Smoking is a major risk factor for cardiovascular disease and smoking cessation reduces excess risk.
E-cigarettes are popular for smoking cessation but there is little evidence on their cardiovascular health effect.
Our objective was to compare the medium- and longer-term cardiovascular effects in smokers attempting to quit smoking using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT).
Methods
This was a single-center, pragmatic three-arm randomized (1:1:1) controlled trial, which recruited adult smokers (≥ 10 cigarettes/day), who were willing to attempt to stop smoking with support (n = 248).
Participants were randomized to receive behavioral support with either (a) e-cigarettes with 18Â mg/ml nicotine, (b) e-cigarettes without nicotine, and (c) NRT.
Flow-mediated dilation (%FMD) and peak cutaneous vascular conductance (CVCmax) responses to acetylcholine (ACh) and sodium nitroprusside (SNP), mean arterial pressure (MAP), and other outcomes were recorded at baseline, 3, and 6Â months after stopping smoking. Data were analyzed using generalized estimating equations (GEE).
Results
At 3- and 6-month follow-up, %FMD showed an improvement over baseline in all three groups (e.g., p < 0.0001 at 6 months). Similarly, ACh, SNP, and MAP improved significantly over baseline in all groups both at 3 and 6 months (e.g., ACh: p = 0.004, at 6 months).
Conclusions
Smokers attempting to quit experienced positive cardiovascular impact after both a 3- and 6-month period. None of the groups (i.e., nicotine-containing and nicotine-free e-cigarettes or NRT) offered superior cardiovascular benefits to the others.
Markos Klonizakis et al. – BMC Medicine – 2022-08-16.
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