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Article

Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial

1
Lifestyle, Exercise and Nutrition Improvement (LENI) Research Group, College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield S10 2BP, UK
2
Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield S10 2BP, UK
3
Addictions, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8BB, UK
4
SPECTRUM Research Consortium, Edinburgh EH8 9YL, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Johannes Vogel
Biology 2021, 10(11), 1208; https://doi.org/10.3390/biology10111208
Received: 18 October 2021 / Revised: 14 November 2021 / Accepted: 15 November 2021 / Published: 19 November 2021
(This article belongs to the Section Physiology)
E-cigarettes are popular for smoking cessation but knowledge of their effect on cardiovascular health is limited. We compared the short-term cardiovascular effects in 248 smokers who quit smoking using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT). All participants received behavioural support. We assessed the cardiovascular effects of these stop smoking methods 3 days following quit date. Our work suggests that e-cigarettes offer similar vascular health benefits to that of NRT. This happens at a very early stage in the stop smoking process (3 days).
Smoking increases cardiovascular disease (CVD) risk by leading to endothelial injury. E-cigarettes remain a popular way to stop smoking. Evidence on their effect on cardiovascular health is growing but remains limited, particularly in the short-term. The main objective of this study was to compare short-term cardiovascular effects in smokers who quit smoking using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT). This was a single-centre (Sheffield, UK) pragmatic three-arm randomised controlled trial which recruited adult smokers (≥10 cigarettes per day), who were willing to attempt to stop smoking with support (n = 248). Participants were randomised to receive either: (a) behavioral support and e-cigarettes with 18 mg/mL nicotine (n = 84); (b) behavioral support and e-cigarettes without nicotine (n = 82); (c) behavioral support and NRT (n = 82). Flow Mediated Dilation (%FMD), peak cutaneous vascular conductance responses to acetylcholine (ACh) and sodium nitroprusside (SNP) and mean arterial pressure (MAP) were recorded at baseline and three days after stopping smoking. General Linear Models were used to compare changes between groups and changes from follow-up. Adjusting for baseline, at follow-up, all outcomes (for the 208 participants that completed the 3-day assessments) with the exception of SNP had improved significantly over baseline and there were no differences between groups (%FMD F = 1.03, p = 0.360, df = 2,207; ACh F = 0.172, p = 0.84, df = 2,207; SNP F = 0.382, p = 0.68, df = 2,207; MAP F = 0.176, p = 0.84, df = 2,207). For smokers ≥20 cigarettes per day, benefits were also pronounced. Smoking cessation showed positive cardiovascular impact even after a 3-day period and the effects did not differ between nicotine-containing e-cigarettes, nicotine-free e-cigarettes and NRT. View Full-Text
Keywords: CVD; smoking cessation; vaping; nicotine replacement therapy; vascular function CVD; smoking cessation; vaping; nicotine replacement therapy; vascular function
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MDPI and ACS Style

Klonizakis, M.; Gumber, A.; McIntosh, E.; Brose, L.S. Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial. Biology 2021, 10, 1208. https://doi.org/10.3390/biology10111208

AMA Style

Klonizakis M, Gumber A, McIntosh E, Brose LS. Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial. Biology. 2021; 10(11):1208. https://doi.org/10.3390/biology10111208

Chicago/Turabian Style

Klonizakis, Markos, Anil Gumber, Emma McIntosh, and Leonie S. Brose. 2021. "Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial" Biology 10, no. 11: 1208. https://doi.org/10.3390/biology10111208

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