REF-1471 · Larue et al., 2021 · Respiratory Medicine · Paper · PubMed

What does a nicotine vape do right away?

Across 27 articles (919 people), heart rate and blood pressure rose and exhaled NO fell; no significant spirometry change. Pooled before-after data, no exercise outcome; abstract.

Main caveat: Abstract only: publisher page behind a bot check; no heterogeneity, risk-of-bias or subgroup data seen.
moderate evidenceMeasured on non-athletes and recreational people

Larue and colleagues (Montreal) reviewed the immediate physiological effects of acute e-cigarette use. PubMed, Web of Science, Cochrane and Scopus were searched to 20 May 2021 for English or French peer-reviewed articles measuring at least one parameter before and after using an e-cigarette.

Of 19,823 articles screened, 45 entered the qualitative synthesis and 27 (919 patients) the meta-analyses. Acute use of a nicotine e-cigarette was associated with higher heart rate (SMD 0.71, 95% CI 0.46-0.95), systolic pressure (0.38, 0.18-0.57), diastolic pressure (0.52, 0.33-0.70) and AIx75 (0.580, 0.220-0.941), with lower FeNO (−0.26, −0.49 to −0.04).

No spirometry measure changed significantly. The authors say the effect could be clinically relevant, especially for cardiovascular morbidity, and that long-term consequences need study. Our reading: it says a nicotine vape is not physiologically neutral at rest.

Unchanged spirometry does not rule out airway effects, since airway resistance is measured differently (REF-1473), and the abstract says nothing about exercise.

Protocol

Search: PubMed, Web of Science, Cochrane, Scopus to 20 May 2021; English or French peer-reviewed articles; at least one physiological parameter before and after use.
Quality and extraction: PRISMA; Downs and Black; two independent reviewers.
Synthesis: random-effect models; sensitivity analysis and meta-regression for heterogeneity.
Outcomes chosen for pooling: systolic and diastolic pressure, heart rate, AIx75, FeNO, spirometry.
Funding and interests: PubMed lists CIHR grants (SMC-151518, HEV-443221); no conflict statement in the record.

Key Results

Outcome after a nicotine e-cigaretteSMD (95% CI)
Heart rate0.71 (0.46 to 0.95)
Systolic pressure0.38 (0.18 to 0.57)
Diastolic pressure0.52 (0.33 to 0.70)
Augmentation index, AIx750.580 (0.220 to 0.941)
Exhaled nitric oxide, FeNO−0.26 (−0.49 to −0.04)
Any spirometry measureno significant change
Not in the abstract: bpm or mmHg, heterogeneity (I²), risk-of-bias results, the split by user type, nicotine dose or device, zero-nicotine comparisons.

Mechanisms

Measured: pooled before-and-after shifts in cardiovascular and respiratory markers.
Authors' interpretation: the devices have a physiological impact that could be clinically relevant, especially for cardiovascular morbidity.
Inference: nicotine moving heart rate fits PHYS-12's rule that heart rate answers the body's state. Lower FeNO is known to occur with smoking, but the abstract does not explain it here.

Practical Application

What does a nicotine vape do right away? Across 27 articles (919 people), heart rate and blood pressure rose and exhaled NO fell; no significant spirometry change. Pooled before-after data, no exercise outcome; abstract.
Reading numbers: a vape shortly before a resting reading can shift heart rate; treat it as a confounder like caffeine (PHYS-12; inference). The abstract gives no duration.
"Better than a cigarette for the session": the CO part is covered by REF-1464 and REF-1463; this entry says the nicotine part does not disappear. Not from this paper; the base's own practice: hour windows before a session are practice.
What it does not show: performance; any effect during exercise; dose response; effects in trained athletes or how habitual use changes the response.

Limitations

Abstract only: publisher page behind a bot check; no heterogeneity, risk-of-bias or subgroup data seen.
Before-and-after inclusion: not limited to controlled comparisons by the abstract's description.
Markers, not performance.
SMDs do not translate directly to bpm or mmHg.
Who was measured: described only as patients or humans; not athletes.
Funding and interests: CIHR per PubMed; no statement in the record.
How this entry was checked and changed
Why this level

(from the abstract) — a systematic review with pooling (rubric A-level design) held at B+: eligible studies only needed a measurement before and after use, so the pooled data are not limited to controlled trials; outcomes are markers; heterogeneity and certainty are not given in the abstract, and the paper itself could not be fetched