EFFECTS OF TREATMENT ON CARDIOVASCULAR RISK AMONG SMOKELESS TOBACCO USERS

Background Studies show sustained levels of nicotine among young males using smokeless tobacco, causing concern for subsequent cardiovascula r risk. Also, there is little information on effects of nicotine repla cement on cardiovascular risk in cessation programs. This study invest igates the effects of nicotine gum replacement in smokeless tobacco ce ssation on cardiovascular risk factors. Methods. Smokeless tobacco use rs, ages 18-65, were randomly assigned in a double-blind fashion to 2- mg nicotine or placebo gum. At baseline, Week 4, and Week 8, dependent measurements, heart rate, blood pressure, and weight were recorded, a nd fasting lipoprotein profiles were drawn. Results. This paper focuse s on the smokeless tobacco users who refrained from use during the stu dy period (N = 56). The nicotine gum group weighed less (P = 0.033) th an the placebo group throughout the study and weight increased at a si gnificant rate between Weeks 4 and 8 for both groups as gum decreased. Triglycerides were higher for the nicotine gum group than the placebo group (P = 0.031), with triglycerides decreasing between Weeks 4 and 8, with a similar effect seen among nonabstinent smokeless tobacco use rs. There was no dose, time, or dose by time effect for the other depe ndent measures. Conclusions. Among smokeless tobacco users who were ab stinent, weight increased, with subjects on nicotine gum weighing less throughout the study. The lipoprotein profile, heart rate, and blood pressure did not improve over time, contrary to smokers in whom HDL in creases and heart rate decreases with cessation. This could relate to different routes of administration, pharmacokinetics, or by-products o f tobacco smoking being absent in smokeless tobacco. In addition, nico tine gum appeared to have neither an adverse nor a positive effect on heart rate, blood pressure, LDL, HDL, or total cholesterol. (C) 1995 A cademic Press, Inc.