Health Outcomes in Copd Smokers Using Heated Tobacco Products: A 3-Year Follow-Up

Polosa, Riccardo; Morjaria, JB; Prosperini, Umberto; Busà, Barbara; Pennisi, Alfio; Gussoni, Gualberto; Rust, Sonja; Maglia, Marilena; Caponnetto, Pasquale

doi:10.1101/2020.12.10.20243857

Cited by 4 publications

(13 citation statements)

References 37 publications

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“…Of the two available studies into long-term health effects, one reported physiologically favourable outcomes (Polosa et al, 2021b) whilst the other did not (Loffredo et al, 2021). There are currently no studies on the potential risk of heated tobacco product use on development of any form of cancer and long-term epidemiological studies into this may be warranted.…”

Section: Discussionmentioning

confidence: 99%

“…In the second study, health parameters were monitored for a period of three years in Chronic Obstructive Pulmonary Disease (COPD) smoking patients who substantially attenuated or ceased conventional cigarette consumption after transitioning to heated tobacco products (Polosa et al, 2021b). Changes in daily cigarette consumption, annualised disease exacerbations, lung function indices, self-reported outcomes and 6-minute walk distance from baseline were measured in the COPD patients using heated tobacco products after 12, 24 and 36 months.…”

Section: Chronic Use Studies (>1 Month)mentioning

confidence: 99%

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The product science of electrically heated tobacco products: a narrative review of the scientific literature

Malt

Thompson²,

Mason

et al. 2022

F1000Res

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Heated tobacco products represent a novel category of tobacco products in which a tobacco consumable is heated to a temperature that releases nicotine from the tobacco leaf but not to a temperature sufficient to cause combustion. Heated tobacco products may therefore have the potential to be a less harmful alternative for adult smokers that would otherwise continue to smoke conventional cigarettes. Given the rapid development of this product category, the aim of this review was to examine the available peer-reviewed scientific evidence related to heated tobacco products and highlight any research gaps. In recent years, manufacturers of heated tobacco products have published a number of studies on their respective heated tobacco products. Whilst there is limited research that is independent of commercial interests, the available scientific evidence indicates that heated tobacco products produce a much simpler aerosol than conventional cigarette smoke, with fewer and substantially lower levels of harmful toxicants. Toxicology assessments indicate these reductions in aerosol toxicants translate to reduced biological effects. Biomarker and clinical data from studies in which product use is controlled within a clinical setting, indicate changes in biomarker levels and clinical end-points similar to observations in cessation studies, indicating the potential for reduced harm. The scientific evidence also indicates that exposure of non-users to emissions from heated tobacco products in indoor environments is significantly reduced compared to exposure resulting from smoking conventional cigarettes. Overall, the available scientific evidence indicates that heated tobacco products hold promise as a less harmful alternative to conventional cigarettes, but more independent data is required to validate industry findings. As a growing product category, epidemiological studies and independent population modelling studies are outstanding, and empirical data on how dual tobacco product category use by consumers affects their risk profile is lacking.

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Section: Discussionmentioning

confidence: 99%

Section: Chronic Use Studies (>1 Month)mentioning

confidence: 99%

The product science of electrically heated tobacco products: a narrative review of the scientific literature

Malt

Thompson²,

Mason

et al. 2022

F1000Res

View full text Add to dashboard Cite

show abstract

“…There were some positive effects among people who used THS in terms of conditions associated with metabolic syndrome, with the most significant improvement being related to blood pressure." 34 In Italy, a retrospective study by Polosa et al 35 looked at the effects of HNB product use on changes in COPD status between 2017 and 2020. Daily cigarette consumption, yearly exacerbation events, pulmonary function, patient-reported health outcomes, and the results of a 6-minute walk test (6MWT) test were measured in 19 adult smokers with COPD who reduced conventional smoking (dual users) or achieved abstinence by switching to heated tobacco products at months 0, 12, 24, and 36.…”

Section: Clinical Evidence Basementioning

confidence: 99%

Current Evidence on Tobacco Harm Reduction in Pneumology: Interviews with Two Key Opinion Leaders

Barrell¹

2022

EMJ

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The negative impact of smoking on the lung is well documented. Cigarette smoke is the cause of 90% of cases of chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. COPD is a progressive and debilitating condition with morbidity and mortality rates similar to myocardial infarction (MI) and stroke. Despite the widely recognised risks, millions of people continue to smoke, in some cases even after receiving a diagnosis of COPD and despite knowing that the habit will accelerate disease progression. While there is no doubt that smoking cessation is the most important health intervention for all cigarette smokers, it can be challenging. Nicotine addiction, social norms and culture, and the length of time it can take smokers to feel the adverse consequences of the habit all contribute to the high cessation failure rate. However, increasing clinical and epidemiological evidence indicates that for those who are unwilling or cannot stop smoking, harm reduction strategies can help reduce exposure to the harmful chemicals and carcinogens released during tobacco combustion. Electronic devices heat processed tobacco without combusting it to deliver an aerosol containing fewer toxic products or harmful and potentially harmful constituents (HPHC) than cigarette smoke. Clinical evidence to support their use is growing. In Japan, for example, a decrease in hospitalisations due to COPD exacerbation after the introduction of such heat-not-burn (HNB), or tobacco heating systems (THS), has been reported. In this article, Wolfgang Popp, Döbling Doctor’s Center, Privatklinik Döbling, Vienna, Austria, and Klara Szondy, Semmelweis University, Budapest, Hungary, discuss the impact of cigarette smoke on the lung, and how to support smoking cessation in those willing and able to quit smoking. They also explain when strategies that reduce the harmful effects of smoking may be useful, and outline the latest evidence supporting the use of HNB systems.

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“…HTP are presented as "modified risk" tobacco products because switching to HTP can potentially reduce deleterious health effects associated with CC use. In a recent study, changes in a daily cigarette smoking, annualized disease exacerbations, lung function indices, patient-reported CAT scores, and 6-Minute Walk Test were measured in 19 COPD patients using HTP at 12-, 24-, and 36-months and compared with a group of age-and sex-matched COPD patients who continued using CC [11]. Subjects using HTP had a substantial decrease in annualized COPD exacerbations within the group mean at baseline and three year follow-up.…”

Section: Introductionmentioning

confidence: 99%

Respiratory Function, Physical Capacity, and Metabolic Syndrome Components in Combustible Cigarettes and Heated Tobacco Products Users: A Four-Year Follow-Up Cohort Study

Sharman

Yermakova

Erenchina

et al. 2022

Glob. J. Respir. Care

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Purpose: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide and is the fourth leading cause of death in Kazakhstan. Cigarette smoking is a prevalent risk factor for COPD. While quitting smoking is the preferred way to reduce COPD risk, literature suggests that heated tobacco products (HTP) might be a better option for people who cannot quit smoking. The aim of this paper was to analyze the long-term effects of shifting to HTP use in long-term smokers compared to continued combustible cigarettes (CC) use. Patients and methods: A cohort of 1200 participants (400 HTP and 800 CC) aged 40-59 years with a minimum of 10 pack-year smoking history were recruited and followed for four years. The functional outcomes compared between HTP and CC users included: (1) COPD Assessment Test (CAT); (2) post-bronchodilator lung function; (3) 6-minute walking distance (6MWD) test; and (4) metabolic syndrome components. One way ANOVA was used to compare functional outcomes between visits, while multivariable linear mixed models were used to test associations between health outcomes and smoking type (HTP vs. CC) over time. Results: Out of 1200 participants 893 (609 CC users and 284 HTP users) remained in the study by the fourth year of follow up. Comparison between functional outcomes showed that most of them have improved between visits, while lung function and fasting blood glucose levels got worse. Linear mixed models showed HTP use was associated with better functional outcomes over time compared to CC users. Lung function decrease was significantly less in HTP users, while improvements in CAT scores, waist circumference, and systolic blood pressure were significantly better compared to CC users. Conclusion: This study demonstrated that HTP users experienced it to a significantly lesser decrease in lung function compared to CC users, while demonstrating better improvements in other functional outcomes. The results of this study suggest that HTP might be a less deleterious alternative compared to CC in people with long history of CC use and who cannot quit smoking.

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Health Outcomes in Copd Smokers Using Heated Tobacco Products: A 3-Year Follow-Up

Cited by 4 publications

References 37 publications

The product science of electrically heated tobacco products: a narrative review of the scientific literature

The product science of electrically heated tobacco products: a narrative review of the scientific literature

Current Evidence on Tobacco Harm Reduction in Pneumology: Interviews with Two Key Opinion Leaders

Respiratory Function, Physical Capacity, and Metabolic Syndrome Components in Combustible Cigarettes and Heated Tobacco Products Users: A Four-Year Follow-Up Cohort Study

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