Acute Effects of Heat‐Not‐Burn, Electronic Vaping, and Traditional Tobacco Combustion Cigarettes: The Sapienza University of Rome‐Vascular Assessment of Proatherosclerotic Effects of Smoking (SUR‐VAPES) 2 Randomized Trial

Introduction:
This text provides a summary of a clinical study investigating the acute effects of heat-not-burn cigarettes (HNBC), electronic vaping cigarettes (EVC), and traditional tobacco combustion cigarettes (TC) on several health parameters in adult smokers. The study compares these products in terms of oxidative stress, antioxidant reserve, platelet function, flow-mediated dilation, blood pressure, and satisfaction scores. The key points section below highlights the study design and its major findings.

Key Points:

* Independent, randomized, cross-over study conducted in 2017 at Sapienza University of Rome, Italy.
* 20 healthy smokers participated in the study, with allocation to different cycles of HNBC, EVC, and TC.
* Blood samples were analyzed for markers of oxidative stress, antioxidant reserve, platelet function, and cotinine levels.
* Endothelial dysfunction (as assessed by FMD) and cardiovascular parameters were analyzed.
* A 7-question product satisfaction questionnaire was administered after each smoking session.
* All measurements were conducted by personnel blinded to the actual product used by the participant during each experimental session.
* HNBC and EVC had less impact than TC on soluble Nox2-derived peptide, H2O2 breakdown activity, soluble CD40 ligand, and soluble P-selectin.
* The effect of HNBC and, to a lesser extent EVC, on blood pressure was less evident than that of TC.
* HNBC appeared more satisfying than EVC in terms of smoking satisfaction.

Main Message:
The study suggests that acute effects of HNBC, EVC, and TC are different on several oxidative stress, antioxidant reserve, platelet function, cardiovascular, and satisfaction dimensions. TCs showed the most detrimental changes in clinically relevant features, suggesting that these modified risk products may be useful for smokers trying to quit TCs. However, the long-term safety and efficacy of these products in smoking cessation need further investigation.

Biondi‐Zoccai, Giuseppe, Sebastiano Sciarretta, Christopher Bullen, Cristina Nocella, Francesco Violi, Lorenzo Loffredo, Pasquale Pignatelli, et al. “Acute Effects of Heat‐Not‐Burn, Electronic Vaping, and Traditional Tobacco Combustion Cigarettes: The Sapienza University of Rome‐Vascular Assessment of Proatherosclerotic Effects of Smoking (SUR‐VAPES) 2 Randomized Trial.” Journal of the American Heart Association 8, no. 6 (March 19, 2019): e010455. https://doi.org/10.1161/JAHA.118.010455.