Background: During the COVID-19 era, the use of surgical face mask hampers the spread of COVID infection. The impact of smoking while wearing a surgical face mask on exhaled CO and vascular function in smokers has not been investigated.

Material and Methods: We studied 40 smokers of conventional cigarettes (ConCig), 40 exclusive heat-non-burn cigarettes (HNBC) users and 40 non-smokers with similar age and sex (p>0.05 [45.1±10.8 years, 34 (28.3%) male]). We measured exhaled CO (parts per million [ppm]), pulse wave velocity (PWV) and central systolic blood pressure (cSBP).

Results: A significant interaction was found between CO at baseline and at the end of an 8h period with and without wearing a mask and the use of tobacco products vs no-smoking (F=46.58, p for interaction <0.001). Exhaled CO was higher in ConCig smokers compared to HNBC and non-smokers throughout the study (p<0.05).

Compared to baseline, the percent increase of CO was greater after smoking ConCig with than without wearing a mask for 8h (141.79% [95% confidence interval (CI): 116.16-167.42] vs 56.99% [95% CI: 44.80–69.18], p<0.001). Similarly, the percent increase of CO was greater after smoking HNBC with than without wearing a mask for 8h (103.84% [95% CI: 70.50-137.18] vs 30.76% [95% CI: 15.61-45.92], p<0.001). Among non-smokers, the use of mask did not alter exhaled CO (p>0.05).

In both ConCig and HNBC users, all vascular markers were increased at the end of each one of two study assessments, compared to baseline (p<0.05). In non-smokers, the use of a mask had a neutral effect on vascular markers (p>0.05).

Compared to baseline, the percent increase of PWV was greater after smoking ConCig with than without wearing a mask for 8h (16.54% [95% CI: 9.13-23.95] vs 4.36% [95% CI: 1.41-7.31], p=0.001).

Compared to baseline, the percent increase of PWV was greater after smoking HNBC with than without wearing a mask for 8h (9.71% [95% CI: 4.57-14.84] vs 2.73% [95% CI: 0.12-5.35], p=0.003).

Conclusions: This study demonstrates that smoking of any tobacco product (conventional tobacco or HNBC) during a prolonged use of a surgical face mask may further compromise vascular function. Thus, quitting both conventional and HNBC cigarettes is imperative for a better health in the COVID-19 pandemic.

AUTHORS: Ignatios Ikonomidis¹, Konstantinos Katogiannis¹, Kallirhoe Kourea¹, Gavriella Kostelli¹, Damianos Tsilivarakis¹, Vaia Lambadiari², Dimitrios Kouretas³, Giuseppe Biondi-Zoccai^4,5

AFFILIATIONS: ¹2^nd Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Greece || ²2^nd Department of Internal Medicine, Research Unit and Diabetes Centre, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Greece || ³Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, Greece || ⁴Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy || ⁵Mediterranea Cardiocentro, Napoli, Italy

Introduction: Nowadays, the smoking rates in Greece are extremely high and a huge part of smokers, especially when it comes to young adults, are looking for more healthy smoking options, such as the electronic cigarette.

Material and Methods: A two-part questionnaire was shared to 550 students in Public Schools of various specialties. The first part included socio-demographic characteristics, such as the gender, age and the students’ smoking habit. The second part included questions that had to do with the effectiveness of electronic cigarette.

Results: Out of 550 students, 42% of them had begun smoking in the age group of 16-19 years old (p<0.05), 59% of total students are not smoking nowadays and 67% of smokers do not want to stop smoking. Furthermore, 53% of the students that participated in the survey consider the e-cigarette as a healthier option for smoking (p<0.05).

Conclusions: More and more students are trying to adapt to a healthier lifestyle and choose alternative and healthier smoking options, such as e-cigarette, instead of the conventional cigarettes.

AUTHORS: Marianna-Foteini Dafni, Zisimos Likudis

AFFILIATION: Department of Public and Community Health, School of Public Health, University of West Attica, Athens, Greece

Generally recognized harm reduction promotion has experienced a significant rise in Kazakhstan over the last years. Following years of research, experience, opinion exchanges and reports, in 2020 industry leaders, healthcare professionals and other respective experts came together and formed Harm Reduction Association of Kazakhstan. The association is now the main holder of harm reduction concept development in the state. The vision is to disseminate and educate the public on harm reduction with real world research results and science-based international reports through the prism of factors of non-infectious diseases and consumers’ rights. The association was the first non-governmental organization that brought drug replacement therapy to Kazakhstan back in 2014 under a pilot project which after being proved effective has evolved into a state program funded by the government. The members’ list of the association has expanded since its formation and its experts have completed numerous studies, organized impactful events and drawn communication reports to government bodies. This recently created organization aspires to further continue developing harm reduction mindset among the public leveraging various forms of research, educational events and publicly available reports.

AUTHORS: Gintautas-Yuozas Kentra, Bakhyt Tumenova

AFFILIATION: ALE “Densaulyk”, Republic of Kazakhstan