Concordia master’s student investigates the health risks posed by e-cigarettes

When electronic cigarettes first hit the market in the mid-2000s, they were marketed as a safe alternative to their combustible counterparts. And while manufacturers continue to make this argument, more and more scientific research is calling this claim into question.

Florent Larue is a master’s student in Concordia’s Department of Health, Kinesiology and Applied Physiology who works at the Montreal Behavioural Medicine Centre (MBMC). He is also a family physician originally from Montpellier in the south of France.

Larue is researching the cardiovascular and respiratory impacts of e-cigarettes, with the hope of expanding the public’s understanding of the real risks involved.

‘E-cigarette consumption is not as benign as it seems to be’

How does this specific image relate to your research at Concordia?

Florent Larue: On this image you can see the room that we have at the MBMC lab to monitor various physiological reactions after e-cigarette consumption. We have a lot of equipment allowing us to measure cardiovascular parameters such as blood pressure, heart rate and impedance cardiography.

We can also measure respiratory parameters such as carbon dioxide and oxygen consumption, spirometry, carbon monoxide levels and so on. This room is essential to our research project in order to assess the physiological impact of vaping.

What is the hoped-for result of your project?

FL: We hypothesize that e-cigarette consumption is not as benign as it seems to be. Although it appears to be less toxic than combustible cigarette smoke, many institutions and scientific papers have warned about the lack of proof of its innocuity. Researchers have already shown some cardiovascular impacts as well as reduction of respiratory function after e-cigarette consumption.

We hope to confirm these first results, but we will also go further, trying to assess what impact e-cigarettes could have on inflammatory parameters, blood markers and the autonomic nervous system. We will look for a sympathetic shift similar to the one observed after combustible cigarette consumption, which is associated with increased cardiovascular morbidity.

What impact could you see your research having on people’s lives?

FL: More and more people are nowadays choosing e-cigarettes to reduce their combustible cigarette consumption, unaware of the lack of information we have about these devices. They consider it as a better way to stop smoking than conventional treatment, even if we have no proof of its innocuity.

On the contrary, more and more scientific research is discovering some physiological effects. The World Health Organization warned in a 2019 report about the harmfulness of e-cigarettes, the details of which still need to be precisely determined. It is therefore really important to clearly acknowledge what the physiological impacts of e-cigarettes could be and warn people who want to use them.

What are some of the major challenges you face in your research?

FL: There are many. One of them is that we have to screen for people with no smoking history and no underlying diseases, to make sure that the effects we see aren’t linked to something else.

We also have to be precise in our measurements, since observed physiological changes can be small but, over many years, potentially significant and harmful.

Finally, when it comes to measuring the impact of e-cigarettes on the autonomic nervous system (a crucial parameter associated with increased cardiovascular morbidity when the stress response system is activated), we face technical difficulties. There are many ways to measure it, none of which are easy. As an example, we had a lot of difficulty getting a good signal to perform impedance cardiography.

What inspired you to study this subject?

FL: Firstly, I had the chance to meet Simon Bacon at a conference in France. We discussed the research he was leading, and I was immediately interested in studying e-cigarettes as a societal problem.

As a family medical resident in France, every day I faced patients who struggled with their tobacco consumption and wondered if e-cigarettes could be the solution. Knowing how important it is for one’s health but also how difficult it is to get rid of nicotine addiction, I thought that doing research on these devices could be really interesting.

What advice would you give interested students to get involved in this line of research?

FL: This field of research is evolving very quickly, and I really appreciate how it concerns almost everyone. Being at the edge of science concerning a device that is so broadly used but also so insufficiently known is really interesting.

Finally, tobacco consumption worldwide is responsible for six million deaths per year, so working in this field is a great step to lead people to a better quality of life.

What do you like best about being at Concordia?

FL: Being at Concordia is interesting for the newness of the buildings and the quality of the equipment. The classes are also of good quality, with few students for each professor. Finally, I was lucky to have a fellowship from the university, without which I couldn’t have come here and learned so much through the experience.

Are there any partners, agencies or other funding/support attached to your research?

FL: Our main partners are Concordia and UQAM as well as the CIUSSS-NIM (Hôpital du Sacré-Cœur de Montréal). We also are lucky to get funding from the Canadian Institutes of Health and Research (CIHR), the Fonds du recherche du Québec - Santé (FRQS) and the Heart and Stroke Foundation.

Find out more about Concordia’s Department of Health, Kinesiology and Applied Physiology.