Lifestyle Exercise and Nutrition Improvement (LENI) Research Group, Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield, S10 2BP, UK.
Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, S10 2BP, UK.
BMC Med. 2022 Aug 16;20(1):276. doi: 10.1186/s12916-022-02451-9.
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).
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).
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).
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.
ClinicalTrials.gov NCT03061253 . Registered on 17 February 2017.
吸烟是心血管疾病的主要危险因素，戒烟可降低风险。电子烟在戒烟方面很受欢迎，但关于其心血管健康影响的证据很少。我们的目的是比较使用含尼古丁或不含尼古丁的电子烟以及处方尼古丁替代疗法（NRT）戒烟的吸烟者在中、长期的心血管效果。
这是一项单中心、实用的三臂随机（1:1:1）对照试验，招募了有意愿在支持下尝试戒烟的成年吸烟者（≥10 支/天）（n=248）。参与者被随机分配接受行为支持，包括（a）含 18mg/ml 尼古丁的电子烟，（b）不含尼古丁的电子烟，和（c）NRT。在戒烟后 3 个月和 6 个月时，记录血流介导的扩张（%FMD）和峰值皮肤血管传导（CVCmax）对乙酰胆碱（ACh）和硝普钠（SNP）的反应、平均动脉压（MAP）和其他结果。使用广义估计方程（GEE）进行数据分析。
在 3 个月和 6 个月的随访中，所有三组的%FMD 均较基线有所改善（例如，在 6 个月时 p<0.0001）。同样，所有三组在 3 个月和 6 个月时，ACh、SNP 和 MAP 均较基线显著改善（例如，ACh：p=0.004，在 6 个月时）。
尝试戒烟的吸烟者在 3 个月和 6 个月后均经历了积极的心血管影响。在含尼古丁和不含尼古丁的电子烟或 NRT 中，没有一组能为其他组提供更好的心血管益处。
ClinicalTrials.gov NCT03061253。于 2017 年 2 月 17 日注册。
