A study published in Scientific Reports reveals that smokers who switch to electronic cigarettes or heated tobacco products (HTPs) can achieve significant improvements in aerobic capacity as early as four weeks after quitting cigarettes. The study, led by researchers at the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) of the University of Catania in Italy, provides the first-ever prospective evidence that substituting combustible cigarettes with noncombustible alternatives can measurably enhance cardiorespiratory performance.
The study, a secondary analysis of the CEASEFIRE trial, used the Chester Step Test to monitor changes in VO₂max, the gold-standard metric for aerobic fitness. Smokers who either quit entirely or substantially reduced their cigarette consumption showed rapid and clinically meaningful increases in VO₂max. These gains were observed equally in users of e-cigs and HTPs, highlighting the potential of combustion-free products as harm reduction tools that also restore physical performance.
“For young smokers, improved cardiovascular health or reduced cancer risk may seem like distant concerns,” said Riccardo Polosa, a professor at the university and co-author of the study. “But the promise of better fitness, faster recovery, and enhanced athletic performance speaks directly to their lifestyle and aspirations. This could be a more persuasive argument for quitting than traditional risk-based messaging.”
