New Technologies for Health: electronic substitutions for smoking reduce harm (research)
UKRAINE, Kyiv, July 19, 2017 – Scientists of the National Scientific Center "M.D. Strazhesko Institute of Cardiology" completed a 6-month research that studied changes in the cardiovascular health of participants after switching from traditional cigarettes to electronic alternatives – tobacco or E-liquid based nicotine inhalers.
According to the biochemical findings, transition to Electronic Nicotine Delivery Systems (ENDS), electronic alternatives that deliver nicotine to the body without the combustion of cigarette, allows to avoid: oxygen transport dysfunction, vascular endothelium damage and proatherogenic changes in metabolism of lipids and lipoproteins in the blood. This, in turn, reflects evidence that tobacco heating or E-liquid based nicotine delivery systems reduce risks of cardiovascular diseases (CVD).
Furthermore, the results of the research revealed absence of any notable side effects caused by use of ENDS.
"Our 6-month study convincingly demonstrated an improvement in endothelial function and a reduction in the risk of cardiovascular disease in smokers when switching to the use of ENDS," summarised Olena Kvasha, MD, head of a group of scientists who carried out the study.
“The results of this research is yet another evidence to consider a harm reduction approach in the health policy, – said Dmytro Rafael, Head of the NGO “New Technologies for Health”. – Replacement of harmful products by less harmful alternatives is a pragmatic and natural way to reduce risk factors for health”.
The research had been conducted for 6 months from September 2016 till May 2017 by the group of scientists of the NSC "M.D. Strazhesko Institute of Cardiology" with support of the NGO “New Technologies for Health”.
Such research was conducted for the first time in Ukraine and as of today its results are considered the only scientific assessment of the effect of ENDS on health of Ukrainian smokers.
Ukrainian scientists mentioned that changes in health indicators of each test group suggest further research of each product that claims to be used within harm reduction approach.
The research had also concluded that use of electronic alternatives together with traditional smoking (so called “double use”) decrease significantly positive health effect of the former.
Research background information
In total 60 smoking men and women (49 and 11 persons respectively) over the age of 18 took part in an open local 6-months research. All participants have passed epidemiological screening of random urban population and were not motivated to quit smoking. All participants had a smoking experience of more than 15 years and smoked 15 or more cigarettes per day. All participants had been medically examined at the beginning of the research, after 3 and 6 months.
The research sample did not include individuals with coronary heart disease, heart failure, hypertensive disease of II-III degree, cerebrovascular disorders, and diabetes mellitus. According to the protocol, 3 groups of 20 people were formed: Group I – users of alternative to traditional smoking, the iQOS tobacco heating system, Group II - users of electronic cigarettes Joyetech eGo AIO and Group III of participants who continued to smoke traditional cigarettes as usually.
The survey included the following parameters.
Measurement of anthropometric indicators with the subsequent calculation of the Quetelet index (QI), assessment of the degree of nicotinic dependence (Fagerstrom test) and the type of smoking behavior (Horn's questionnaire), recording of the 12-lead electrocardiogram in resting state, and measurement of blood pressure (BP) with a sphygmomanometer.
The flow-dependent vasodilatation test was performed on the Philips HD11XE ultrasound device with a 3-12 MHz linear sensor. A value of more than 10% was considered as normal rate.
The blood samples to determine the level of lipids, glucose C-reactive protein (CRP), endotheliocyte progenitor cells (EPC), endothelin 1, carboxyhemoglobin (COHb) was drawn in the fasted state. The content of total cholesterol (CH), triglycerides (TG), high density lipoprotein cholesterol (HDL cholesterol) and CRP was determined by semi-automatic biochemical photometer Biosystem BTS 330 (Spain).
The content of low density lipoproteins (LDL cholesterol) was calculated by the Friedwald formula. To assess the ratio of atherogenic cholesterol fractions, the atherogenicity coefficient (AC) was used.
The level of endothelin 1 (ET-1) in the blood plasma was determined by an immunoenzymometric method with the Biomedica kit (Germany) and Elx800 photometer (BioTek). Calculation of the number of circulating EPC (CD 34 + 45 +) was performed by the flowing cytofluorimetry method on a laser cytofluorimeter Navios (BeckmanCoulter). 2956 ± 298 cells per ml had been considered as a normal rate of EPC.
Control of the use of traditional cigarettes was carried out by means of a questionnaire with a consecutive determination of the COHb level in blood plasma by a modified Wolf method with a biochemical photometer Biosystem BTS 330 (Spain). The content of COHb in non-smokers of the same age (0.1-1%) was considered as a reference value.
More details on the results and progress of the research can be found in scientific publications that will shortly appear on the "New Technologies for Health" website.
“New Technologies for Health" is a public initiative for development and advocacy of solutions for the important and urgent social problems in public health. The organisation considers it reasonable to address the public health issues in finding effective approaches to prevent the causes of morbidity, particularly by implementation of harm reduction approaches in the health policy. The origin of illness frequency is a prevalence of modified risk factors for health, particularly those provoking cardiovascular diseases as those that cause the majority of deaths in Ukraine. By preventing or minimising health risks, we make people healthier.
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