Heated tobacco products (HTPs) are a new, rapidly emerging category of tobacco products that are designed to heat the tobacco instead of burning it, thus substantially reducing the emission of harmful chemicals. Currently there is a debate about whether HTPs provide an opportunity for public health, to accelerate the decline in cigarette smoking prevalence and thereby smoking-related population harm. To answer this question, HTPs have to be scientifically substantiated to reduce the harm to the individual smoker, but they also have to be satisfying for adult smokers to maximize the number of adult smokers who switch, while minimizing the number of youths and non-smokers who initiate or relapse to these products, as well as minimizing the number of smokers who intend to quit who may use those products instead. In this article we present the evidence showing that switching to the THS reduces the negative health effects that are triggered by chronic exposure to the toxic substances generated during tobacco combustion and that lead to disease, compared to continuing smoking.

The primary goal of the Exposure response Study (ErS) was to generate direct evidence that actual use of Philip Morris international's smoke-free alternative to cigarettes, Tobacco Heating System (THS), can reduce smokers' risk of harm compared to continuing to smoke cigarettes. in the study eight bio-markers of potential harm (BopH) were measured, to provide further evidence on effects of current adult smokers switching to THS. Each of the BopH were selected because they are associated with smoking-related diseases, are negatively impacted by smoking and are reversible following smoking cessation. Given the study hypothesis, that the eight BopH which cover eight different pathways of disease would change favorably, similarly to what is reported in the literature following smoking cessation. Therefore all eight BopH were included and tested as co-primary endpoints. In total 984 smokers were randomized to either switch to THS use, or continue to smoke cigarettes. The eight BopH were assessed over a period of six months in an ambulatory setting. The results showed that when smokers switched to THS, all eight BopH showed a changes similar to what is seen following smoking cessation, and five of the eight BopH were statistically significant better in smokers who switched to THS than smokers who continued to smoke cigarettes. This led to the conclusion that switching from cigarettes to THS-use likely reduces a smoker's risk of tobacco-related disease and may present less risk of harm compared to continued smoking.

Nicotine is naturally present in many crops, including but not limited to tobacco, eggplant, and tomatoes. Only in the tobacco plant is nicotine present in high enough quantities (~2% of dry weight) to have pharmacological effects. People have recognized the stimulating effects of the smoke created by burning dried tobacco leaves for thousands of years, and cigarette smoking remains the most common form of nicotine uptake from tobacco. Decades of epidemiologic data show that smoking causes a number of serious diseases (including cardiovascular diseases, lung cancer, and chronic obstructive pulmonary disease [COPD]). Undoubtedly, the best way to avoid the harm from smoking is to never start. For current smokers, quitting smoking altogether is the most effective way to reduce the risk of harm and smoking-related disease. Along with other aspects such as taste and ritual, nicotine is one of the reasons people smoke. Nicotine, while addictive and not risk-free, is not the primary cause of smoking-related diseases. Indeed, experts agree that smoking-related diseases are caused primarily by chronic exposure to the harmful constituents that are produced when tobacco is burning. Nevertheless, many people still mistakenly believe that nicotine is a major cause of tobacco-related diseases. While nicotine-containing products should not be used by certain groups of people - such as minors, people with or at risk of heart disease, diabetes, epilepsy, or seizure, pregnant or breast-feeding women or women who think they may be pregnant - delivery of nicotine by less harmful means can support public health goals by encouraging smokers who would otherwise continue smoking to switch to less harmful products. It is, therefore, pivotal to address the biggest misconceptions about nicotine to empower smokers to make informed decisions. In this article, we discuss basic facts about nicotine, its effects on the human body, as well as the risks related to nicotine consumption.