Reducing the Cardiovascular Risks of Smoking: Insights From the European Society of Cardiology (ESC) Congress 2024 and Two Key Opinion Leaders

Smoking is a major risk factor for cardiovascular disease (CVD) and responsible for around 25% of all CVD-related deaths worldwide. Cigarette combustion releases nicotine and produces thousands of chemicals, many of which are toxic. Complete cessation of smoking is the most effective way of reducing the associated CVD risk. However, many people find it difficult to quit smoking due to nicotine’s addictive nature and the ritualistic aspect of smoking. The European Society of Cardiology Congress (ESC) 2024, held in London, UK, between 30th August–2nd September, included several sessions discussing tobacco harm reduction in relation to CVD, with a particular focus on e-cigarettes and heat-not-burn products (HNBP) as alternatives to cigarettes. EMJ interviewed two key opinion leaders (KOL), who had attended ESC 2024, to obtain their insights into tobacco harm reduction in Europe: Vincenzo Montemurro, Professor and Consultant Cardiologist at the Scilla Hospital of America, Reggio Calabria, Italy; and Emil Toldy-Schedel, Professor, Consultant Cardiologist, and General Director of the St. Francis Hospital, Budapest, Hungary. Montemurro explained that switching from cigarettes to alternative products that generate fewer toxins would likely reduce CVD risk in people who are unable to quit smoking, which would benefit public health and decrease healthcare expenditure in Europe. Toldy-Schedel agreed with this view but called for well-designed studies to fully characterise the risk profile of these newer products so that healthcare professionals can be better equipped to answer patients’ questions about possible long-term effects.