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38,39 Smokeless oral nicotine users: Lower FMD and increased arterial stiffness reported in both acute and chronic settings

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while four studies received five yes answers [25, 33, 43, 45] and two received four yes answers [32, 51], thus receiving moderate risk of bias note

Further studies are needed to confirm the effects of smoking cessation on endothelial function using an appropriate study design, several smoking cessation methods, short- to long-term follow-up periods, different grades of smoking status, and diverse subjects including subjects with advanced atherosclerosis and healthy subjects in large clinical trials

10.1155/2014/689360 168 PadmavathiP.RaghuP