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Dual use of cigarettes and e-cigarettes is associated with higher diastolic blood pressure in adolescents: The School*Vape*Science study

M. Lüthgen, A. Burgard, Maike Truempelmann, P. Axt, H. Faesser, T. Jagomast, D. Drömann, F. Brinkmann et al.

Vascular Medicine, 2026

1 citation

Abstract

BACKGROUND

E-cigarette use is increasing significantly worldwide, particularly among young people. However, the cardiovascular impact of nicotine exposure during adolescence remains unclear. Although cigarette and e-cigarette use are known to increase arterial stiffness in adults, data from younger populations are lacking. Early vascular alterations may indicate a premature cardiovascular risk.

METHODS

In a cross-sectional study, we assessed arterial stiffness and central hemodynamics using the Mobil-O-Graph device (IEM GmbH). Smoking and vaping behaviors were evaluated using standardized questionnaires. The participants were classified according to the frequency and combination of cigarette and e-cigarette use.

RESULTS

From 444 involved school-aged adolescents (median age: 15.0 years), 5.0% reported e-cigarette consumption and 4.5% dual use. The adolescents reporting dual use of cigarettes and e-cigarettes exhibited significantly higher peripheral diastolic blood pressure than those with infrequent (< 1 per week) or no nicotine use (p = 0.003). Central diastolic blood pressure was also elevated in the dual users (p = 0.007).

CONCLUSIONS

Dual exposure to combustible and electronic nicotine products was associated with higher diastolic blood pressure among adolescents in this cohort. These findings suggest that nicotine-induced vascular changes may occur earlier in life than previously recognized. Preventive interventions targeting youth are needed to mitigate long-term…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.

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