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Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial
SIMPLE SUMMARY: 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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614829/ https://www.ncbi.nlm.nih.gov/pubmed/34827200 http://dx.doi.org/10.3390/biology10111208 |
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author | Klonizakis, Markos Gumber, Anil McIntosh, Emma Brose, Leonie S. |
author_facet | Klonizakis, Markos Gumber, Anil McIntosh, Emma Brose, Leonie S. |
author_sort | Klonizakis, Markos |
collection | PubMed |
description | SIMPLE SUMMARY: 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). ABSTRACT: 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. |
format | Online Article Text |
id | pubmed-8614829 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-86148292021-11-26 Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial Klonizakis, Markos Gumber, Anil McIntosh, Emma Brose, Leonie S. Biology (Basel) Article SIMPLE SUMMARY: 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). ABSTRACT: 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. MDPI 2021-11-19 /pmc/articles/PMC8614829/ /pubmed/34827200 http://dx.doi.org/10.3390/biology10111208 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Klonizakis, Markos Gumber, Anil McIntosh, Emma Brose, Leonie S. Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial |
title | Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial |
title_full | Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial |
title_fullStr | Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial |
title_full_unstemmed | Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial |
title_short | Short-Term Cardiovascular Effects of E-Cigarettes in Adults Making a Stop-Smoking Attempt: A Randomized Controlled Trial |
title_sort | short-term cardiovascular effects of e-cigarettes in adults making a stop-smoking attempt: a randomized controlled trial |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8614829/ https://www.ncbi.nlm.nih.gov/pubmed/34827200 http://dx.doi.org/10.3390/biology10111208 |
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