Medium- and longer-term cardiovascular effects of e-cigarettes in adults making a stop-smoking attempt: a randomized controlled trial.

Background 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 18 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 6 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.

E-cigarettes and Cardiovascular Health: A Randomized Trial

Vaping is used widely as a stop smoking aid, however, its cardiovascular effects on smokers wishing to stop smoking, remain unknown. The study compared the medium- and longer-term cardiovascular effects of smokers attempting to quit using e-cigarettes with or without nicotine or prescription nicotine replacement therapy (NRT). The study found that all three groups experienced an improvement in the function of both small veins and arteries, as well as a reduction in vascular stiffness indices, which is a positive sign for cardiovascular health. Our findings suggest that e-cigarettes can help reverse smoking-induced endothelial dysfunction, in a similar manner to NRT.

This research is important because it provides valuable information on the effects of e-cigarettes on cardiovascular health in comparison to nicotine replacement therapy (NRT), which is considered as the """"golden standard"""" for stop smoking tools, during smoking cessation. It contributes to the ongoing debate on the safety and efficacy of e-cigarettes as a smoking cessation tool.

Key Takeaways:

1. Smokers attempting to quit experienced a positive cardiovascular impact after both a 3-and 6-month period.

2. None of the groups (i.e., nicotine-containing and nicotine-free e-cigarettes or NRT) offered superior cardiovascular benefits to the others.

3. Smoking cessation appears to support the reversal of smoking-induced endothelial dysfunction, in a similar manner to NRT.

4. Our findings also suggest a stronger improvement in women, while a lower age was associated with marginally larger beneficial changes. The latter highlights the fact that although it is never too late to stop smoking, the earlier this happens, the easier it is to reverse the negative effects of cigarettes.