# Metal Exposure and Early Cardiovascular Risk in Adult E-Cigarette Users

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2024 · $648,515

## Abstract

PROJECT SUMMARY
Despite limited knowledge about their toxicity and health effects, the use of electronic cigarettes (e-cigs) has
increased among former smokers and young adults who have never smoked. Increasing evidence shows that
e-cig aerosol contains relatively high levels of toxic metals, including lead and nickel, metals with strong
evidence for a role in cardiovascular (CV) disease. The objective of this proposal is to evaluate (1) the
association of e-cig use with metal exposure, (2) the association of e-cig use with coronary artery calcification
and other relevant pathways (endothelial cell health, blood pressure and inflammation), and (3) the potential
role of e-cig metals to explain, at least in part, the CV effects of e-cigs. In preliminary studies, we found marked
increases in metal levels in the generated aerosol compared to e-liquid from the dispenser from devices of
daily e-cig users, demonstrating that the heating coil is a source of metal exposure. Metals in e-cig aerosols,
moreover, were positively associated with metal biomarker levels. We will conduct a longitudinal study of men
and women 18 to 50 years of age of diverse race/ethnic backgrounds from New York City (130 never tobacco
smokers or e-cig users (controls), 130 e-cig users who are never tobacco smokers, 130 e-cig users who are
former smokers, and 130 e-cig users who are current smokers and evaluate each participant 3 times over a
1.5-year period (month 1, 9, and 18). For exposure assessment, we will collect data on e-cig use and use
patterns from a questionnaire and 4-weekly mobile assessments (month 3, 6, 12, 15), an aerosol sample from
the participants' e-cig device and urine and blood samples to measure metals. For outcome assessment, we
will measure coronary artery calcification (CAC) using cardiac CT-scan at baseline estimating the spatially
weighted calcium score (SWCS). The SWCS provides a valid, continuous measure of CAC suitable for
quantifying the extent of atherosclerosis without a threshold. At each visit will also measure endothelial cell
health through endothelium-dependent arterial vasodilation using EndoPAT2000 device and endothelial cells-
derived microparticles (EMPs) (a marker of endothelial cell injury), blood pressure, and biomarkers of
inflammation (C-reactive protein and interleukin-6). We will estimate differences in metal biomarkers and in CV
risk comparing e-cig users to non-users and by e-cigarette use patterns (e.g., type of device, number of puffs,
e-liquid consumed per week, type of coil). In a formal mediation analysis, we will assess the association of e-
cig use with the CV measures accounting for the mediating role of metals. The proposed longitudinal study
utilizes interdisciplinary expertise in the characterization of CV disease, assessment of metals, the recruitment
and examination of e-cig users, and the general field of tobacco regulatory science, to fill a critical gap in the
knowledge about the possible long-term effects of e-c...

## Key facts

- **NIH application ID:** 10845680
- **Project number:** 5R01ES029967-05
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Ana Navas-Acien
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $648,515
- **Award type:** 5
- **Project period:** 2020-08-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10845680

## Citation

> US National Institutes of Health, RePORTER application 10845680, Metal Exposure and Early Cardiovascular Risk in Adult E-Cigarette Users (5R01ES029967-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10845680. Licensed CC0.

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