Heated Tobacco Products: A Review of Current Knowledge and Initial Assessments.

Nadja Mallock,Andreas Luch,Christoph Hutzler,Frank Henkler-Stephani,Elke Pieper

doi:10.3389/fpubh.2019.00287

Nadja Mallock, Andreas Luch + Show 3 more

Open Access

https://doi.org/10.3389/fpubh.2019.00287

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Abstract

The health risks of tobacco smoking have been documented in numerous studies and smoking rates have declined in developed countries over the last 50 years. Today, we know that cigarette smoking is the major cause of preventable deaths due to tobacco smoke induced diseases. As a consequence of an increased awareness of smoking-related health risks, heated tobacco products (HTPs) are marketed as reduced toxicant alternatives to conventional tobacco products. Manufacturers claim that levels of toxicants and hazardous compounds are significantly reduced, implying that inhalation of the modified aerosol is less harmful compared to conventional cigarettes. In this manuscript, previous assessments of HTPs are briefly summarized, including a short discussion on challenges with the adaption of standard analytical methods used for tobacco smoke. The reliability of analytical data is important for risk assessment approaches that are based on reduced toxicant exposure. In order to assess a putative reduction of health risks, an integrated study design is required that should include clinical studies and epidemiology data. One manufacturer applied for a classification as a Modified Risk Tobacco Product (MRTP) in the United States, based on extensive toxicological studies that have also been published. However, data are not yet sufficient for a reliable assessment or recognition of putatively reduced health risks. Challenges regarding a classification in Europe are also discussed briefly in this review.

Highlights

Most smokers are aware that tobacco smoking is harmful to their health, it is still the leading cause of premature death worldwide and claims the lives of more than 6 million people every year due to cancer, heart disease, stroke, chronic bronchitis, and emphysema [1,2,3,4]
Framework Convention on Tobacco Control (FCTC) was successfully applied to conventional tobacco products, uncertainties remain on how to cover novel products
One way to reduce the exposure to harmful and potential harmful compounds (HPHCs) in the mainstream smoke of tobacco products is to lower the temperature applied to the tobacco

Summary

INTRODUCTION

Most smokers are aware that tobacco smoking is harmful to their health, it is still the leading cause of premature death worldwide and claims the lives of more than 6 million people every year due to cancer, heart disease, stroke, chronic bronchitis, and emphysema [1,2,3,4]. A recent study has shown that tobacco smoking increases the risk for lung cancer, and for at least 17 different malignant diseases in humans [5]; successful tobacco control can save millions of lives. The overall aim is to decrease toxicity, addictiveness, and appeal to consumers. Parties of this convention have committed themselves to restrict the supply and demand of tobacco products through a wide range of policies and measures. In October 2018, Conference of Parties (COP) 8 explicitly proposed to extend the scope of the according legislations to Heated Tobacco Products (HTPs) [7]

Heated Tobacco Products

Findings

RISK ASSESSMENT APPROACHES