Effect of cigar smoking on endothelium-dependent brachial artery dilation in healthy young adults

Background: Cigar smoking has become a quickly growing trend among teenagers, women, and young adults. The objective was to explore whether cigar smoking affects flow-mediated vasodilation in healthy, non-smoking young adults. Methods: This was a prospective randomized trial with open design. It was performed in a cardiology teaching program in a private community hospital that serves as a major referral center within the greater Miami area. Apparently healthy, non-smoking young adult cardiology trainees and staff between the ages of 20 and 45 years were randomly assigned to a cigar smoking group (n = 15) or a control group (n = 14). The main outcome measures were the difference in percent diameter increase in the brachial artery after reactive hyperemia and sublingual nitroglycerin between members of the cigar smoking and control groups at baseline, measured after cigar smoking, and at 5 hours. Results: Twenty-nine participants were randomized. Percent diameter increase in the brachial artery was measured with the use of high-resolution ultrasonography. Baseline percent diameter increase after reactive hyperemia and sublingual nitroglycerin was similar in both groups (6.2% vs 6.7%, P =. 4 and 22% vs 23%, P =. 5, respectively). We observed a 2.5% increase in brachial artery diameter with hyperemia after cigar smoking compared with a 9.4% increase in the control group, P =. 045. Values after nitroglycerin were similar between groups, P =. 2. Between-group analysis showed no significant difference in percent dilation after reactive hyperemia at 5 hours, P =. 4, but a significant difference was seen after sublingual nitroglycerin, P =. 02. Conclusions: These data are compatible with the possibility that cigar smoking may have an acute effect on endothelium-dependent, flow-mediated brachial artery dilation and do not support the possibility of an immediate effect on endothelium-independent vasodilation. Taken together, these results suggest that cigars are not an innocuous alternative to cigarette smoking.