Switching from tobacco to e-cigarettes improves vascular health

Vascular health has significantly improved within 1 month of switching from tobacco cigarette (TC) to e-cigarette (EC), particularly in females, a study has shown. Switching from TC to EC may thus be regarded as a harms reduction measure.

This prospective, randomized controlled trial with a parallel nonrandomized preference cohort and blinded endpoint included smokers aged ≥18 years who had smoked ≥15 cigarettes/day for ≥2 years and were free from established cardiovascular disease. They were randomly assigned to EC with or without nicotine for 1 month. Those unwilling to quit continued with TC in a parallel preference arm.

The authors performed a propensity-score analysis to adjust for differences between the randomized and preference arms. They then assessed vascular function by flow-mediated dilation (FMD) and pulse wave velocity. Carbon monoxide levels were used to measure compliance with EC.

A significant improvement was achieved within 1 month of switching from TC to EC in endothelial function (linear trend β, 0.73 percent, 95 percent confidence interval [CI], 0.41–1.05; p<0.0001; TC vs EC combined: 1.49 percent, 95 percent CI, 0.93–2.04; p<0.0001) and vascular stiffness (−0.529 m/s, 95 percent CI, −0.946 to −0.112; p=0.014).

In every between-group comparison, females benefitted more than males from switching to EC, and those with the best compliance to the EC switch showed the largest improvement. Moreover, no difference was seen in vascular effects between EC with and without nicotine within the study timeframe.

“Meta-analysis of FMD studies indicate 13-percent lower pooled, adjusted relative risks of cardiovascular events with every 1-percent improvement in FMD,” the authors said.