Heat Not Burn Tobacco Product—A New Global Trend: Impact of Heat-Not-Burn Tobacco Products on Public Health, a Systematic Review

Abstract

Introduction: The use of heat-not-burn tobacco products (HnB) is being adopted increasingly as an alternative to smoking combusted products, primarily cigarettes. Substantial controversy has accompanied their marketing and use in the public health context. In this study, we aimed to consider the probable impacts of HnB tobacco products use on public health. Methods: In May 2019, we conducted a systematic review of 15 studies concerning awareness and use of IQOS (abbrv. I Quit Ordinary Smoking) selected from three databases: Cochrane, PubMed, and Embase regarding public health. Results: All key outcomes varied by smoking status: more young adults who were currently smoking reported being aware of, interested in trying, and prone to trying heat-not-burn tobacco products. Interest in trying HnB products was also present among non-smokers, which raises concerns regarding new smokers. Interestingly, susceptibility to trying IQOS (25.1%) was higher than for traditional cigarettes (19.3%), but lower than for e-cigarettes (29.1%). Conclusions: Present studies suggest that HnB tobacco products have the potential to be a reduced risk product for public health compared to conventional cigarettes, considering indirectly the potential effects on the chronic diseases which are traditionally linked to traditional cigarette use as well as second hand exposure, but further studies are needed to determine whether this potential is likely to be realized. The process of HnB tobacco products becoming increasingly popular is of a global scale. Only small differences between countries on different continents regarding popularity and use of HnB tobacco products have been reported.

The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea

“…Findings from selected studies suggest that HTPs may create new nicotine-addicted populations. 52) The newly planned comprehensive national health promotion plan and tobacco regulation policy should reflect the emergence of novel tobacco products. In particular, the goal of the current smoking rate should include conventional cigarettes and novel tobacco products.…”

“…The public health impact of HTPs depends not only on their harmfulness relative to traditional cigarettes but also on whether they encourage an increase or decrease in the prevalence of smoking. Findings from selected studies suggest that HTPs may create new nicotine-addicted populations [ 52 ].…”

Pharmacological Approach to Smoking Cessation: An Updated Review for Daily Clinical Practice

“…Data on animals found pro-inflammatory effects and data on humans found no improvement in pulmonary function after switching from combusted to heated tobacco. Independent studies found that HNB products are likely to have the pathogenic potential for COPD development [46].…”

Impact of Electronic Alternatives to Tobacco Cigarettes on Indoor Air Particular Matter Levels

“…Even if the association between the use of EATCs and adverse effects for human health is still under debate, there are several recent evidences of possible negative outcomes [13][14][15]. In addition to the possible adverse effects for active smokers of EATCs (the so-called vapers), experimental evidences demonstrate that the use of these devices worsen indoor air quality determining a typical passive exposure also called Environmental Electronic Vape (EEV) exposure [16][17][18]. The results of our previous researches [2,[19][20][21] highlighted that EEV exposure to particulate matter (PM) always occurs when e-cigs are used in indoor settings.…”