Children of snus users at high blood pressure risk

Smokeless tobacco harms

NEW YORK, Oct 17, (Agencies): Children whose mothers used smokeless tobacco during pregnancy have higher blood pressure by the time they’re 5-6 years old compared to peers whose mothers avoided tobacco, a small Swedish study finds.

Researchers examined blood pressure in 21 kids exposed in the womb to snus, a moist powdered smokeless tobacco, and 19 children without any prenatal tobacco exposure.

In kids exposed to snus, systolic blood pressure – the “top number” – averaged 4.2 mmHG (millimeters of mercury) higher than in children without any prenatal tobacco exposure, showing higher pressure exerted by blood against artery walls when the heart beats.

“We don’t know if the increased systolic blood pressure has implications for cardiovascular health in later life, that remains to be studied,” said Dr Felicia Nordenstam, lead author of the study and a researcher the Karolinska Institute in Stockholm.

But no amount of tobacco exposure is known to be safe during pregnancy, Nordenstam said by email.

Quitting

“Women should abstain from all types of tobacco and nicotine containing products during pregnancy,” Nordenstam said. “If quitting tobacco and nicotine is not an option, cutting down the doses as much as possible is recommended.”

The study also looked at each child’s heart rate, which is controlled by a part of the nervous system that is affected by nicotine. Assessing heart-rate variability (HRV), a measure of the heart’s responsiveness to changing demands, the study team found that children of snus users had poorer HRV.

Researchers didn’t find an association between prenatal snus exposure and “diastolic” blood pressure – the bottom number – which indicates how much pressure the blood exerts on artery walls when the heart is at rest between beats.

Smoking during pregnancy has long been linked to a wide variety of pregnancy complications including preterm births, low birth weight and stillbirth. Kids also have an increased risk of high blood pressure when mothers smoked during pregnancy, previous studies have found.

Pregnant women who used snus were included in the current study only if they used high doses of the tobacco product, providing 48 milligrams or more of nicotine a day, throughout their entire pregnancy. Outcomes for their children were compared to kids of mothers who used no tobacco products at all during pregnancy.

None of the kids in the study had parents who smoked cigarettes during pregnancy or during their early childhood.

The differences in systolic blood pressure between children with and without snus exposure in the study were larger than the 1 to 3 mmHG difference found in some recent studies of cigarette smoking in pregnancy, researchers note in the Journal of the American Heart Association.

Beyond its small size, other limitations of the study include the lack of long-term data to determine whether and how snus exposure during pregnancy might lead to lasting cardiovascular problems for the children.

“The full extent and precise mechanism behind prenatal nicotine exposure and altered cardiac control and blood pressure regulation is not fully understood,” Nordenstam said.

But blood pressure does tend to follow a trajectory that begins in childhood, making kids with even slightly elevated numbers more likely to develop hypertension as adults, researchers note.

E-cigarettes:

A Michigan judge temporarily blocked the state’s weeks-old ban on flavored e-cigarettes Tuesday, saying it may force adults to return to smoking more harmful tobacco products and has irreparably hurt vaping businesses.

Court of Claims Judge Cynthia Stephens put the prohibition on hold until “further order of this court”. The preliminary injunction will be appealed by Gov Gretchen Whitmer, who ordered the creation of the emergency rules in a bid to combat the epidemic of teen vaping.

The judge said two businesses that sued showed a likelihood of prevailing on the merits of their contention that the rules are procedurally invalid, because state officials did not justify short-cutting the normal rule-making process.

“Thus, and at this stage of the litigation, defendants have undercut their own assertions of an emergency by the fact that they demurred on taking action for nearly a year, and in the case of some information even longer than that, after they were in possession of the information cited in support of the emergency declaration,” Stephens wrote.

She also said improved health outcomes for adults who switch to vaping products from combustible tobacco “could, and likely would, be lost under the emergency rules.”

Vaping

Several states have banned the sale of flavored vaping products amid a rising number of vaping-related lung illnesses and an epidemic of teen e-cigarette use. As of last week, vaping-related illnesses in the US had reached about 1,300 cases in 49 states and one US territory, including at least 26 deaths.

Most who got sick said they vaped products containing THC, the marijuana ingredient that causes a high, but some said they vaped only nicotine.

In New York, a state appeals court this month preliminarily blocked the state from enforcing a prohibition on flavored e-cigarette sales.

The Michigan lawsuits, which were consolidated, were filed by Houghton-based 906 Vapor and A Clean Cigarette, which has 15 locations across the state.

“We are pleased today that the court saw the ban of flavored vaping products for what it truly is: an overreach of government into the lives of adults,” said Andrea Bitely, spokeswoman for the Defend MI Rights Coalition, a vaping industry group. “We are ready to work through the normal legislative process to arrive at a balanced solution that protects the rights of adults to use vaping products as an alternative to combustible cigarettes and at the same time get these products out of the children’s hands.”