Effect of continuous smoking reduction and abstinence on blood pressure and heart rate in smokers switching to electronic cigarettes

Introduction:
This text presents the results of a prospective 12-month double-blind, controlled, randomized clinical trial examining the effects of smoking reduction and abstinence on resting blood pressure (BP) and heart rate (hR) in smokers who switch to electronic cigarettes (ECs). The study aims to evaluate smoking reduction, smoking abstinence, and adverse events in apparently healthy smokers not intending to quit after switching to a popular EC brand.

Key Points:

* The study included 300 regular smokers, randomly assigned to three groups: Group a received 2.4% nicotine cartridges, Group B received 1.8% nicotine cartridges, and Group C received no-nicotine cartridges.
* BP and hR were compared among study groups and pooled continuous smoking phenotype classifications (quitters, reducers, and failures).
* The analysis was repeated in a subgroup of participants with abnormal elevated BP at baseline.
* No significant changes were observed among study groups for SBP, DBP, and hR.
* In 145 subjects with a continuous smoking phenotype, a small but statistically significant reduction in SBP was observed at week 52 compared to baseline.
* In 66 subjects with elevated BP at baseline, a substantial reduction in SBP was observed at week 52 compared to baseline, with a significant effect found for smoking phenotype classification.
* after adjusting for weight change, gender, and age, reduction in SBP from baseline at week 52 remains associated significantly with both smoking reduction and smoking abstinence.

Main Message:
The study suggests that smokers who reduce or quit smoking by switching to ECs may lower their systolic BP in the long term, especially in those with elevated BP. This reduction is apparent whether ECs are regularly used or not, providing evidence that using ECs as a substitute for tobacco smoking is unlikely to raise significant health concerns. The study's findings can improve counseling between physicians and their cardiovascular patients using or intending to use ECs, ultimately contributing to tobacco harm reduction.

Farsalinos, Konstantinos, Fabio Cibella, Pasquale Caponnetto, Davide Campagna, Jaymin Bhagwanji Morjaria, Eliana Battaglia, Massimo Caruso, Cristina Russo, and Riccardo Polosa. “Effect of Continuous Smoking Reduction and abstinence on Blood Pressure and heart Rate in Smokers Switching to Electronic Cigarettes.” Internal and Emergency Medicine 11, no. 1 (February 2016): 85–94. https://doi.org/10.1007/s11739-015-1361-y.