in lifetime |
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| Primary | Forced Expiratory Volume (FEV1)- Pre Challenge | FEV1 is a primary measure of pulmonary disease obtained by spirometry that will be assessed before and after an acute exposure challenge. These are per-challenge values | Posted | Mean | Standard Deviation | percentage of volume exhaled | V2 up to 4 weeks from enrollment visit , fasting, pre challenge session |
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| Primary | Carotid Intima-Media Thickness (IMT) | Carotid Intima-Media Thickness is a cardiovascular biomarker and a measure of sub-clinical arterial injury and atherosclerosis as a result of chronic exposure. IMT will be measured via ultrasonography. | Posted | Mean | Standard Deviation | mm | V2 up to 4 weeks from enrollment visit, only done pre-challenge |
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| Primary | Changes in Systolic Blood Pressure Pre- and Post-challenge. | Visit 2 was scheduled up to 4 weeks from enrollment visit, fasting.. They came in the morning after 8 hours of fasting and refraining from nicotine products. Systolic blood pressure (left brachial artery using an oscillometric method) was measured supine, after 10 minutes rest ("Pre") and repeated after they underwent smoking or vaping changes. The "post challenge" blood pressures were recorded 15-20 minutes post end of exposure. For controls, all measurements were repeated in the same order after a 10 minute break. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. | Posted | Mean | Standard Deviation | mmHg | During Visit 2 (1 - 4 weeks post enrollment) before and after smoking/vaping challenge and for controls after a 10 minute break |
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| Primary | Changes in Diastolic Blood Pressure Pre- and Post-challenge. | Participants returned for V2 up to 4 weeks from enrollment visit, fasting. They came in the morning after 8 hours of fasting and refraining from nicotine products. Diastolic blood pressure (left brachial artery using an oscillometric method) was measured supine, after 10 minutes rest ("Pre") and repeated after they underwent smoking or vaping changes. The "post challenge" blood pressures were recorded 15-20 minutes post end of exposure. For controls, all measurements were repeated in the same order after a 10 minute break. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. | Posted | Mean | Standard Deviation | mmHg | before and after smoking/vaping challenge during Visit 2 (up to 4 weeks from enrollment) |
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| Primary | Changes in Heart Rate Pre- and Post-challenge. | Visit 2 was scheduled up to 4 weeks from enrollment visit, fasting. Participants attended fasting and refraining from nicotine products for at least 8 hours prior. All visits were in the morning. Pre-challenge heart rate measured supine, after 10 minutes rest from blood pressure monitor (dinamap). The post challenge heart rates were recorded 15-20 minutes post end of exposure to smoking or vaping challenge completion or in the case of controls after a 10 minute break. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. | Posted | Mean | Standard Deviation | beats per minute (bpm) | Before and after smoking/vaping challenge during Visit 2 (up to 4 weeks from enrollment) |
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| Primary | Changes in Brachial Artery Diameter Pre- and Post-challenge | Visit 2 was scheduled up to 4 weeks from enrollment visit. Participants attended fasting and refraining from nicotine products for at least 8 hours prior. All visits were in the morning. Pre-challenge brachial artery diameter imaged with ultrasound after resting supine for 10 minutes before and repeated 15-20 minutes after smoking/vaping challenge ended. or in the case of controls after a 10 minute break. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. | Posted | Mean | Standard Deviation | centimeters (cm) | before and after smoking/vaping challenge during Visit 2 (up to 4 weeks from enrollment) |
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| Primary | Changes in Brachial Artery Flow Mediated Dilation (FMD) Pre- and Post-challenge | Visit 2 was scheduled up to 4 weeks from enrollment visit. Participants attended fasting and refraining from nicotine products for at least 8 hours prior. All visits were in the morning. Pre-challenge ultrasound of brachial artery diameter imaged with ultrasound after resting supine for 10 minutes before and repeated 15-20 minutes after smoking/vaping challenge ended. or in the case of controls after a 10 minute break. The FMD protocol includes measuring % change in resting diameter after 60-90 seconds post fore-arm cuff occlusion release. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. | Posted | Mean | Standard Deviation | percent change | Testing was done after 10 minutes rest and fasting for pre- and post-challenge. The post challenge FMD were recorded 15-20 minuted after end of exposure (up to 4 weeks from enrollment) |
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| Primary | Changes in Percent of Sequential Heart Cycles That Differ by More Than 50 ms From Each Other in Length (PNN50, %) Pre- and Post-challenge | Expressed as a percentage of beats (supine recordings had be 5 minutes or longer to be valid). We used the SphygmoCor system for these recordings (Atcor medical). Participants attended V2 1-2 weeks after enrollment visit. They came in the morning fasting and refraining from nicotine for at least 8 hours. Heart rate variability was recorded supine for 10 minutes or more, pre and post smoking/vaping challenge. For controls is was repeated after a 10-minute break. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. Some participants pre or post challenge due to poor ECG signals (noise) or frequent premature ventricular contractions did not have a usable 10 minute recording | Posted | Mean | Standard Deviation | percent of sequential intervals | During V2 (scheduled up to 4 weeks from enrollment) and obtained after 10 minutes of supine rest, before and after smoking/vaping challenge |
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| Primary | Changes in Root Mean Square of Successive Differences Between Normal Heart Beats (RMSSD, ms) Pre- and Post-challenge | Participants attended V2 up to 4 weeks after enrollment visit. They came in the morning fasting and refraining from nicotine for at least 8 hours. Heart rate variability was recorded supine for 10 minutes or more, pre and post smoking/vaping challenge. For controls it was repeated after a 10 minute break. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. Some participants pre or post challenge due to poor ECG signals (noise) or frequent premature ventricular contractions did not have a usable 10 minute recording | Posted | Mean | Standard Deviation | milliseconds | heart rate variability recordings of at least 10 minutes per-challenge and 15 minutes post-challenge (up to 4 weeks from enrollment) |
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| Primary | Changes in Heart Rate Variability Standing Ratio Pre- and Postchallenge | We used the SphygmoCor system for these recordings (Atcor medical). Participants attended V2 up to 4 weeks after enrollment visit. They came in the morning fasting and refraining from nicotine for at least 8 hours. Heart rate variability standing ratio was assessed pre and post smoking/vaping challenge. For controls is was repeated after a 10-minute break. Ratio between maximal heart rate after abrupt standing from a supine position and the subsequent lowest heart rate value within 40 seconds of peak. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. Some participants pre or post challenge due to poor ECG signals (noise) or frequent premature ventricular contractions did not have a usable recording | Posted | Mean | Standard Deviation | ratio (unitless) | Ratio was measured pre- and post- smoking/vaping challenge after completion of the 10 minutes of heart rate variability measures (up to 4 weeks from enrollment) |
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| Primary | Changes in Predicted Forced Expiatory Volume in 1 Second (FEV1, %) Pre- and Post-challenge | maximum amount of air that the subject can forcibly expel during the first second following maximal inhalation, expressed as a percentage of the predicted normal values in the population. Participants attended V2 1-4 weeks after enrollment. They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge spirometry was performed sitting before all other tests and repeated within 15 minutes after smoking/vaping challenge. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. Some spirometry recordings were of poor quality and upon review by pulmonologist they were deemed not usable. | Posted | Mean | Standard Deviation | predicted percentage of population | before and after smoking/vaping challenge during Visit 2 (1-4 weeks after enrollment visit) |
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| Primary | Changes in Forced Vital Capacity (FVC, %) Pre- and Post-Challenge. | Amount of air that can be forcibly exhaled after taking the deepest breath possible expressed as a predicted percentage from the normal population. Participants attended V2 1-4 weeks after enrollment. They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge spirometry was performed sitting before all other tests and repeated within 15 minutes after smoking/vaping challenge. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. Some spirometry recordings were of poor quality and upon review by pulmonologist they were deemed not usable. | Posted | Mean | Standard Deviation | predicted percentile | before and after smoking/vaping challenge during Visit 2 Visit 2 which was scheduled 1 to 4 weeks from enrollment visit, fasting |
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| Primary | Changes in Ratio Between Predicted Forced Expiatory Volume in First Second and Predicted Total Vital Capacity (FEV1/FVC Ratio) Pre- and Post-challenge | The post challenge spirometry was recorded <15 minutes post end of exposure. Participants attended V2 1-4 weeks after enrollment. They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge spirometry was performed sitting before all other tests and repeated within 15 minutes after smoking/vaping challenge. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. Some spirometry recordings were of poor quality and upon review by pulmonologist they were deemed not usable. | Posted | Mean | Standard Deviation | ratio (unitless) | before and after smoking/vaping challenge during Visit 2 (1-4 weeks after enrollment visit) |
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| Primary | Changes in Percent Predicted Forced Expiratory Flow at 25 and 75% of the Pulmonary Volume (FEF 25-75, %) Pre and Pos-challenge | Participants attended Visit 2 (1-4 weeks after enrollment visit). They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge spirometry was performed sitting before all other tests and repeated within 15 minutes after smoking/vaping challenge. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. Some spirometry recordings were of poor quality and upon review by pulmonologist they were deemed not usable. | Posted | Mean | Standard Deviation | predicted percentile | Spirometry performed pre-challenge and within 15 minutes post-challenge (up to 4 weeks from enrollment) |
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| Primary | Changes in Fractional Exhaled Nitric Oxide (FeNO, Ppb) Pre- and Post-challenge | Participants attended V2 1-4 weeks after enrollment. They came in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. Pre-challenge FeNO was obtained sitting and repeated within 15 minutes after smoking/vaping challenge. | Not all controls (never users) were assessed post (after 10 minute break) due to time restrictions in personnel and one exclusive e-cigarette user was not assessed post due to a vaso-vagal response during blood draw. Other missing records were due to equipment malfunction or participant not being able to follow instructions to complete the test correctly. | Posted | Mean | Standard Deviation | parts per billion (ppb) | before and after less than 15 minutes from smoking/ vaping product (up to 4 weeks from enrollment) |
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| Secondary | Heart Rate (HR) | Heart Rate pre-acute exposure challenge was obtained after resting supine for 10 minutes during V2 in the morning, fasting and refraining from nicotine exposure for at least 8 hours prior. | Posted | Mean | Standard Deviation | beats/minute | Participants attended V2 generally 1-4 weeks after enrollment with a window that allowed up to 4 weeks after enrollment |
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| Secondary | Heart Rate Variability (HRV) - Pre Product Use Challenge | Heart Rate Variability PNN50(%) measured before an exposure challenge. Participants attended visit 2 fasting and refraining from nicotine for at least 8 hours. | heart rate variability depends on a good quality electrocardiogram, and some participants due to noise, significant pauses, very slow heart rate or frequent premature ventricular contractions did not have usable records, hence lower number analyzed. | Posted | Median | Inter-Quartile Range | percentage of intervals | V2 two was generally scheduled 1-4 weeks after enrollment visit with a window up to 4 weeks. HRV measures obtained after resting supine for 10 minutes |
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| Secondary | Systolic Blood Pressure (BP) | Blood Pressure measured using the oscillometric technique before an acute exposure challenge following standardized protocol. After resting supine for 10 minutes blood pressure was measured on both arms and the average of the last two values was used. | Posted | Mean | Standard Deviation | mmHg | V2 was up to 4 weeks from enrollment visit, after resting supine for 10 minutes |
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| Secondary | Forced Vital Capacity (FVC) | Forced Vital Capacity is a measure of how much air can be exhaled forcefully obtained by spirometry pre acute exposure challenge. | Posted | Mean | Standard Deviation | Percent predicted FVC | recordings obtained during V2 in the morning, fasting and refraining from nicotine for at least 8 hours. This visit was generally 1-2 weeks after enrollment date with a window up to 4 weeks |
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| Secondary | Fractional Exhaled Nitric Oxide (FeNO) | Fractional Exhaled Nitric Oxide is a measure of airway inflammation measured before an acute exposure challenge. | Posted | Mean | Standard Deviation | ppb | recordings obtained during V2 in the morning, fasting and refraining from nicotine for at least 8 hours. This visit was generally 1-2 weeks after enrollment date with a window up to 4 weeks |
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| Secondary | Autonomic Measures - RMSSD | Root mean square of standard deviation of rr intervals. Obtained fasting and refraining from nicotine exposure using the Sphymocor system. We used 10 or more minutes of supine data to derive heart rate variability measures. | Posted | Median | Inter-Quartile Range | ms | v2 was generally 1-2 weeks after enrollment visit, with a window up to 4 weeks from V1 |
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| Secondary | Arterial Pulse Wave Analysis (PWA), Augmentation Index (at 75 Bpm, %) | Analysis of radial pressure wave forms allows for non-invasive estimation of central aortic pressures, accounting for pressure amplification and the amplitude of the arterial pulse wave as it moves through arteries away from the heart. The Atcor Sphygmacor system can derive central aortic pressures from radial tracings using a validated transfer function. This computation is performed using the pulse wave analysis (PWA) mode. Pulse Wave Analysis via radial tonometry was obtained as a measure of chronic exposure. | Posted | Median | Inter-Quartile Range | percentage of central pulse pressure | v2 was generally 1-2 weeks after enrollment visit, with a window up to 4 weeks from V1 |
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| Secondary | Exercise Treadmill Stress Test (ETT)-Peak METS | An ETT to determine exercise capacity will be completed as a measure of chronic exposure. Peak metabolic equivalents (METs, 1 MET=3.5 ml O2 uptake/kg body weight/minute) were determined at all exercise stages, peak exercise, and 1-minute post-exercise. | Posted | Mean | Standard Deviation | METS | Treadmill test done only once at the end of v2 after completion of all other post-challenge assessment tests. V2 was scheduled 1-4 weeks from enrollment vist |
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| Secondary | Diastolic Blood Pressure (DBP) | During V2, Diastolic Blood Pressure was measured using the oscillometric technique before an acute exposure challenge following a standardized protocol. After resting supine for 10 minutes blood pressure was measured on both arms and the average of the last two values was used. Participants attended v2 in the morning, fasting and refraining from nicotine products for at least 8 hours. | Posted | Mean | Standard Deviation | mmHg | V2 was generally 1-2 weeks after enrollment with a window up to 4 weeks from V1, recorded after resting supine for 10 minutes |
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| Secondary | Peak Rate Pressure Product (RPP, Peak Heart Rate Multiplied by Peak Systolic Blood Pressure) | Peak RPP was calculated by multiplying maximun heart rate during exercise by systolic blood pressure as a reliable assessment of cardiac workload | Posted | Mean | Standard Deviation | mmHg x bpm | During V2 (1-4 weeks after enrollment visit) the treadmill stress test was done last, following Nicotine-containing product challenge (users) or pretend 10 minute exposure for controls |
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| Secondary | Heart Rate Reserve (%) | Measure of maximal exercise capacity adjusted for age, calculated as max heart rate during treadmill divided by (220 minus the participant's age in yrs) | Posted | Mean | Standard Deviation | percentage of heart rate reserve | During V2 (1-4 weeks after enrollment visit) the treadmill stress test was done last, following Nicotine-containing product challenge (users) or 10 minute pretend exposure for never-users |
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| Secondary | 60 Seconds Heart Rate Recovery (Beats Per Minute) | Difference in heart rate 60 seconds post treadmill minus maximal heart rate during treadmill.. | Posted | Mean | Standard Deviation | beats per minute (bpm) | During V2 (1-4 weeks after enrollment visit) the treadmill stress test was done last, following Nicotine-containing product challenge (users) or pretend 10 minute exposure for controls |
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| 0 |
| 117 |
| 0 |
| 117 |
| 0 |
| 117 |
| EG001 | Exclusive E-Cig Users | E-cig usage >/= 5 days/week for last 3 months E-Cigarettes: E-cigarette usage >/= 5 days/week | 0 | 164 | 0 | 164 | 1 | 164 |
| EG002 | Never Users | < 100 cigarettes in lifetime, none for > 5 years; < 3 E-cig usage in lifetime | 0 | 114 | 0 | 114 | 1 | 114 |
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| Vasovagal response | General disorders | Non-systematic Assessment | During blood draw a control subject fainted. Recovered in a few seconds but then vomited. Remained in observation for 30 minutes afterwards until all symptoms subsided |
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Not provided
Not provided
| ANCOVA post-hoc pairwise group compariso |
Age, sex, and race/ethnicity were covaried. |
| 0.822 |
| Mean Difference (Final Values) |
| -0.420 |
| 2-Sided |
| 95 |
| -4.080 |
| 3.240 |
| Other |
| these are pairwise follow-up tests probing a larger omnibus group difference involving three groups. | ANCOVA post-hoc pairwise group compariso | Age, sex, and race were covaried | 0.001 | Mean Difference (Final Values) | 7.267 | 2-Sided | 95 | 2.974 | 11.559 | Other |
| These are pairwise follow-up tests probing a larger omnibus group difference involving three groups. | ANCOVA post-hoc pairwise group compariso | Age, sex and race were covaried | <0.001 | Mean Difference (Final Values) | 7.687 | 2-Sided | 95 | 3.485 | 11.889 | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | 0.001 | interaction estimate | 3.30 | Standard Error of the Mean | 0.99 | 2-Sided | 95 | 1.36 | 5.24 | fixed effects from linear mixed model testing for effects of group, time, and group x time in systolic blood pressure, adjusting for age, sex, and race. Here presented the Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.002 | interaction term estimate | 3.29 | Standard Error of the Mean | 1.06 | 2-Sided | 95 | 1.20 | 5.38 | fixed effects from linear mixed model testing for effects of group, time, and group x time in systolic blood pressure, adjusting for age, sex, and race. Here presented the Exclusive cigarette smokers x Time vs never users x time as reference | Other |
| ANCOVA | .992 | Mean Difference (Final Values) | 0.09 | Standard Error of the Mean | 0.948 | 2-Sided | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | .002 | Interaction term Coefficient | 0.03 | Standard Error of the Mean | 0.01 | 2-Sided | 95 | 0.01 | 0.05 | fixed effects from linear mixed model testing for effects of group, time, and group x time in diastolic blood pressure, adjusting for age, sex, and race. Here presented the Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | .003 | Interaction term Coefficient | 0.03 | Standard Error of the Mean | 0.01 | 2-Sided | 95 | 0.01 | 0.05 | fixed effects from linear mixed model testing for effects of group, time, and group x time in diastolic blood pressure, adjusting for age, sex, and race. Here presented the Exclusive Smokers x Time vs never users x time as reference | Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | .917 | Interaction term Coefficient | 0.00 | Standard Error of the Mean | 0.01 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in diastolic blood pressure, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | <0.001 | interaction term coefficient | 6.06 | Standard Error of the Mean | 0.63 | 2-Sided | 95 | 4.83 | 7.3 | fixed effects from linear mixed model testing for effects of group, time, and group x time in Heart Rate, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | <0.001 | interaction term coefficient | 5.09 | Standard Error of the Mean | 0.68 | 2-Sided | 95 | 3.76 | 6.42 | fixed effects from linear mixed model testing for effects of group, time, and group x time in Heart Rate, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.107 | interaction term coefficient | -0.97 | Standard Error of the Mean | 0.602 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in Heart Rate, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | 0.003 | interaction term coefficient | -0.005 | Standard Error of the Mean | 0.001 | 2-Sided | 95 | -0.01 | -0.002 | fixed effects from linear mixed model testing for effects of group, time, and group x time in Brachial Artery Diameter, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.001 | interaction term coefficient | -0.01 | Standard Error of the Mean | 0.002 | 2-Sided | 95 | -0.01 | -0.002 | fixed effects from linear mixed model testing for effects of group, time, and group x time in Brachial Artery Diameter, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.582 | interaction term coefficient | -0.001 | Standard Error of the Mean | 0.002 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in Brachial Artery Diameter, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | 0.067 | interaction term coefficient | 0.75 | Standard Error of the Mean | 0.41 | 2-Sided | 95 | -0.05 | 1.56 | fixed effects from linear mixed model testing for effects of group, time, and group x time in Brachial Artery Flow Mediated Dilation, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.464 | interaction term coefficient | 0.33 | Standard Error of the Mean | 0.44 | 2-Sided | 95 | -0.55 | 1.20 | fixed effects from linear mixed model testing for effects of group, time, and group x time in Brachial Artery Flow Mediated Dilation, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.284 | interaction term coefficient | -0.43 | Standard Error of the Mean | 0.4 | 2-Sided | fixed effects from re-parameterized linear mixed model testing effects of group, time, and group x time in FMD, age, sex, race adjusted, for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | <0.001 | interaction term coefficient | -6.55 | Standard Error of the Mean | 1.7 | 2-Sided | 95 | -9.89 | -3.20 | fixed effects from linear mixed model testing for effects of group, time, and group x time in PNN50, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.001 | interaction term coefficient | -6.11 | Standard Error of the Mean | 1.83 | 2-Sided | 95 | -9.71 | -2.52 | fixed effects from linear mixed model testing for effects of group, time, and group x time in PNN50, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.787 | interaction term coefficient | 0.44 | Standard Error of the Mean | 1.61 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in PNN50, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | 0.001 | interaction term coefficient | -0.2 | Standard Error of the Mean | 0.06 | 2-Sided | 95 | -0.31 | -0.08 | fixed effects from linear mixed model testing for effects of group, time, and group x time in RMSSD, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.001 | interaction term coefficient | -0.21 | Standard Error of the Mean | 0.06 | 2-Sided | 95 | -0.33 | -0.09 | fixed effects from linear mixed model testing for effects of group, time, and group x time in RMSSD, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.847 | interaction term coefficient | -0.01 | Standard Error of the Mean | 0.05 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in RMSSD, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Mixed Models Analysis | 0.07 | interaction term coefficient | -0.04 | Standard Error of the Mean | 0.02 | 2-Sided | 95 | -0.09 | 0.004 | fixed effects from linear mixed model testing for effects of group, time, and group x time in HRV-Standing Ratio, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.196 | interaction term coefficient | -0.03 | Standard Error of the Mean | 0.03 | 2-Sided | 95 | -0.09 | 0.02 | fixed effects from linear mixed model testing for effects of group, time, and group x time in HRV-Standing Ratio adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.69 | interaction term coefficient | 0.09 | Standard Error of the Mean | 0.02 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in HRV-Standing Ratio adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Mixed Models Analysis | 0.005 | interaction term coefficient | -3.04 | Standard Error of the Mean | 1.09 | 2-Sided | 95 | -5.18 | -0.91 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FEV1, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.274 | interaction term coefficient | -1.29 | Standard Error of the Mean | 1.18 | 2-Sided | 95 | -3.61 | 1.03 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FEV1, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.098 | interaction term coefficient | 1.75 | Standard Error of the Mean | 1.06 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in FEV1, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | 0.918 | interaction term coefficient | -0.12 | Standard Error of the Mean | 1.14 | 2-Sided | 95 | -2.35 | 2.12 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FVC, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.518 | interaction term coefficient | -0.8 | Standard Error of the Mean | 1.23 | 2-Sided | 95 | -3.22 | 1.63 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FVC, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.539 | interaction term coefficient | -0.68 | Standard Error of the Mean | 1.11 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in FVC, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Mixed Models Analysis | 0.001 | interaction term coefficient | -3.39 | Standard Error of the Mean | 1.04 | 2-Sided | 95 | -5.43 | -1.35 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FEV1/FVC, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.778 | interaction term coefficient | -0.32 | Standard Error of the Mean | 1.12 | 2-Sided | 95 | -2.53 | 1.89 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FEV1/FVC, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.002 | interaction term coefficient | 3.08 | Standard Error of the Mean | 1.08 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in FEV1/FVC, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | 0.016 | interaction term coefficient | -5.08 | Standard Error of the Mean | 2.1 | 2-Sided | 95 | -9.21 | -0.95 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FEF 25-75, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.998 | interaction term coefficient | 0.01 | Standard Error of the Mean | 2.28 | 2-Sided | 95 | -4.47 | 4.48 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FEF 25-75, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.013 | interaction term coefficient | 5.09 | Standard Error of the Mean | 2.04 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in FEF 25-75, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| Other |
| Fixed effects from mixed models of measures before and after nicotine-containing product challenge (covariate-adjusted) | Mixed Models Analysis | 0.001 | interaction term coefficient | -0.09 | Standard Error of the Mean | 0.03 | 2-Sided | 95 | -0.14 | -0.04 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FeNO, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.555 | interaction term coefficient | -0.02 | Standard Error of the Mean | 0.03 | 2-Sided | 95 | -0.08 | 0.04 | fixed effects from linear mixed model testing for effects of group, time, and group x time in FeNO, adjusting for age, sex, and race for Exclusive Smokers x Time vs never users x time as reference | Other |
| Mixed Models Analysis | 0.007 | interaction term coefficient | 0.007 | Standard Error of the Mean | 0.03 | 2-Sided | fixed effects from re-parameterized linear mixed model testing for effects of group, time, and group x time in FeNO, adjusting for age, sex, and race for Exclusive E-cigarette users x Time vs Exclusive Smokers x time as reference | Other |
| ANCOVA post-hoc pairwise group compariso |
Age, sex, and race were covaried |
| 0.269 |
| Mean Difference (Final Values) |
| 1.352 |
| 2-Sided |
| 95 |
| -1.048 |
| 3.752 |
| Other |
| Never Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex and race were covaried | <0.001 | Mean Difference (Final Values) | -5.575 | 2-Sided | 95 | -8.37 | -2.780 | Other |
| Exclusive E-Cig Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex and race were covaried. | <0.001 | Mean Difference (Final Values) | -6.927 | 2-Sided | 95 | -9.672 | -4.183 | Other |
Never Users minus Exclusive E-Cig Users |
| ANCOVA post-hoc pairwise group compariso |
Age, sex, and race were covaried |
| 0.952 |
| Other |
| post hoc pairwise group comparisons.. Never Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex, and race were covaried | 0.014 | Other |
| Exclusive E-Cig Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | 0.011 | Age, sex, and race were covaried | Other |
Never Users minus Exclusive E-Cig Users: |
| ANCOVA post-hoc pairwise group compariso |
Age, sex, and race were covaried |
| 0.013 |
| Mean Difference (Final Values) |
| 0.180 |
| 2-Sided |
| 95 |
| 0.039 |
| 0.322 |
Estimated marginal mean differences (log-transformed scale) |
| Other |
| Never Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex and race were covaried | <0.001 | Mean Difference (Final Values) | 0.679 | 2-Sided | 95 | 0.514 | 0.844 | Estimated marginal mean differences (log-transformed scale) | Other |
| Exclusive E-Cig users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex, and race/ethnicity were covaried | <0.001 | Mean Difference (Final Values) | 0.498 | 2-Sided | 95 | 0.336 | 0.660 | Estimated marginal mean differences (log-transformed scale)" | Other |
Never Users minus Exclusive E-Cig Users |
| ANCOVA post-hoc pairwise group compariso |
Age, sex, and race were covaried |
| 0.003 |
| Mean Difference (Final Values) |
| -3.632 |
| 2-Sided |
| 95 |
| -6.019 |
| -1.245 |
| Other |
| Never Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex, and race were covaried | <0.001 | Mean Difference (Final Values) | -8.380 | 2-Sided | 95 | -11.14 | -5.62 | Other |
| Exclusive E-Cig Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex, and race were covaried | 0.001 | Mean Difference (Final Values) | -4.748 | 2-Sided | 95 | -7.456 | -2.040 | Other |
Never Users minus Exclusive E-Cig Users
| ANCOVA post-hoc pairwise group compariso |
age, sex and race were covaried |
| <0.001 |
| Mean Difference (Final Values) |
| 1.279 |
| 2-Sided |
| 95 |
| 0.733 |
| 1.824 |
| Other |
| Never Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex and race were covaried | <0.001 | Mean Difference (Final Values) | 1.739 | 2-Sided | 95 | 1.083 | 2.395 | Other |
| Exclusive E-Cig Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | age, sex and race were covaried | 0.165 | Mean Difference (Final Values) | 0.460 | 2-Sided | 95 | -0.190 | 1.110 | Other |
Never Users minus Exclusive E-Cig users
| ANCOVA post-hoc pairwise group compariso |
Age, sex and race were covaried |
| <0.001 |
| Mean Difference (Final Values) |
| 1.279 |
| 2-Sided |
| 95 |
| 0.733 |
| 1.824 |
| Other |
| Never Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | age, sex, race covaried | <0.001 | Mean Difference (Final Values) | 1.739 | 2-Sided | 95 | 1.083 | 2.395 | Other |
| Exclusive E-Cig Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex and race were covaried | 0.165 | Mean Difference (Final Values) | 0.460 | 2-Sided | 95 | -0.190 | 1.110 | Other |
Never Users minus Exclusive E-Cig Users
| ANCOVA post-hoc pairwise group compariso |
Age, sex, race were covaried |
| <0.001 |
| Mean Difference (Final Values) |
| 1.279 |
| 2-Sided |
| 95 |
| 0.733 |
| 1.824 |
| Other |
| Never Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex and race were covaried | <0.001 | Mean Difference (Final Values) | 1.739 | 2-Sided | 95 | 1.083 | 2.395 | Other |
| Exclusive E-Cig Users minus Exclusive Smokers | ANCOVA post-hoc pairwise group compariso | Age, sex and race were covaried | 0.165 | Mean Difference (Final Values) | 0.460 | 2-Sided | 95 | -0.190 | 1.110 | Other |