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They found calcification to be more prevalent in the carotid plaques of the smokers compared to the non-smokers, confirming higher atherosclerotic burden. The researchers also induced vascular smooth muscle cell calcification in vitro using nicotine and found that the pro-calcifying effects of nicotine were mediated by Ca2+-dependent Nox5. They then studied what happened in vitro when vascular smooth muscle cell was pretreated with vitamin K2 and found that pretreatment with vitamin K2 helped decrease nicotine-induced intracellular oxidative stress, extracellular vesicle secretion, and calcification

The research didnt show an increased risk of heart failure

doi: 10.1080/07329113.2007.10756611 113 WickenW

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Nicotine is often considered a social and biological "gateway" to the use of other substances, such as combustible cigarettes, alcohol, and drugs