Ricerc@Sapienza

Smoking is a worldwide healthy issue, concerning millions of people including youth individuals with a serious impact 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 subjects to quit. In order to minimize
smoking-related damages, modern strategies essentially based on surrogates of traditional tobacco products, have been developed.
Accordingly, Electronic Cigarettes (EC), a technological surrogate of traditional tobacco cigarettes (TC) has been firtly marketed in 2004. As EC employ heat to convert nicotine or flavored nicotine-free solutions into vapour avoiding combustion, in theory they should represent a much less harmful alternative to TC. Despite this apparent advantage, the harmlessness of EC is still to be fully proven. In 2016 an improvement of these devices has been launched on the market as I-Quit-Ordinary-Smoking (iQOS 2.2, by Philip Morris). However little independent research on the heat-not-burn Tobacco Heating System 2.2 (THS2.2, IQOS) has been reported. Since 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, in particular on oxidative stress and on endothelial function, we aim to compare in a new randomized controlled clinical trial the in vivo effects on cardiovascular and pulmonar function of TC, EC or iQOS.
Our study may provide new biological insights into the cardiovascular effects of both iQOS and EC with high clinical and social relevance.