Pathophysiologie der Gefäßwandschädigung durch Zigarettenkonsum – unterschiedliche Relevanz von Verbrennungsrauch und Nikotin

Smoking is a recognized risk factor for cardiovascular disease. This finding is based on a large number of studies, which have always been based on the consumption of combustion cigarettes. Smoking is associated with the intake of a large number of harmful substances from the combustion process. E‑cigarettes and tobacco heaters release a vapor that differs significantly from the smoke of combustion cigarettes. From the point of view of atherosclerosis, it is important that this vapor leads to significantly less or no depletion of NO in the endothelium. After several months, people who had switched to e‑cigarettes and tobacco heaters showed significantly reduced CO levels that were within the range of non-smoker status. There is an increasing number of studies showing significantly reduced effects of e‑cigarettes on endothelial function compared to smoking combustion cigarettes. Tobacco heaters and e‑cigarettes also had a smaller effect than combustion cigarettes on flow-mediated dilation, soluble CD40 ligand, and soluble P‑selectin. Since e‑cigarettes increase the likelihood of successful smoking cessation as compared to nicotine replacement therapy in addition to eliciting these reduced endothelial effects, they should not be dismissed for smoking cessation.