Comparative Indoor Pollution from Glo, Iqos, and Juul, Using Traditional Combustion Cigarettes as Benchmark: Evidence from the Randomized SUR-VAPES AIR Trial

Abstract

Modified risk products (MRP) such as electronic vaping cigarettes (EVC) and heat-not-burn cigarettes (HNBC) are appealing alternatives to combustion cigarettes. Limited between- and within-device comparative data are available on MRP. We aimed at comparing indoor particulate matter (PM) emissions measured in a randomized trial enforcing standardized smoking sessions, testing different devices and flavors of MRP, using traditional combustion cigarettes (TCC) as benchmark. Overall, MRP yielded significantly lower levels of indoor PM in comparison to TCC (with median PM levels during smoking for MRP < 100 μg/m3, and for TCC > 1000 μg/m3). Despite this, significant differences among MRP were found, with Iqos appearing associated with a significantly lower burden of emissions for all the monitored fractions of PM, including total PM (all p < 0.05). Precisely, during use, PM ≤1 µm (PM1) emissions were 28 (16; 28) μg/m3 for Glo, 25 (15; 57) μg/m3 for Iqos, and 73 (15; 559) μg/m3 for Juul (p < 0.001 for Glo vs. Iqos, p < 0.001 for Glo vs. Juul, and p = 0.045 for Iqos vs. Juul). Exploratory within-MRP analyses suggested significant differences between flavors, favoring, for instance, Ultramarine for Glo, Bronze for Iqos, and Mango for Juul, even if results varied substantially according to individual smoker. In conclusion, leading MRP have significantly less intense and persistent effects on indoor pollution in comparison to TCC. Yet, when focusing solely on MRP, between-product and between-flavor differences appear, with quantitative estimates suggesting lower polluting effects with Iqos. These results, if confirmed externally, could be used to individualize product and flavor choice to minimize the untoward effects of EVC and HNBC on indoor pollution.

Particle emissions from heated tobacco products

“…Size-segregated mass size fraction concentration measurements confirmed, as presented in Figure 1 , that all the devices emit very fine particles, with a dynamic diameter <1μm, at a percentage higher than 99.7%. This is in accordance with previously published works 24 , 33 .…”

“…The results for different devices and use conditions present significant variations. Foster et al 22 found 6.5–10.3μg/m 3 PM 1 , 6.6–10.7 μg/m 3 PM 2.5 , 6.0–12.8 μg/m 3 PM 10 , during use of THP1.0 under three different ventilation conditions, Mitova et al 23 measured both PM 1 and PM 2.5 <11 μg/m 3 during use of THS 2.2 under natural ventilation, and TPM using two different brands, IQOS and GLO, under the same conditions, was 39 (24–127) μg/m 3 (GLO) and 31 (20–63) μg/m 3 (IQOS) 24 .…”

Toxicological Aspects Associated with Consumption from Electronic Nicotine Delivery System (ENDS): Focus on Heavy Metals Exposure and Cancer Risk

“…In fact, as discussed below, the use of a metal blade as a tobacco heating element in the case of HTPs normally releases significant amounts of debris, fluids, and fragments of cast left in the holder and, for this reason, it is necessary to clean the devices after 20 tobacco sticks. The most common devices use the blade to heat the tobacco sticks; however, new heating systems have been developed, such as an induction heating chamber (Glo TM ), where tobacco sticks are placed inside the device, and the use of an external resistive heater made of stainless-steel tracks is utilized [ 43 ].…”

Immunology in COPD and the use of combustible cigarettes and heated tobacco products

“…The emissions of PM in confined spaces were assessed when smoking traditional cigarettes and using non-combustible tobacco products. Peruzzi et al showed in the randomised trial that using non-combustible tobacco products leads to significantly lower levels of indoor PM in comparison to classic cigarettes [ 62 ]. A similar study was performed by Protano et al where PM with an aerodynamic diameter smaller than 10, 4, 2.5 and 1 µm (PM10, PM4, PM2.5, PM1) were measured indoors after using alternatives to conventional cigarettes.…”