Tobacco habit still represents the leading preventable cause of morbidity and mortality worldwide. Heat-not-burn cigarettes (HNBCs) are considered as an alternative to traditional combustion cigarettes (TCCs) due to the lack of combustion and the absence of combustion-related specific toxicants. The aim of this observational study was to assess the effect of HNBC on endothelial function, oxidative stress and platelet activation in chronic adult TCC smokers and HNBC users. The results showed that both HNBC and TCC display an adverse phenotype in terms of endothelial function, oxidative stress and platelet activation. Future randomised studies are strongly warranted to confirm these data.
- oxidative stress
- tobacco control
- heated tobacco product
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GB-Z and GF are co-senior authors.
LL and RC contributed equally.
Contributors LL and RC: full access to all of the data in the study, takes responsibility for the integrity of the data and the accuracy of the data analysis, and wrote the manuscript; SBat, RM and SP: patient recruitment; SBar, CN and VC experimental work, writing the manuscript; SS, IC, EDF, EC, MP, AM, FM, FV and AM: data analysis and interpretation, writing the manuscript, review and editing; GB-Z: formal analysis; GF: conceptualisation, supervision, writing the manuscript, review and editing.
Funding This study was supported by Sapienza University of Rome (grant 2018 Prot. RM118164264ED867), 'The Sapienza University of Rome-Vascular Assessment of Proatherosclerotic Effects of Smoking (SUR-VAPES) 4 trial' to GF and by Sapienza University of Rome (grant 2020 Prot. RM120172B3C38D48), 'Impact of chronic use of heat-not-burn cigarettes on oxidative stress, endhotelial dysfunction and platelet activation in adults and children' to LL.
Competing interests GB-Z has consulted for Cardionovum, InnovHeart, Meditrial and Replycare. All remaining authors declare no conflict of interest or financial disclosures.
Provenance and peer review Not commissioned; externally peer reviewed.
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