Ricerc@Sapienza

Smoking is a worldwide healthy issue, affecting millions of people including youth individuals with profound repercussions on National Health Systems. Although international recommendations encourage smoking cessation, relapses always occur due to the variety of known and unknown biological mechanisms underlying smoking addiction, which hamper the subject to quit. In order to minimize smoking-related damages, modern strategies essentially based on substitutes of tobacco smoking cessation, have been developed such as the Electronic cigarettes (EC), a technological surrogate of traditional tobacco cigarettes (TC) marketed in 2004. As EC employ heat to convert nicotine or flavored nicotine-free solutions into vapour avoiding combustion, they represent a much less harmful alternative than TC. Despite this apparent advantage, the harmlessness of EC is still to be fully proven. In 2016 an improvement of the heating-not-burning device has been launched on the market as I-Quit-Ordinary-Smoking (iQOS, by Philip Morris). Although iQOS seem less harmful than TC, skepticism still remains as no study on proper comparison among TC, EC and iQOS devices is currently available to prove similarities or differences.
Recently, we have firstly conducted in literature a cross-over single-blind study on the impact of EC vs. TC, demonstrating an equal and unfavourable influence on the cardiovascular function parallel to increased oxidative stress and impaired endothelial function.
Here, we aim to compare in a new randomized controlled clinical trial the in vivo effects on cardiovascular function in TC, EC or iQOS users and to evaluate their potential biological effects on the angiogenic, epigenetic and oxidative-related profile by employing the in vitro model of circulating endothelial progenitor cells (EPCs) obtained from recruited subjects. Our study may provide new biological insights into the cardiovascular effects of both iQOS and EC also with high clinical and social relevance.