title: Effect of continuous smoking reduction and abstinence on blood pressure and heart rate in smokers switching to electronic cigarettes.
abstract: We present prospective blood pressure (BP) and hear rate (HR) changes in smokers invited to switch to e-cigarettes in the ECLAT study. BP and HR changes were compared among (1) different study groups (users of high, low, and zero nicotine products) and (2) pooled continuous smoking phenotype classification (same phenotype from week 12 to -52), with participants classified as quitters (completely quit smoking), reducers (≥50% reduction in smoking consumption) and failures (<50% or no reduction in smoking consumption). Additionally, the latter comparison was repeated in a subgroup of participants with elevated BP at baseline. No significant changes were observed among study groups for systolic BP, diastolic BP, and HR. In 145 subjects with a continuous smoking phenotype, we observed lower systolic BP at week 52 compared to baseline but no effect of smoking phenotype classification. When the same analysis was repeated in 66 subjects with elevated BP at baseline, a substantial reduction in systolic BP was observed at week 52 compared to baseline (132.4 ± 12.0 vs. 141.2 ± 10.5 mmHg, p < 0.001), with a significant effect found for smoking phenotype classification. After adjusting for weight change, gender and age, reduction in systolic BP from baseline at week 52 remains associated significantly with both smoking reduction and smoking abstinence. In conclusion, smokers who reduce or quit smoking by switching to e-cigarettes may lower their systolic BP in the long term, and this reduction is apparent in smokers with elevated BP. The current study adds to the evidence that quitting smoking with the use of e-cigarettes does not lead to higher BP values, and this is independently observed whether e-cigarettes are regularly used or not.
authors.affiliation: Department of Cardiology, Onassis Cardiac Surgery Center, Kallithea, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Farsalinos
authors.affiliation: National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Cibella
authors.affiliation: Centro Per La Prevenzione e Cura Del Tabagismo, Azienda Ospedaliero, Universitaria "Policlinico-V. Emanuele", Università di Catania, Catania, Italy. p.caponnetto@unict.it.|Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Azienda Ospedaliero, Universitaria "Policlinico-Vittorio Emanuele", Università di Catania, Catania, Italy. p.caponnetto@unict.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Caponnetto
authors.affiliation: Centro Per La Prevenzione e Cura Del Tabagismo, Azienda Ospedaliero, Universitaria "Policlinico-V. Emanuele", Università di Catania, Catania, Italy.|Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Azienda Ospedaliero, Universitaria "Policlinico-Vittorio Emanuele", Università di Catania, Catania, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Campagna
authors.affiliation: Division of Cardiovascular and Respiratory Studies, Hull York Medical School, Castle Hill Hospital, University of Hull, Cottingham, UK.
authors.forename: Jaymin Bhagwanji
authors.initials: JB
authors.lastname: Morjaria
authors.affiliation: Centro Per La Prevenzione e Cura Del Tabagismo, Azienda Ospedaliero, Universitaria "Policlinico-V. Emanuele", Università di Catania, Catania, Italy.|Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Azienda Ospedaliero, Universitaria "Policlinico-Vittorio Emanuele", Università di Catania, Catania, Italy.
authors.forename: Eliana
authors.initials: E
authors.lastname: Battaglia
authors.affiliation: Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Azienda Ospedaliero, Universitaria "Policlinico-Vittorio Emanuele", Università di Catania, Catania, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Caruso
authors.affiliation: Centro Per La Prevenzione e Cura Del Tabagismo, Azienda Ospedaliero, Universitaria "Policlinico-V. Emanuele", Università di Catania, Catania, Italy.|Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Azienda Ospedaliero, Universitaria "Policlinico-Vittorio Emanuele", Università di Catania, Catania, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Russo
authors.affiliation: Centro Per La Prevenzione e Cura Del Tabagismo, Azienda Ospedaliero, Universitaria "Policlinico-V. Emanuele", Università di Catania, Catania, Italy. polosa@unict.it.|Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Azienda Ospedaliero, Universitaria "Policlinico-Vittorio Emanuele", Università di Catania, Catania, Italy. polosa@unict.it.|UOC di Medicina Interna e d'Urgenza, Edificio 4, Piano 3, AOU ''Policlinico-V. Emanuele'', Via S. Sofia 78, 95123, Catania, Italy. polosa@unict.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Polosa
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000503:physiopathology*; D016540:Smoking Cessation; D000074606:Smoking Prevention
keywords: Blood pressure; Electronic cigarette; Heart rate; Smoking cessation; Smoking reduction; Tobacco harm reduction