Table 1
Chemical information for nicotine in different forms.
| COMMON CHEMICAL NAMES | UNIQUE IDENTIFIER: CAS REGISTRY NUMBERS* | ORIGIN |
|---|---|---|
| (S)-nicotine / (S)-(-)- nicotine / (-)-nicotine | 54-11-5 |
|
| (R, S)-nicotine mixture / (±)-nicotine | 22083-74-5 | |
| (R)-nicotine / (R)-(+)-nicotine / (+)-nicotine | 25162-00-9 |
[i] * A Chemical Abstracts Service Registry Number is a unique numerical identifier assigned to a specific chemical substance [35].
Table 2
Effects of nicotine on cardiovascular parameters and risk factors.
| PARAMETERS | EFFECTS OF NICOTINE | POTENTIAL COMPLICATIONS |
|---|---|---|
| Heart rate | Increase | Acute tachycardia |
| Blood pressure | Increase | Acute hypertension |
| Coronary vasodilator reserve | Decrease | Myocardial ischemia (chest pain) |
| Action on blood vessels | Hypertension | |
| Cutaneous vessels | Vasoconstriction | |
| Skeletal muscles | Vasodilatation | |
| Peripheral vascular resistance | Increase | |
| Blood viscosity | Increase | Thrombosis |
| Platelet aggregation | Increase | Thrombosis |
| Production and release of nitric oxide | Decrease | Endothelial dysfunction |
| Total and LDL cholesterol levels | Increase | Accelerated atherosclerosis |
| Insulin resistance | Increase | Macrovascular complications |
| MEASURES | OBJECTIVES |
|---|---|
| All people, particularly those with cardiovascular risk factors or disease, should refrain from using tobacco and non-medical nicotine products. |
|
| Educators and community leaders should raise public awareness, particularly through educational activities dedicated to special populations: adolescents, young adults, and women. |
|
| All health care providers should systematically recommend tobacco cessation and provide tobacco cessation services or referrals to patients as standard of care. |
|
| The health care community, civil society, and public should constantly call on governments to implement and enforce regulatory measures that protect public health from tobacco and non-medical nicotine products and from the vested interests of the tobacco industry. |
|
| MEASURES | OBJECTIVES |
|---|---|
| Researchers should study the long-term effects of ENDS, HTP, and other newer recreational nicotine products on cardiovascular health. |
|
| Researchers should further probe the drivers of disparities in nicotine and tobacco product use globally and within vulnerable or marginalized communities in a country. |
|
| All researchers, academic institutions, and medical and scientific journals should reject tobacco industry collaboration and refrain from publishing and/or presenting studies funded by the tobacco industry. |
|
| MEASURES | RATIONALE |
|---|---|
| Regulate by prohibiting or restricting the production, distribution, marketing, sale, and use of tobacco and recreational nicotine products. |
|
| Require manufacturers of tobacco and nicotine products to provide evidence of safety of their products. |
|
| Regulate the amounts of nicotine delivered by tobacco and nicotine products, including delivery devices. |
|
| Introduce or strengthen pro-health excise taxes for tobacco and non-medical nicotine products. |
|
| Require standardized packaging with pictorial health warnings and appropriate labelling on tobacco and nicotine products. |
|
| Prohibit the addition of flavouring agents in all tobacco and recreational nicotine products, including ENDS. |
|
| Prohibit the use of aerosol-generating tobacco and nicotine products in indoor public places, workplaces, and public transports. |
|
| Prohibit and monitor all direct and indirect advertising, promotion, and sponsorship of tobacco and recreational nicotine products. |
|
| Prohibit and monitor the dissemination of misleading claims on the health effects of tobacco and recreational nicotine products. |
|
| Regulate the supply of and retail access to tobacco and nicotine products. |
|
