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Sep 24, 2021
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Smoking: is there a less risky alternative?

What is the problem?

In matters of tobacco consumption, scientists and doctors are unanimous: only a complete rejection of nicotine in any form can be considered a reduction in all risks from its consumption. Consumers themselves do not seem to argue with this. According to TRAIN, 60% of smokers around the world would like to give up their bad habit. But not everyone succeeds.

Despite the fact that smoking bind with cardiovascular pathologies and diseases such as cancer, asthma, COPD, tuberculosis, erectile dysfunction, many nicotine addicts do not want or are unable to quit smoking. The question arises, is it possible to make the process of consuming nicotine less risky? Although there is still no unequivocally positive answer, the world community is trying to find a solution to this problem.

What options?

There are a number of products that completely eliminate combustion processes: tobacco heating systems, vapes, electronic cigarettes and nicotine packs. One of the most popular technologies, tobacco heating systems, works by heating a tobacco stick. This eliminates the formation of smoke and tar, and the delivery of nicotine to the body is carried out by aerosol.

This technology does not make the main component – nicotine – harmless, but excludes the effects of other tobacco combustion products. It is known that when an ordinary cigarette is burned together with smoke, harmful substances such as carbon monoxide, nitrosamines, aldehydes, resins are released – only about 4 thousand chemical compounds, more than 70 of which are considered carcinogenic.

Smoke-free allows scientists to consider new systems delivery of nicotine as a potentially less harmful alternative to conventional cigarettes. There is still controversy surrounding this hypothesis. To be clear, scientists explore aerosol of innovative devices, comparing them to traditional cigarettes. Researchers are analyzing how switching to heating systems reduces toxic substances in the body compared to continuing to smoke. To study the issue, volunteer smokers are involved, as British scientists recently did.

Fresh research

In the UK, a half-year study was conducted and compared how much less harm from glo electronic heating systems is compared to conventional cigarettes. Results of work published in the journal Internal and Emergency Medicine this June.

Who were invited as participants?

During the experiment, scientists selected 295 men and women who smoked 10 to 30 cigarettes or roll-ups with tobacco for at least five years in a row.

They were divided into three groups:

  • 59 people continued to smoke their regular cigarettes;
  • 127 – switched exclusively to glo tobacco heating systems;
  • 109 participants quit smoking using nicotine replacement therapy.

The participants were mainly young people, whose average age is from 37 to 40 years. They had no obvious health problems, and the ECG, laboratory tests and lung function tests remained within normal limits. In addition, at least two weeks before the start of the experiment and during the study itself, none of the subjects took drugs that suppress inflammation or affect the functioning of the liver.

How was the effect measured?

Five times within six months, the researchers measured the level of 13 biomarkers in the participants’ daily urine – toxic and carcinogenic substances that accumulate as a result of the consumption of tobacco products. We chose those indicators that are usually associated with the risk of developing “diseases from smoking”. For example, the biomarker NNAL, which is considered a carcinogen that causes lung cancer.

Scientists also assessed the general state of the body of smokers who switched to the tobacco heating system and switched to nicotine replacement therapy. For this, biomarkers of potential harm were investigated. For example, white blood cell and prostaglandin levels 8-Epi-PGF2a type IIIindicating general inflammation and oxidative stress. Whole blood, plasma and serum were used to detect biomarkers of potential harm. The exhaled air was also analyzed. It measured the level of nitric oxide (FeNO), which indirectly indicates the state of the vessels of the lungs and inflammation of the respiratory system.

The transition from conventional cigarettes to the tobacco heating system and smoking cessation in the quitting group was monitored by measuring the CEVal (N-2-cyanoethyl-valine) index. This substance is a marker of burnt tobacco in erythrocytes – red blood cells – and persists in the blood for up to 120 days.

What happened as a result?

Scientists several times during the study compared rates between groups and with data from a control group of never smokers. In regular cigarette smokers, all biomarkers remained stably expressed during six months of observation, which indicates a high level of health risk. In the remaining groups, changes in biomarkers such as the carcinogen NNAL, prostaglandin 8-Epi-PGF2a type III, and the number of leukocytes were especially pronounced.

These rates declined in those who gave up cigarettes altogether and switched to using the tobacco heating system. For example, the level of NNAL in this group of participants by the end of the first month decreased by about half and remained at this mark until the end of the study.

Also significant were the data on benzene (s-PMA) and hydrocarbon (MHBMA) products. By the end of the study, the levels of these markers in those who switched to tobacco heating systems and in those who quit smoking were equal to those of never-smokers in the control group.

It also turned out that the level of nitrogen oxide (FeNO) increased in the exhaled air when switching from cigarettes to tobacco heating systems. A change in this indicator indicates that the vessels of the lungs have probably become less spasmodic.

Predictably, of the three groups of smokers, the best changes occurred in those who quit completely. Their level of the biomarker of carcinogenicity NNAL after 30 days fell by almost 80%, and after six months it was equal to the indicators of the non-smoking group. For most indicators, quitters also outperformed the smokers group significantly. The results of those who completely switched to glo are in many ways comparable to those study participants who completely quit smoking.

What are the conclusions?

Any use of nicotine is associated with health risks and the best decision for health is to stop using it completely. The new study builds on scientists’ past work on alternative nicotine products and provides some useful insights.

Due to the lack of smoke, tobacco heating systems can provide a more gentle alternative to regular cigarettes for those adults who already smoke. it confirm American experts (CDC), clarifying that sparing does not mean safe. These devices contain nicotine, which means they can cause the same addiction as regular tobacco.

Clarification from the authors of the study

NSThe positive changes in biomarkers in those who switched to tobacco heating systems occurred only with a strict rejection of conventional cigarettes. The difficulty, which the authors of the article themselves write about, is that average healthy people were selected for the study and the results may differ slightly at the population level. According to the authors of the work, the results will not necessarily be the same if smokers use both cigarettes and their counterparts at the same time. The long-term impact of switching from cigarettes to tobacco heating systems remains for further study.

How do I apply the new data?

By eliminating the harmful effects of cigarette smoke, tobacco heating technology can be a good supportive aid in the fight against smoking. This application of modern technology proposes British National Health Service (NHS).

This is indeed confirm Cochrane Science Library data: out of a hundred people who quit smoking, 10 will be able to do it by switching to electronic nicotine delivery systems, six – using nicotine replacement therapy, and only four – on their own


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