June 1, 2002Open Access
View Full PaperCardiovascular Effects of Nasal and Transdermal Nicotine and Cigarette Smoking
Key Result
Transdermal nicotine and nicotine nasal spray produced fewer effects on cardiovascular risk biomarkers, including plasma epinephrine and fibrinogen, compared to cigarette smoking.
Study Design
Type
RCT (n=12)
Structured PICO
Do transdermal and nasal nicotine replacement therapies have fewer effects on cardiovascular risk biomarkers compared to cigarette smoking in healthy smokers?
P
Population
12 healthy cigarette smokers evaluated across 4 different 5-day nicotine delivery conditions.
I
Intervention
Transdermal nicotine (15 mg/16 h) and nicotine nasal spray (24 1-mg doses per day), each for 5 days
C
Comparator
Cigarette smoking (16 per day) and placebo nasal spray, each for 5 days
O
Outcome
Circadian blood pressure and heart rate patternssurrogate
Transdermal and nasal nicotine replacement therapies have fewer adverse effects on cardiovascular risk biomarkers than cigarette smoking.
Abstract
The purpose of this study was to compare circadian blood pressure and heart rate patterns and other cardiovascular effects of nicotine delivered rapidly (via nasal spray, NNS), slowly (transdermal nicotine, TDN), by cigarette smoking (rapid delivery of nicotine plus other smoke toxins), and placebo NNS. Twelve healthy cigarette smokers were studied on a research ward when they smoked cigarettes (16 per day) or used TDN (15 mg/16 h), NNS (24 1-mg doses per day), or placebo NNS, each for 5 days. There were no significant differences in systolic blood pressure, but diastolic blood pressure was slightly increased during cigarette smoking. Plasma epinephrine, beta-thromboglobulin, and fibrinogen levels were higher during cigarette smoking than with TDN. For most measurements, NNS values were intermediate between and not significantly different from those of cigarette smoking and TDN. We conclude that, at recommended doses, TDN and NNS have fewer effects on biomarkers of cardiovascular risk than does cigarette smoking.