Abstract
Objective: Exposure to electronic cigarette smoke causes an increase of free radicals. Physiologically, the body produces antioxidant superoxide dismutase to neutralize the free radicals. However, an excessive increase of the free radicals will result in an imbalance between the amount of free radicals and antioxidants. The free radicals in the body can trigger lipid peroxidation so that it will result in oxidative stress causing cell damage. Malondialdehyde increase is a marker of oxidative stress in the body. The aim of this research is to understand the changes and the relationship between levels of superoxide dismutase and malondialdehyde in the blood due to exposure to electronic cigarette smoke.
 Methods: This research is an experimental study using male Wistar rats as experimental animal models. In the study, the exposure to electronic cigarette smoke with different duration of administration was carried out. Next, blood samples were taken to check the levels of superoxide dismutase and malondialdehyde.
 Results: The results showed a difference in antioxidant levels between antioxidant Superoxide Dismutase and malondialdehyde (p<0.05). Meanwhile the relationship between the two groups showed a strong (r = 0.893) and significant (p = 0.000) relationship.
 Conclusion: The exposure to electronic cigarette smoke can reduce the level of antioxidant superoxide dismutase and increase the level of malondialdehyde in blood. In addition, changes in the levels of antioxidant superoxide dismutase and malondialdehyde had a strong and significant relationship.
Highlights
Electronic cigarettes have become one of the alternative products as a substitute for tobacco cigarettes
The results showed a difference in antioxidant levels between antioxidant Superoxide Dismutase and malondialdehyde (p
The exposure to electronic cigarette smoke can reduce the level of antioxidant superoxide dismutase and increase the level of malondialdehyde in blood
Summary
Electronic cigarettes have become one of the alternative products as a substitute for tobacco cigarettes. Intense promotion has increasingly accelerated the use of electronic cigarettes in public [1]. In 2016, the use of electronic cigarettes in America had reached 4.3% among middle school children and 11.3% among high school children [2]. One-third of teenagers in America consider electronic cigarettes to be less dangerous than the tobacco cigarettes [3]. The usage prevalence of electronic cigarettes in several countries in Asia is smaller, such as in China (3.1%), in Taiwan (3%), and in Hong Kong (2.3%). This is due to the less aggressive promotion of electronic cigarettes compared to the one in the Western countries [4]
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