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

Introduction:
This text discusses a randomized controlled trial that aimed to compare the medium- and longer-term cardiovascular effects of smoking cessation attempts supported using e-cigarettes with nicotine, e-cigarettes without nicotine, and prescription nicotine replacement therapy (NRT). The study's key points provide insight into the trial design, participant characteristics, and cardiovascular outcomes.

Key Points:

* Three-arm randomized controlled trial with 248 participants randomized into three groups: nicotine-containing e-cigarettes, nicotine-free e-cigarettes, and NRT.
* Participants were smokers who smoked ≥ 10 cigarettes/day for the last year, aged ≥ 18, and willing to make a cessation attempt using a stop-smoking service or e-cigarettes.
* The primary outcome was macrovascular function assessed using percentage change in flow-mediated dilation (FMD). Secondary outcomes included peak cutaneous vascular conductance (CVC) responses to acetylcholine (aCh) and sodium nitroprusside (SNP), mean arterial pressure (MaP), quality of life, q-Risk, and total cholesterol over high-density lipoprotein (hDL) ratio.
* Participants were abstinent from caffeine, main meals, supplements, and e-cigarettes and smoking for at least 3 hours prior to the assessments.
* The trial found no significant differences in FMD, CVC responses to aCh and SNP, and MaP between the three groups at 3 and 6 months.
* all groups showed improvements in FMD, CVC responses to aCh and SNP, and MaP at 3 and 6 months compared to baseline.
* Females had a greater gain in macrovascular function improvement than males.
* The study suggests that smokers attempting to quit experienced positive cardiovascular impact after both a 3- and 6-month period, regardless of the group they belonged to.

Main Message:
The main message of this study is that smoking cessation attempts using e-cigarettes with nicotine, e-cigarettes without nicotine, or NRT offer similar cardiovascular benefits. The study suggests that smoking cessation is essential for improving cardiovascular health, and smokers attempting to quit can choose the method that works best for them. additionally, the study highlights the need for further research to determine the long-term cardiovascular effects of e-cigarettes and NRT use in smoking cessation attempts.

Klonizakis M, Gumber a, McIntosh E, Brose LS. Medium- and longer-term cardiovascular effects of e-cigarettes in adults making a stop-smoking attempt: a randomized controlled trial. BMC medicine. 2022;20(1):276. doi:10.1186/s12916-022-02451-9