Are heated tobacco products a healthy alternative to cigarettes? Review article
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Published:
Mar 31, 2021
Keywords:
heated tobacco products, cigarettes, IQOS, smoking, alternative
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Abstract
As well as being an extremely widespread addiction, tobacco smoking is a well-known cause of numerous deaths around the world. Most (80–90%) of lung cancer cases occur among smokers. The awareness of harmful effects of smoking is growing constantly. Manufacturers of tobacco products have recently opted to face this challenge by marketing heated tobacco products. Based on the performed research, tobacco companies maintain that these products are less harmful. They advertise their products as a smokeless, unconventional, less harmful cigarette. Due to the short follow-up period, the studies on consequences of using heated tobacco products are still scarce. This article presents a review of the literature focused on the use of heated tobacco products as an alternative to traditional cigarettes.
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Romaszko-Wojtowicz A, Doboszyńska A, Nawrocki S. Are heated tobacco products a healthy alternative to cigarettes?. OncoReview [Internet]. 2021Mar.31 [cited 2024Dec.23];11(1(41):5-11. Available from: https://journalsmededu.pl/index.php/OncoReview/article/view/1303
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
1. Chapman S, Wakefield MA. Large-scale unassisted smoking cessation over 50 years: lessons from history for endgame planning in tobacco control. Tobacco Control. 2013; 22(suppl 1): i33-i5.
2. Lüdicke F, Picavet P, Baker G et al. Effects of switching to the tobacco heating system 2.2 menthol, smoking abstinence, or continued cigarette smoking on biomarkers of exposure: a randomized, controlled, open-label, multicenter study in sequential confinement and ambulatory settings (Part 1). Nicotine Tob Res. 2018; 20(2): 161-72.
3. Lüdicke F, Picavet P, Baker G et al. Effects of switching to the menthol tobacco heating system 2.2, smoking abstinence, or continued cigarette smoking on clinically relevant risk markers: a randomized, controlled, open-label, multicenter study in sequential confinement and ambulatory settings (Part 2). Nicotine Tob Res. 2018; 20(2): 173-82.
4. PMI (access: 15.02.2021).
5. Jaccard G, Djoko DT, Moennikes O et al. Comparative assessment of HPHC yields in the Tobacco Heating System THS2. 2 and commercial cigarettes. Regul Toxicol Pharmacol. 2017; 90: 1-8.
6. Pratte P, Cosandey S, Goujon Ginglinger C. Investigation of solid particles in the mainstream aerosol of the Tobacco Heating System THS2. 2 and mainstream smoke of a 3R4F reference cigarette. Hum Exp Toxicol. 2017; 36(11): 1115-20.
7. Wong ET, Kogel U, Veljkovic E et al. Evaluation of the Tobacco Heating System 2.2. Part 4: 90-day OECD 413 rat inhalation study with systems toxicology endpoints demonstrates reduced exposure effects compared with cigarette smoke. Regul Toxicol Pharmacol. 2016; 81: S59-S81.
8. Jean-Pierre S, Keller D, Poget L et al. Evaluation of the Tobacco Heating System 2.2. Part 2: Chemical composition, genotoxicity, cytotoxicity, and physical properties of the aerosol. Rom J Med Prac. 2018; 13(4).
9. Hagemejer J, Malinowska A, Poniatowski G et al. Wpływ produkcji wyrobów tytoniowych na polską gospodarkę. Centrum Analiz Społeczno-Rynkowych, Warszawa 2020.
10. Drope J, Schluger N, Cahn Z et al. The tobacco atlas. Atlanta: American Cancer Society and Vital Strategies. Atlanta 2018.
11. Borland R, Partos TR, Yong HH et al. How much unsuccessful quitting activity is going on among adult smokers? Data from the International Tobacco Control Four Country cohort survey. Addiction. 2012; 107(3): 673-82.
12. Etter JF, Perneger TV, Ronchi A. Distributions of smokers by stage: international comparison and association with smoking prevalence. Prev Med. 1997; 26(4): 580-5.
13. Kaidar-Person O, Bar-Sela G, Person B. The two major epidemics of the twenty-first century: obesity and cancer. Obes Surg. 2011; 21(11): 1792-7.
14. U.S. Department of Health and Human Services. The Health Consequences of Smoking – 50 Years of Progress: A Report of the Surgeon General. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Atlanta, GA, USA 2014: 1-36.
15. Secretan B, Straif K, Baan R et al. A review of human carcinogens – Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. Lancet Oncol. 2009; 10(11): 1033-4.
16. Agudo A, Bonet C, Travier N et al. Impact of cigarette smoking on cancer risk in the European prospective investigation into cancer and nutrition study. J Clin Oncol. 2012; 30(36): 4550-7.
17. Doll R, Peto R, Boreham J et al. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004; 328(7455): 1519.
18. Kiiskinen U, Vartiainen E, Puska P et al. Long-term cost and life-expectancy consequences of hypertension. J Hypertens. 1998; 16(8): 1103-12.
19. Hay SI, Abajobir AA, Abate KH et al. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1260-344.
20. Cheng TYD, Cramb SM, Baade PD et al. The international epidemiology of lung cancer: latest trends, disparities, and tumor characteristics. J Thorac Oncol. 2016; 11(10): 1653-71.
21. Access to innovative cancer drugs in Poland in comparison with selected European Union countries and Switzerland. Report ordered by Young People Oncology Foundation Alivia and prepared by EY Poland April 2015.
22. Potrykowska A, Strzelecki Z, Szymborski J et al. Zachorowalność i umieralność na nowotwory a sytuacja demograficzna Polski. Rządowa Rada Ludnościowa, Warszawa 2014.
23. Didkowska J, Wojciechowska U. Zachorowania i zgony na nowotwory złośliwe w Polsce. Krajowy Rejestr Nowotworów, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie. (access: 4.02.2021).
24. Ferlay J, Soerjomataram I, Dikshit R et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015; 136(5): E359-E86.
25. Malik K. Human development report 2013. The rise of the South: Human progress in a diverse world. The Rise of the South: Human Progress in a Diverse World (March 15, 2013). UNDP-HDRO Human Development Reports. 2013.
26. Calm J. The cancer problem. Sci Am. 1975; 233: 64-78.
27. Islami F, Torre lA, Jemal A. Global trends of lung cancer mortality and smoking prevalence. Transl Lung Cancer Res. 2015; 4(4): 327.
28. Tindle HA, Stevenson Duncan M, Greevy RA et al. Lifetime smoking history and risk of lung cancer: results from the Framingham Heart Study. J Natl Cancer Inst. 2018; 110(11): 1201-7.
29. Mallock N, Böss L, Burk R et al. Levels of selected analytes in the emissions of “heat not burn” tobacco products that are relevant to assess human health risks. Arch Toxicol. 2018; 92: 2145-9.
30. Lee A, Lee SY, Lee KS. The use of heated tobacco products is associated with asthma, allergic rhinitis, and atopic dermatitis in Korean adolescents. Sci Rep. 2019; 9(1): 1-8.
31. Chaaban T. Acute eosinophilic pneumonia associated with non-cigarette smoking products: a systematic review. Adv Respir Med. 2020; 88(2): 142-6.
32. Glantz SA, Barnes DE, Bero L et al. The Cigarette Papers. Chapter 4: The Search for a „Safe” Cigarette. CA University of California Press, Berkeley, 1996.
33. US Department of Health and Human Services. The tobacco industry’s influences on the use of tobacco among youth and young adults. Preventing tobacco use among youth and young adults: A report of the Surgeon General 2012: 483-603.
34. Chaudhuri S. BAT to submit FDA application to sell Glo in U.S. MarketWatch, 2017.
35. British American Tobacco. E-cigarettes and other Next Generation Products.
36. Glantz SA. Heated tobacco products: the example of IQOS. Tob Control. 2018; 27(suppl 1): s1-s6.
37. Caputi TL. Industry watch: heat-not-burn tobacco products are about to reach their boiling point. Tob Control. 2017; 26(5): 609-10.
38. Cozzani V, Barontini F, McGrath T et al. An experimental investigation into the operation of an electrically heated tobacco system. Thermochimica Acta. 2020; 684: 178475.
39. Smith MR, Clark B, Lüdicke F et al. Evaluation of the Tobacco Heating System 2.2. Part 1: Description of the system and the scientific assessment program. Regul Toxicol Pharmacol. 2016; 81(suppl 2): S17-S26.
40. Glantz SA. Heated tobacco products: the example of IQOS. Tob Control. 2018; 27: s1-s6.
41. Lüdicke F, Haziza C, Weitkunat R et al. Evaluation of biomarkers of exposure in smokers switching to a carbon-heated tobacco product: a controlled, randomized, open-label 5-day exposure study. Nicotine Tob Res. 2016; 18: 1606-13.
42. Simonavicius E, McNeill A, Shahab L et al. Heat-not-burn tobacco products: A systematic literature review. Tob Control. 2018: 1-13. http://doi.org/10.1136/tobaccocontrol-2018-054419.
43. Leigh NJ, Tran PL, O’Connor RJ et al. Cytotoxic effects of heated tobacco products (HTP) on human bronchial epithelial cells. Tob Control. 2018; 27: s26-s9. http://doi.org/10.1136/tobaccocontrol-2018-054317.
44. Neilsen K, Glantz SA. A tobacco industry study of airline cabin air quality: dropping inconvenient findings. Tob Control. 2004; 13(suppl 1): i20-9.
45. Wertz MS, Kyriss T, Paranjape S et al. The toxic effects of cigarette additives. Philip Morris’ project mix reconsidered: an analysis of documents released through litigation. PLoS Med. 2011; 8: e1001145. http://doi.org/10.1371/journal.pmed.1001145.
46. El-Toukhy S, Baig SA, Jeong M et al. Impact of Modified Risk Tobacco Product Claims on Beliefs of US Adults and Adolescents. Tob. Control. 2018; 27: s62-s9.
47. Gentzke AS, Wang TW, Jamal A et al. Tobacco Product Use Among Middle and High School Students – United States. MMWR Morb Mortal Wkly Rep. 2020; 69(50): 1881.
48. Osibogun O, Taleb ZB, Bahelah R et al. Correlates of Poly-Tobacco Use among Youth and Young Adults: Findings from the Population Assessment of Tobacco and Health Study, 2013–2014. Drug Alcohol Depend. 2018; 187: 160-4.
49. Attitudes of Europeans towards tobacco and electronic cigarettes (access: 10.04.2021).
50. Program zwalczania następstw zdrowotnych używania wyrobów tytoniowych i wyrobów powiązanych w ramach Narodowego Programu Zdrowia (access: 10.04.2021).
51. Picciotto MR, Brunzell DH, Caldarone B. Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport. 2002; 13(9): 1097-106.
52. Kim M, Watkins SL, Koester KA et al. Unboxed: US Young Adult Tobacco Users’ Responses to a New Heated Tobacco Product. Int J Environ Res Public Health. 2020; 17(21): 8108.
53. Sutanto E, Miller C, Smith DM et al. Prevalence, Use Behaviors, and Preferences among Users of Heated Tobacco Products: Findings from the 2018 ITC Japan Survey. Int J Environ Res Public Health. 2019; 16: 4630.
54. Lee CM. The impact of heated tobacco products on smoking cessation, tobacco use, and tobacco sales in South Korea. Korean J Fam Med. 2020; 41(5): 273.
55. Tabuchi T, Gallus S, Shinozaki T et al. Heat-not-burn tobacco product use in Japan: its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-burn tobacco aerosol. Tob Control. 2018; 27(e1): e25-e33.
56. Stoklosa M, Cahn Z, Liber A et al. Effect of IQOS introduction on cigarette sales: evidence of decline and replacement. Tobacco Control. 2019; 0: 1-7.
57. Cummings KM, Nahhas GJ, Sweanor DT. What Is Accounting for the Rapid Decline in Cigarette Sales in Japan? Int J Environ Res Public Health. 2020; 17: 3570. http://doi.org/10.3390/ijerph17103570.
58. Dyrektywa Parlamentu Europejskiego i Rady 2014/40/UE z dnia 3 kwietnia 2014 r. w sprawie zbliżenia przepisów ustawowych, wykonawczych i administracyjnych państw członkowskich w sprawie produkcji, prezentowania i sprzedaży wyrobów tytoniowych i powiązanych wyrobów oraz uchylająca dyrektywę 2001/37/WE.
59. Morean ME, Butler ER, Bold KW et al. Preferring more e-cigarette flavors is associated with e-cigarette use frequency among adolescents but not adults. PloS One. 2018; 13(1): e0189015.
60. Du P, Bascom R, Fan T et al. Changes in flavor preference in a cohort of long-term electronic cigarette users. Ann Am Thorac Soc. 2020; 17(5): 573-81.
61. Berg CJ. Preferred flavors and reasons for e-cigarette use and discontinued use among never, current, and former smokers. Int J Public Health. 2016; 61(2): 225-36.
62. Konsumpcja nikotyny – raport 2020 r. Badanie przeprowadzone dla Biura do spraw Substancji Chemicznych przez Centrum Badania Opinii Społecznej (CBOS).
63. Mallock N, Böss L, Burk R et al. Levels of selected analytes in the emissions of „heat not burn” tobacco products that are relevant to assess human health risks. Arch Toxicol. 2018; 92(6): 2145-9.
64. IARC Monograph 71, Acetaldehyde, 1999. (access: 15.02.2021).
65. Forster M, Fiebelkorn S, Yurteri C et al. Assessment of novel tobacco heating product THP1.0. Part 3: Comprehensive chemical characterisation of harmful and potentially harmful aerosol emissions. Regul Toxicol Pharmacol. 2018; 93: 14-33.
66. Caponnetto P, Maglia M, Prosperini G et al. Carbon monoxide levels after inhalation from new generation heated tobacco products. Respir Res. 2018; 19(1): 1-4.
67. Adriaens K, Van Gucht D, Baeyens F. IQOSTM vs. e-cigarette vs. tobacco cigarette: a direct comparison of short-term effects after overnight-abstinence. Int J Environ Res Public Health. 2018; 15(12): 2902.
68. Baker RR. The formation of the oxides of carbon by the pyrolysis of tobacco. Beiträge Tab. 1975; 8: 16-27. http://doi.org/10.2478/cttr-2013-0350.
69. Herod AA, Kandiyoti R. Pyrolysis. 2011. (access: 15.02.2021).
70. Food and Drug Administration FDA Briefing Document: January 24-25, 2018 TPSAC Meeting. 2018. (access: 3.02.2021).
71. Gale N, McEwan M, Eldridge AC et al. Changes in Biomarkers of Exposure on Switching From a Conventional Cigarette to Tobacco Heating Products: A Randomized, Controlled Study in Healthy Japanese Subjects. Nicotine Tob Res. 2019; 21(9): 1220-7.
72. Miura N, Yuki D, Minami N et al. A study to investigate changes in the levels of biomarkers of exposure to selected cigarette smoke constituents in Japanese adult male smokers who switched to a non-combustion inhaler type of tobacco product. Regul Toxicol Pharmacol. 2015; 71(3): 498-506.
73. Lüdicke F, Picavet P, Baker G et al. Effects of switching to the menthol tobacco heating system 2.2, smoking abstinence, or continued cigarette smoking on clinically relevant risk markers: a randomized, controlled, open-label, multicenter study in sequential confinement and ambulatory settings (part 2). Nicotine Tob Res. 2017; 20(2): 173-82. http://doi.org/10.1093/ntr/ntx028.
74. Ikonomidis I, Vlastos D, Kostelli G et al. Differential effects of heat‑not‑burn and conventional cigarettes on coronary flow, myocardial and vascular function. Scientific Reports | NATURE. 2021; 11: 11808.
75. Polosa R, Morjaria JB, Prosperini U et al. Health outcomes in COPD smokers using heated tobacco products: a 3-year follow-up. Int Emerg Med. 2021; 16: 687-96.
76. Stephens WE. Relative cancer potencies of formaldehyde and acetaldehyde in vapour from e-cigarettes compared with tobacco smoke, heat-notburn devices, a nicotine inhaler and ambient air. Tobacco Control BMJ. 2018; 27: 10-7.
77. Slob W, Soeteman-Hernandez LG, Bil W et al. A Method for Comparing the Impact on Carcinogenicity of Tobacco Products: A Case Study on Heated Tobacco Versus Cigarettes. Risk Analysis. 2020. http://doi.org/10.1111/risa.13482.
78. Hirano T, Takei T. Estimating the Carcinogenic Potency of Second-Hand Smoke and Aerosol from Cigarettes and Heated Tobacco Products. Int J Environ Res Public Health. 2020; 17: 8319. http://doi.org/10.3390/ijerph17228319.
79. Cho HJ, Kim HJ, Lee CM et al. Analysis on Use Pattern of Heated Tobacco Products and Their Impact on Quit Smoking Intention; Ministry of Health and Welfare: Sejong, Korea 2018.
80. Akiyama Y, Sherwood N. Systematic review of biomarker findings from clinical studies of electronic cigarettes and heated tobacco products. Toxicol Rep. 2021; 8: 282-94.
81. Leigh NJ, Tran PL, O’Connor RJ et al. Cytotoxic effects of heated tobacco products (HTP) on human bronchial epithelial cells. Tob Control. 2018; 27(suppl 1): s26-s9.
82. St Helen G, Jacob Iii P, Nardone N et al. IQOS: examination of Philip Morris International’s claim of reduced exposure. Tob Control. 2018; 27(suppl 1): s30-s6.
83. Harmful and Potentially Harmful Constituents (HPHCs) (access: 10.04.2021).
84. Philip Morris Products S.A. Modified Risk Tobacco Product (MRTP) Applications (access: 1.04.2021).
85. Food and Drug Administration (FDA). (access: 10.04.2021).
86. How are Non-Combusted Cigarettes, Sometimes Called Heat-Not-Burn Products, Different from E-Cigarettes and Cigarettes? (access: 10.04.2021).
2. Lüdicke F, Picavet P, Baker G et al. Effects of switching to the tobacco heating system 2.2 menthol, smoking abstinence, or continued cigarette smoking on biomarkers of exposure: a randomized, controlled, open-label, multicenter study in sequential confinement and ambulatory settings (Part 1). Nicotine Tob Res. 2018; 20(2): 161-72.
3. Lüdicke F, Picavet P, Baker G et al. Effects of switching to the menthol tobacco heating system 2.2, smoking abstinence, or continued cigarette smoking on clinically relevant risk markers: a randomized, controlled, open-label, multicenter study in sequential confinement and ambulatory settings (Part 2). Nicotine Tob Res. 2018; 20(2): 173-82.
4. PMI (access: 15.02.2021).
5. Jaccard G, Djoko DT, Moennikes O et al. Comparative assessment of HPHC yields in the Tobacco Heating System THS2. 2 and commercial cigarettes. Regul Toxicol Pharmacol. 2017; 90: 1-8.
6. Pratte P, Cosandey S, Goujon Ginglinger C. Investigation of solid particles in the mainstream aerosol of the Tobacco Heating System THS2. 2 and mainstream smoke of a 3R4F reference cigarette. Hum Exp Toxicol. 2017; 36(11): 1115-20.
7. Wong ET, Kogel U, Veljkovic E et al. Evaluation of the Tobacco Heating System 2.2. Part 4: 90-day OECD 413 rat inhalation study with systems toxicology endpoints demonstrates reduced exposure effects compared with cigarette smoke. Regul Toxicol Pharmacol. 2016; 81: S59-S81.
8. Jean-Pierre S, Keller D, Poget L et al. Evaluation of the Tobacco Heating System 2.2. Part 2: Chemical composition, genotoxicity, cytotoxicity, and physical properties of the aerosol. Rom J Med Prac. 2018; 13(4).
9. Hagemejer J, Malinowska A, Poniatowski G et al. Wpływ produkcji wyrobów tytoniowych na polską gospodarkę. Centrum Analiz Społeczno-Rynkowych, Warszawa 2020.
10. Drope J, Schluger N, Cahn Z et al. The tobacco atlas. Atlanta: American Cancer Society and Vital Strategies. Atlanta 2018.
11. Borland R, Partos TR, Yong HH et al. How much unsuccessful quitting activity is going on among adult smokers? Data from the International Tobacco Control Four Country cohort survey. Addiction. 2012; 107(3): 673-82.
12. Etter JF, Perneger TV, Ronchi A. Distributions of smokers by stage: international comparison and association with smoking prevalence. Prev Med. 1997; 26(4): 580-5.
13. Kaidar-Person O, Bar-Sela G, Person B. The two major epidemics of the twenty-first century: obesity and cancer. Obes Surg. 2011; 21(11): 1792-7.
14. U.S. Department of Health and Human Services. The Health Consequences of Smoking – 50 Years of Progress: A Report of the Surgeon General. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Atlanta, GA, USA 2014: 1-36.
15. Secretan B, Straif K, Baan R et al. A review of human carcinogens – Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. Lancet Oncol. 2009; 10(11): 1033-4.
16. Agudo A, Bonet C, Travier N et al. Impact of cigarette smoking on cancer risk in the European prospective investigation into cancer and nutrition study. J Clin Oncol. 2012; 30(36): 4550-7.
17. Doll R, Peto R, Boreham J et al. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004; 328(7455): 1519.
18. Kiiskinen U, Vartiainen E, Puska P et al. Long-term cost and life-expectancy consequences of hypertension. J Hypertens. 1998; 16(8): 1103-12.
19. Hay SI, Abajobir AA, Abate KH et al. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1260-344.
20. Cheng TYD, Cramb SM, Baade PD et al. The international epidemiology of lung cancer: latest trends, disparities, and tumor characteristics. J Thorac Oncol. 2016; 11(10): 1653-71.
21. Access to innovative cancer drugs in Poland in comparison with selected European Union countries and Switzerland. Report ordered by Young People Oncology Foundation Alivia and prepared by EY Poland April 2015.
22. Potrykowska A, Strzelecki Z, Szymborski J et al. Zachorowalność i umieralność na nowotwory a sytuacja demograficzna Polski. Rządowa Rada Ludnościowa, Warszawa 2014.
23. Didkowska J, Wojciechowska U. Zachorowania i zgony na nowotwory złośliwe w Polsce. Krajowy Rejestr Nowotworów, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie. (access: 4.02.2021).
24. Ferlay J, Soerjomataram I, Dikshit R et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015; 136(5): E359-E86.
25. Malik K. Human development report 2013. The rise of the South: Human progress in a diverse world. The Rise of the South: Human Progress in a Diverse World (March 15, 2013). UNDP-HDRO Human Development Reports. 2013.
26. Calm J. The cancer problem. Sci Am. 1975; 233: 64-78.
27. Islami F, Torre lA, Jemal A. Global trends of lung cancer mortality and smoking prevalence. Transl Lung Cancer Res. 2015; 4(4): 327.
28. Tindle HA, Stevenson Duncan M, Greevy RA et al. Lifetime smoking history and risk of lung cancer: results from the Framingham Heart Study. J Natl Cancer Inst. 2018; 110(11): 1201-7.
29. Mallock N, Böss L, Burk R et al. Levels of selected analytes in the emissions of “heat not burn” tobacco products that are relevant to assess human health risks. Arch Toxicol. 2018; 92: 2145-9.
30. Lee A, Lee SY, Lee KS. The use of heated tobacco products is associated with asthma, allergic rhinitis, and atopic dermatitis in Korean adolescents. Sci Rep. 2019; 9(1): 1-8.
31. Chaaban T. Acute eosinophilic pneumonia associated with non-cigarette smoking products: a systematic review. Adv Respir Med. 2020; 88(2): 142-6.
32. Glantz SA, Barnes DE, Bero L et al. The Cigarette Papers. Chapter 4: The Search for a „Safe” Cigarette. CA University of California Press, Berkeley, 1996.
33. US Department of Health and Human Services. The tobacco industry’s influences on the use of tobacco among youth and young adults. Preventing tobacco use among youth and young adults: A report of the Surgeon General 2012: 483-603.
34. Chaudhuri S. BAT to submit FDA application to sell Glo in U.S. MarketWatch, 2017.
35. British American Tobacco. E-cigarettes and other Next Generation Products.
36. Glantz SA. Heated tobacco products: the example of IQOS. Tob Control. 2018; 27(suppl 1): s1-s6.
37. Caputi TL. Industry watch: heat-not-burn tobacco products are about to reach their boiling point. Tob Control. 2017; 26(5): 609-10.
38. Cozzani V, Barontini F, McGrath T et al. An experimental investigation into the operation of an electrically heated tobacco system. Thermochimica Acta. 2020; 684: 178475.
39. Smith MR, Clark B, Lüdicke F et al. Evaluation of the Tobacco Heating System 2.2. Part 1: Description of the system and the scientific assessment program. Regul Toxicol Pharmacol. 2016; 81(suppl 2): S17-S26.
40. Glantz SA. Heated tobacco products: the example of IQOS. Tob Control. 2018; 27: s1-s6.
41. Lüdicke F, Haziza C, Weitkunat R et al. Evaluation of biomarkers of exposure in smokers switching to a carbon-heated tobacco product: a controlled, randomized, open-label 5-day exposure study. Nicotine Tob Res. 2016; 18: 1606-13.
42. Simonavicius E, McNeill A, Shahab L et al. Heat-not-burn tobacco products: A systematic literature review. Tob Control. 2018: 1-13. http://doi.org/10.1136/tobaccocontrol-2018-054419.
43. Leigh NJ, Tran PL, O’Connor RJ et al. Cytotoxic effects of heated tobacco products (HTP) on human bronchial epithelial cells. Tob Control. 2018; 27: s26-s9. http://doi.org/10.1136/tobaccocontrol-2018-054317.
44. Neilsen K, Glantz SA. A tobacco industry study of airline cabin air quality: dropping inconvenient findings. Tob Control. 2004; 13(suppl 1): i20-9.
45. Wertz MS, Kyriss T, Paranjape S et al. The toxic effects of cigarette additives. Philip Morris’ project mix reconsidered: an analysis of documents released through litigation. PLoS Med. 2011; 8: e1001145. http://doi.org/10.1371/journal.pmed.1001145.
46. El-Toukhy S, Baig SA, Jeong M et al. Impact of Modified Risk Tobacco Product Claims on Beliefs of US Adults and Adolescents. Tob. Control. 2018; 27: s62-s9.
47. Gentzke AS, Wang TW, Jamal A et al. Tobacco Product Use Among Middle and High School Students – United States. MMWR Morb Mortal Wkly Rep. 2020; 69(50): 1881.
48. Osibogun O, Taleb ZB, Bahelah R et al. Correlates of Poly-Tobacco Use among Youth and Young Adults: Findings from the Population Assessment of Tobacco and Health Study, 2013–2014. Drug Alcohol Depend. 2018; 187: 160-4.
49. Attitudes of Europeans towards tobacco and electronic cigarettes (access: 10.04.2021).
50. Program zwalczania następstw zdrowotnych używania wyrobów tytoniowych i wyrobów powiązanych w ramach Narodowego Programu Zdrowia (access: 10.04.2021).
51. Picciotto MR, Brunzell DH, Caldarone B. Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport. 2002; 13(9): 1097-106.
52. Kim M, Watkins SL, Koester KA et al. Unboxed: US Young Adult Tobacco Users’ Responses to a New Heated Tobacco Product. Int J Environ Res Public Health. 2020; 17(21): 8108.
53. Sutanto E, Miller C, Smith DM et al. Prevalence, Use Behaviors, and Preferences among Users of Heated Tobacco Products: Findings from the 2018 ITC Japan Survey. Int J Environ Res Public Health. 2019; 16: 4630.
54. Lee CM. The impact of heated tobacco products on smoking cessation, tobacco use, and tobacco sales in South Korea. Korean J Fam Med. 2020; 41(5): 273.
55. Tabuchi T, Gallus S, Shinozaki T et al. Heat-not-burn tobacco product use in Japan: its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-burn tobacco aerosol. Tob Control. 2018; 27(e1): e25-e33.
56. Stoklosa M, Cahn Z, Liber A et al. Effect of IQOS introduction on cigarette sales: evidence of decline and replacement. Tobacco Control. 2019; 0: 1-7.
57. Cummings KM, Nahhas GJ, Sweanor DT. What Is Accounting for the Rapid Decline in Cigarette Sales in Japan? Int J Environ Res Public Health. 2020; 17: 3570. http://doi.org/10.3390/ijerph17103570.
58. Dyrektywa Parlamentu Europejskiego i Rady 2014/40/UE z dnia 3 kwietnia 2014 r. w sprawie zbliżenia przepisów ustawowych, wykonawczych i administracyjnych państw członkowskich w sprawie produkcji, prezentowania i sprzedaży wyrobów tytoniowych i powiązanych wyrobów oraz uchylająca dyrektywę 2001/37/WE.
59. Morean ME, Butler ER, Bold KW et al. Preferring more e-cigarette flavors is associated with e-cigarette use frequency among adolescents but not adults. PloS One. 2018; 13(1): e0189015.
60. Du P, Bascom R, Fan T et al. Changes in flavor preference in a cohort of long-term electronic cigarette users. Ann Am Thorac Soc. 2020; 17(5): 573-81.
61. Berg CJ. Preferred flavors and reasons for e-cigarette use and discontinued use among never, current, and former smokers. Int J Public Health. 2016; 61(2): 225-36.
62. Konsumpcja nikotyny – raport 2020 r. Badanie przeprowadzone dla Biura do spraw Substancji Chemicznych przez Centrum Badania Opinii Społecznej (CBOS).
63. Mallock N, Böss L, Burk R et al. Levels of selected analytes in the emissions of „heat not burn” tobacco products that are relevant to assess human health risks. Arch Toxicol. 2018; 92(6): 2145-9.
64. IARC Monograph 71, Acetaldehyde, 1999. (access: 15.02.2021).
65. Forster M, Fiebelkorn S, Yurteri C et al. Assessment of novel tobacco heating product THP1.0. Part 3: Comprehensive chemical characterisation of harmful and potentially harmful aerosol emissions. Regul Toxicol Pharmacol. 2018; 93: 14-33.
66. Caponnetto P, Maglia M, Prosperini G et al. Carbon monoxide levels after inhalation from new generation heated tobacco products. Respir Res. 2018; 19(1): 1-4.
67. Adriaens K, Van Gucht D, Baeyens F. IQOSTM vs. e-cigarette vs. tobacco cigarette: a direct comparison of short-term effects after overnight-abstinence. Int J Environ Res Public Health. 2018; 15(12): 2902.
68. Baker RR. The formation of the oxides of carbon by the pyrolysis of tobacco. Beiträge Tab. 1975; 8: 16-27. http://doi.org/10.2478/cttr-2013-0350.
69. Herod AA, Kandiyoti R. Pyrolysis. 2011. (access: 15.02.2021).
70. Food and Drug Administration FDA Briefing Document: January 24-25, 2018 TPSAC Meeting. 2018. (access: 3.02.2021).
71. Gale N, McEwan M, Eldridge AC et al. Changes in Biomarkers of Exposure on Switching From a Conventional Cigarette to Tobacco Heating Products: A Randomized, Controlled Study in Healthy Japanese Subjects. Nicotine Tob Res. 2019; 21(9): 1220-7.
72. Miura N, Yuki D, Minami N et al. A study to investigate changes in the levels of biomarkers of exposure to selected cigarette smoke constituents in Japanese adult male smokers who switched to a non-combustion inhaler type of tobacco product. Regul Toxicol Pharmacol. 2015; 71(3): 498-506.
73. Lüdicke F, Picavet P, Baker G et al. Effects of switching to the menthol tobacco heating system 2.2, smoking abstinence, or continued cigarette smoking on clinically relevant risk markers: a randomized, controlled, open-label, multicenter study in sequential confinement and ambulatory settings (part 2). Nicotine Tob Res. 2017; 20(2): 173-82. http://doi.org/10.1093/ntr/ntx028.
74. Ikonomidis I, Vlastos D, Kostelli G et al. Differential effects of heat‑not‑burn and conventional cigarettes on coronary flow, myocardial and vascular function. Scientific Reports | NATURE. 2021; 11: 11808.
75. Polosa R, Morjaria JB, Prosperini U et al. Health outcomes in COPD smokers using heated tobacco products: a 3-year follow-up. Int Emerg Med. 2021; 16: 687-96.
76. Stephens WE. Relative cancer potencies of formaldehyde and acetaldehyde in vapour from e-cigarettes compared with tobacco smoke, heat-notburn devices, a nicotine inhaler and ambient air. Tobacco Control BMJ. 2018; 27: 10-7.
77. Slob W, Soeteman-Hernandez LG, Bil W et al. A Method for Comparing the Impact on Carcinogenicity of Tobacco Products: A Case Study on Heated Tobacco Versus Cigarettes. Risk Analysis. 2020. http://doi.org/10.1111/risa.13482.
78. Hirano T, Takei T. Estimating the Carcinogenic Potency of Second-Hand Smoke and Aerosol from Cigarettes and Heated Tobacco Products. Int J Environ Res Public Health. 2020; 17: 8319. http://doi.org/10.3390/ijerph17228319.
79. Cho HJ, Kim HJ, Lee CM et al. Analysis on Use Pattern of Heated Tobacco Products and Their Impact on Quit Smoking Intention; Ministry of Health and Welfare: Sejong, Korea 2018.
80. Akiyama Y, Sherwood N. Systematic review of biomarker findings from clinical studies of electronic cigarettes and heated tobacco products. Toxicol Rep. 2021; 8: 282-94.
81. Leigh NJ, Tran PL, O’Connor RJ et al. Cytotoxic effects of heated tobacco products (HTP) on human bronchial epithelial cells. Tob Control. 2018; 27(suppl 1): s26-s9.
82. St Helen G, Jacob Iii P, Nardone N et al. IQOS: examination of Philip Morris International’s claim of reduced exposure. Tob Control. 2018; 27(suppl 1): s30-s6.
83. Harmful and Potentially Harmful Constituents (HPHCs) (access: 10.04.2021).
84. Philip Morris Products S.A. Modified Risk Tobacco Product (MRTP) Applications (access: 1.04.2021).
85. Food and Drug Administration (FDA). (access: 10.04.2021).
86. How are Non-Combusted Cigarettes, Sometimes Called Heat-Not-Burn Products, Different from E-Cigarettes and Cigarettes? (access: 10.04.2021).