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Exposure to Heated Tobacco Products and Adverse Health Effects, a Systematic Review

Author

Listed:
  • Małgorzata Znyk

    (Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Lodz, Poland)

  • Joanna Jurewicz

    (Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Lodz, Poland)

  • Dorota Kaleta

    (Department of Hygiene and Epidemiology, Medical University of Lodz, 90-647 Lodz, Poland)

Abstract

Heated tobacco products (HTP) are a form of nicotine delivery intended to be an alternative to traditional cigarettes. HTP tobacco products are sold to consumers as a less harmful alternative to traditional cigarettes, both for users and bystanders. The actual impact of HTP on the health of users and its overall impact on public health is still not fully known. A systematic search of the literature was carried out to identify relevant studies published in English from 2015 to February 2021. The following databases were used: PubMed, Scopus, Elsevier and ClinicalKey. 25 studies (independent and sponsored by the tobacco industry) were considered. The analysis of exposure biomarkers and cardiovascular and respiratory biomarkers showed differences between smokers and people using heated tobacco products. Improvements in clinically relevant risk markers, especially cholesterol, sICAM-1, 8-epi-PGF2α, 11-DTX-B2, HDL and FEV1, were observed compared to persistent cigarette smokers. On the other hand, exposure to IQOS has been reported to alter mitochondrial function, which may further exaggerate airway inflammation, airway remodeling and lung cancer. These products have the potential to increase oxidative stress and increase respiratory tract infections by increasing microbial adherence to the respiratory tract. Our review suggests that HTP products may be products with a reduced risk of chronic diseases, including respiratory and cardiovascular diseases and cancer compared to traditional smoking, although in the case of non-smokers so far, they may pose a risk of their occurrence. Research seems to be necessary to assess the frequency of HTP use and its potential negative health effects.

Suggested Citation

  • Małgorzata Znyk & Joanna Jurewicz & Dorota Kaleta, 2021. "Exposure to Heated Tobacco Products and Adverse Health Effects, a Systematic Review," IJERPH, MDPI, vol. 18(12), pages 1-18, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:12:p:6651-:d:578765
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    References listed on IDEAS

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    1. Aleksandra Ratajczak & Piotr Jankowski & Piotr Strus & Wojciech Feleszko, 2020. "Heat Not Burn Tobacco Product—A New Global Trend: Impact of Heat-Not-Burn Tobacco Products on Public Health, a Systematic Review," IJERPH, MDPI, vol. 17(2), pages 1-12, January.
    2. Wouter F. Visser & Walther N. Klerx & Hans W. J. M. Cremers & Ramon Ramlal & Paul L. Schwillens & Reinskje Talhout, 2019. "The Health Risks of Electronic Cigarette Use to Bystanders," IJERPH, MDPI, vol. 16(9), pages 1-14, April.
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    Cited by:

    1. Hong Gwan Seo & Steve S. Xu & Grace Li & Shannon Gravely & Anne C. K. Quah & Sungkyu Lee & Sujin Lim & Sung-il Cho & Yeol Kim & Eon Sook Lee & Yoon-Jung Choi & Connor R. Miller & Maciej L. Goniewicz &, 2023. "Reasons for Initiation and Regular Use of Heated Tobacco Products among Current and Former Smokers in South Korea: Findings from the 2020 ITC Korea Survey," IJERPH, MDPI, vol. 20(6), pages 1-12, March.
    2. Lindsey S. Sparrock & Lilianna Phan & Julia Chen-Sankey & Kiana Hacker & Aniruddh Ajith & Bambi Jewett & Kelvin Choi, 2023. "Heated Tobacco Products: Awareness, Beliefs, Use and Susceptibility among US Adult Current Tobacco Users, 2021," IJERPH, MDPI, vol. 20(3), pages 1-11, January.
    3. Yoshihiko Hosokawa & Masayoshi Zaitsu & Sumiyo Okawa & Naho Morisaki & Ai Hori & Yukiko Nishihama & Shoji F. Nakayama & Takeo Fujiwara & Hiromi Hamada & Toyomi Satoh & Takahiro Tabuchi, 2022. "Association between Heated Tobacco Product Use during Pregnancy and Fetal Growth in Japan: A Nationwide Web-Based Survey," IJERPH, MDPI, vol. 19(18), pages 1-9, September.
    4. Agnieszka Jankowska & Linda Nazareth & Dorota Kaleta & Kinga Polanska, 2021. "Review of the Existing Evidence for Sex-Specific Relationships between Prenatal Phthalate Exposure and Children’s Neurodevelopment," IJERPH, MDPI, vol. 18(24), pages 1-18, December.
    5. Elisabet Söderström & Torbjörn K. Nilsson & Jörn Schneede & Per-Magne Ueland & Øivind Midttun & Björn Gylling & Ingegerd Johansson & Johan Hultdin, 2021. "Plasma Cotinine Is Positively Associated with Homocysteine in Smokers but Not in Users of Smokeless Tobacco," IJERPH, MDPI, vol. 18(21), pages 1-9, October.
    6. David T. Levy & Christopher J. Cadham & Yameng Li & Zhe Yuan & Alex C. Liber & Hayoung Oh & Nargiz Travis & Mona Issabakhsh & David T. Sweanor & Luz Maria Sánchez-Romero & Rafael Meza & K. Michael Cum, 2022. "A Decision-Theoretic Public Health Framework for Heated Tobacco and Nicotine Vaping Products," IJERPH, MDPI, vol. 19(20), pages 1-17, October.
    7. Hagai Levine & Zongshuan Duan & Yael Bar-Zeev & Lorien C. Abroms & Amal Khayat & Sararat Tosakoon & Katelyn F. Romm & Yan Wang & Carla J. Berg, 2023. "IQOS Use and Interest by Sociodemographic and Tobacco Behavior Characteristics among Adults in the US and Israel," IJERPH, MDPI, vol. 20(4), pages 1-14, February.

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