Translational Research Project Grant

Dr Markos Klonizakis, Sheffield Hallam University

Amount: £144,134

There are 10 million cigarette smokers in the UK and the electronic cigarette or e-cigarette is considered as the number one aid to stop smoking. This project will investigate the health benefits and risks of using e-cigarettes.

It is estimated that there are 10 million cigarette smokers in the UK and 1.3 billion in the world. Smoking is the leading preventable cause of death worldwide, with the majority of these deaths due to cardiovascular disease.


Cigarette smoke contains more than 9,000 chemicals. While nicotine is thought to cause the greatest harm to the heart and blood vessels, there are other chemicals present that also have damaging effects. In fact, the effects of smoking on the blood vessels are so powerful that cigarette smoking can have immediate harmful effects on the small blood vessels, whilst ‘passive smoking’ can increase heart disease risk by as much as 30 per cent.


Nicotine can be highly addictive and if it cannot be avoided, it is important to encourage replacement of cigarettes with ‘cleaner’ nicotine-based products as an aid to stop smoking. The NHS has adopted this approach and supports the use nicotine replacement therapy (NRT). However, its appeal to smokers is quite low and 75 per cent of ‘quitters’ start smoking again within six months.


The electronic cigarette (or e-cigarette) has been embraced by the public, with an estimated 2.8 million users in the UK in 2016. It is currently considered the number one aid to stop smoking among those who want to quit. Although e-cigarettes have been found to successfully support reduction in the numbers of cigarettes smoked and appear to have a relatively small number of side effects, little is known about their effects on the heart and blood vessels, or their effects on cardiovascular disease risk.


This project will involve 267 smokers who want to stop smoking and will be randomly divided into the following three groups:


  • Group A will receive nicotine-rich e-cigarettes and behavioural change support


  • Group B will receive nicotine-free e-cigarettes and behavioural change support


  • Group C will be referred to NHS smoking cessation clinics (with a view to receiving nicotine replacement therapy and behavioural change support)


The researchers will study the effects of these three aids to stop smoking on the cardiovascular system. They will assess the health of the small and large arteries, cardiovascular disease risk, degree of nicotine addiction and also compare the cost of the three options. Finally, they will interview a number of participants to find out the effects of these approaches to their lives, and explore what encourages and what deters them from quitting smoking.


E-cigarettes are becoming increasingly popular but little is known about their safety and health effects. More research is urgently needed and the findings will help smokers who want to quit to make an informed decision about which option to choose.


If you live in Sheffield and want to take part, please contact Dr Gareth Jones on 0114 225 4312 or email

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