Differential Effects of Heated Tobacco Products and Conventional Cigarettes on Cardiovascular System A Systematic Review of Randomized Trials
Keywords:Heated Tobacco Products; Cardiovascular system; Adverse effects
Background: Heated tobacco products (HTP) are alternative forms to traditional cigarettes. Harmful
components contained in HTP tobacco aerosol are in lower amounts than those in smoke from traditional
cigarettes. That’s why HTP are believed to reduce the burden of smoking related-diseases. However,
due to its potentially toxic chemicals and the increased concentration of nicotine, HTP devices may not
be as safe as the industries claim. This review was completed to summarize effects of HTP on user’s
health, in particular on cardiovascular system.
Methods: A systematic search of the literature in PubMed database was performed to identify significant
articles published from 2015 to 2021. For this review we selected randomized clinical trials that explore
the effects of heat-not-burn cigarettes on the cardiovascular system. Independent and sponsored studies
by the tobacco industry were included.
Conclusion: The analysis of biomarkers of biological effect, such as those for oxidative stress, platelet
activation, endothelial dysfunction, inflammation, antioxidant reserve and others showed differences
between smokers and people using heated tobacco products in favor of the latter. However, studies
comparing the acute effects of different tobacco products on arterial stiffness, heart rate and myocardial
function indicated no relevant differences between IQOS and traditional cigarettes.
So, Heated Tobacco Products appear less harmful. Nevertheless, due to conflicting information and
the restricted knowledge of IQOS exposure, further long-therm human studies are needed to assess the
potential benefit and risk of heated tobacco products