We must remember that two to three out of four smokers want to quit 30 and almost all smokers regret that they started to smoke 31 32. Quoting the tobacco industry on ‘safer products’: “Quitters may be discouraged from quitting, or at least kept in the market longer …” 29. Experiences with filter cigarettes and light cigarettes have shown that ‘safer products’ undermine smokers’ wish to quit, and they have not improved smokers’ health 28. It is tempting to recommend to smokers to switch to heated tobacco products without considering all the consequences. ERS cannot recommend any product damaging the lungs and human health. What does ERS recommend?Įven though heated tobacco products may perhaps be less harmful for smokers they nevertheless remain both harmful and highly addictive, and there may be a risk that smokers will switch to heated tobacco products instead of quitting. In addition, a study found that users of heated tobacco may be forced to smoke at a rapid pace which could lead to an increase in intake of carbonyls (potentially carcinogenic) and nicotine, inducing a high level of nicotine dependence 23. Experimental animal studies found that exposure to heated tobacco led to decreased blood vessel function comparable to that induced by cigarette smoke 26 and impaired arterial flow-mediated dilation, a measure of vascular endothelial function in a manner very similar to tobacco smoke 27. In-vitro studies found that emissions for heated tobacco cause damage to human bronchial epithelial cells 24, have the potential to increase oxidative stress and inflammation, infections and airway remodeling and initiate epithelial mesenchymal transition-related changes in the airways 25. Nicotine and tar levels have been found to be almost identical to a conventional cigarette 22, the potentially carcinogenic substance acenaphthene is found to be almost 3 times higher than in conventional cigarettes 21, and release of formaldehyde cyanohydrin takes place, which is of great concern as it is highly toxic at very low concentrations 23. Independent research shows that heated tobacco products emit substantial levels of carcinogenic tobacco specific nitrosamines 19 20 as well as toxic and irritant substances and potential carcinogens 21. Former employees and contractors have detailed irregularities in the clinical experiments on heated tobacco products performed by the industry 18. Historically, there is strong evidence that studies performed by the tobacco industry or by researchers funded by the tobacco industry cannot be trusted 13-17. Independent research: a substantially higher risk than claimed by the tobacco industry Both animal and human studies performed by the tobacco industry also show there is no evidence of improvement in pulmonary function or inflammation in smokers who switched to heated tobacco 11 and there is possible hepatotoxicity of heated tobacco 12. Further, human studies show that there is no statistically detectable difference between users of heated tobacco and conventional cigarette for 23 of the 24 biomarkers of potential harm 10. Twenty two harmful or potentially harmful substances were >200% higher and seven were >1000% higher than in reference cigarette smoke 9. Independent researchers have investigated tobacco industry data and point out that heated tobacco products emit significantly higher levels of several substances that are not recognised as harmful or potentially harmful by the Food and Drug Administration compared with combustible cigarette smoke. particulate matter, tar, acetaldehyde (a carcinogen), acrylamide (a potential carcinogen), an acrolein metabolite (toxic and irritant) 2-6 and formaldehyde (a potential carcinogen) 7, 8. Tobacco companies have not informed the public that their studies on emissions from heated tobacco found high concentrations of e.g. Not the full picture: digging deeper into tobacco industry research The tobacco industry claims that there is a 90-95% reduction in harmful and potentially harmful substances and toxicity 1. Tobacco industry research claims a 90-95% reduction in harmĪccording to a press release by the tobacco industry the main ingredient in their heated tobacco products is water, whereas the main ingredient in conventional cigarettes is tar. The tobacco industry is actively pursuing the market with sales on the rise of products such as ‘iQOS’ and ‘glo’. Heated tobacco products consist of a small tobacco stick that is heated electronically, rather than burned. Heated tobacco is a new nicotine delivery system that is commonly referred to as “Heat-not-Burn” by the tobacco industry. A statement prepared by the ERS Tobacco Control Committee and approved by the ERS Advocacy Council, Science Council and Executive Committee What are heated tobacco products?
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