Unburned Tobacco Cigarette Smoke Alters Rat Ultrastructural Lung Airways and DNA

Vivarelli, Fabio; Canistro, Donatella; Cirillo, Silvia; Elias, Ryan J.; Granata, Silvia; Mussoni, Matilde; Burattini, Sabrina; Falcieri, Elisabetta; Turrini, Eleonora; Fimognari, Carmela; Buschini, Annamaria; Lazzaretti, Mirca; Beghi, Sofia; Girotti, Stefano; Sangiorgi, Simonetta; Bolelli, Luca; Ghini, Severino; Ferri, Elida Nora; Fagiolino, Ivan; Franchi, Paola; Lucarini, Marco; Mercatante, Dario; Rodríguez‐Estrada, Maria Teresa; Lorenzini, Antonello; Marchionni, Silvia; Gabriele, Morena; Longo, Vincenzo; Paolini, Moreno

doi:10.1093/ntr/ntab108

Cited by 22 publications

(28 citation statements)

References 51 publications

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“…A recent in vivo study demonstrated that irritating and carcinogenic compounds including aldehydes and polycyclic aromatic hydrocarbons are contained in the IQOS mainstream and indicates that IQOS causes grave lung damage and promotes factors that increase cancer risk [ 31 ]. Meanwhile, a recent review suggests that HTPs may be products with a reduced risk of chronic diseases, including respiratory and cardiovascular diseases and cancer, compared to traditional smoking, although exposure to IQOS has been reported to alter mitochondrial function, which may further exaggerate airway inflammation, airway remodeling and lung cancer [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Exposure to Heated Tobacco Products Aerosol Causes Acute Stress Responses in the Lung of Mouse

et al. 2022

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In the present study, we evaluated the acute response of mice exposed to IQOS aerosol, a brand-name heated tobacco product (HTP), in the lung tissue. First, the thiobarbituric acid-reactive substances (TBA-RS) value was measured as an index to assess oxidative stress, and a significant increase was observed after exposure, followed by a significant increase in the total lung GSH concentration. The stress responses induced by IQOS aerosols was then analyzed by focusing on the changes in Nrf2 and ATF4, which are transcription factors that induce the expression of genes involved in GSH biosynthesis or metabolism. Although Nrf2 activation was not observed, significant accumulation of ATF4 in the nuclear fraction was noted three hours after exposure to IQOS aerosols. Upon an examination of changes in factors in the GSH biosynthetic system, a significant increase in cystine concentration in the lung tissue was measured, and an increase in xCT expression level was observed in the cell membrane fraction three–six hours after IQOS exposure. Furthermore, characteristic changes in HO-1, a stress-response protein regulated by ATF4, was discovered six hours after IQOS exposure. Moreover, analysis of the upstream ATF4 regulatory system revealed that phosphorylation of eIF2α was enhanced in the lung cytoplasmic fraction three hours after exposure to IQOS aerosols. These findings suggest that ER stress might be induced as an early response to IQOS aerosol exposure, accompanied by the activation of the eIF2α-ATF4 axis. These intracellular changes have also been reported after exposure to combustible cigarette smoke. Thus, the acute response found in the lungs of mice in the present study demonstrate that the inhalation of aerosols from IQOS elicits a biological response similar to that of combustible cigarette smoke. In conclusion, our results provide evidence that the biological effects of HTPs, such as IQOS, cannot be ignored in the lungs.

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Section: Discussionmentioning

confidence: 99%

Exposure to Heated Tobacco Products Aerosol Causes Acute Stress Responses in the Lung of Mouse

et al. 2022

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“…First, building on the industry’s earlier tactical co-option of harm reduction terminology,27 PMI is now attempting to redefine the concepts ‘smokefree’ (away from the complete absence of tobacco products) and ‘quitting’ (away from ending the use of tobacco and nicotine products). Its presentation of iqosas ‘smokefree’ may not be entirely accurate, due to the pyrolysis that occurs when the tobacco is heated 51 52. Similarly, PMI publishes estimates of ‘quitting’ based on the number of people who have ‘switched’ to iqos, even for a brief period, including dual users alongside cigarettes 16.…”

Section: Methodsmentioning

confidence: 99%

Understanding the long-term policy influence strategies of the tobacco industry: two contemporary case studies

et al. 2022

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ObjectiveThis paper explores transnational tobacco companies’ (TTCs) long-term policy influence strategies using two case studies, harm reduction and illicit tobacco, to identify lessons for the tobacco control movement and wider efforts to address the commercial determinants of health.MethodsEvidence from a broad combination of sources including leaked documents and findings from over two decades of TTC monitoring were reviewed for each case study and categorised using the Policy Dystopia Model, focusing on the primary discursive strategy and key instrumental (action-based) strategies used.ResultsIn both case studies, TTCs seek to advance their interests by engaging primarily in reputation management, coalition management and information management strategies over the long-term to propagate their over-riding discursive strategy—‘we’ve changed, we are part of the solution’—despite clear evidence from both case studies that this is not the case. These strategies are globally coordinated and attempt primarily to reshape norms towards TTC involvement in tobacco control policy and delivery. Findings also suggest that industry denormalisation and the advent of Article 5.3 have led to the TTCs growing use of increasingly complex and opaque ‘webs of influence’.ConclusionsThe tobacco control community must develop its own proactive long-term strategies which should include industry denormalisation, new ways to fund research that reduce industry control, and improved transparency measures for research and policy. These findings, including TTC adaptations to Article 5.3, also indicate the need for more structural solutions, addressing corporate power and the underlying political and economic system. These lessons can be applied to other unhealthy commodity industries.

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“…It is also important to note that emissions from earlier generation of HTPs (e.g., Eclipse) were classed as smoke by a study affiliated to the manufacturer 39 ( Table 1 ), and the emissions were also found to contain soot (black carbon). 40 In addition, Vivarelli et al 41 refers to IQOS aerosol as smoke containing carcinogenic compounds, including aldehydes and polycyclic aromatic hydrocarbons, that are sign of incomplete combustion and degradation of tobacco. This raises the question as to what extent IQOS emissions differ from those from these earlier HTPs so as not to be classed as smoke.…”

Section: To What Extent Can Iqos Be Considered Smoke Free?mentioning

confidence: 99%

Should IQOS Emissions Be Considered as Smoke and Harmful to Health? A Review of the Chemical Evidence

Uguna

Snape

2022

ACS Omega

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The chemical evidence that IQOS emissions fit the definition of both an aerosol and smoke, and that IQOS and potentially other heated tobacco products (HTPs) pose some harmful health threats from the range of compounds released even at somewhat lower concentrations is reviewed. Further, we address the yields of harmful and potentially harmful compounds (HPHCs), including polycyclic aromatic hydrocarbons (PAHs), and the constituents of IQOS emission that are diagnostic of pyrolysis to provide information on the temperatures reached in IQOS tobacco sticks. The HPHCs present in IQOS emissions are the same as in conventional cigarette smoke (CCs), analogous to emissions from earlier generation of HTPs classed as smoke. However, Philip Morris International (PMI) studies have to some degree underestimated IQOS aerosol HPHC yields, which are a factor of between 3.2 and 3.6 higher when expressed on a tobacco rather than an IQOS stick basis compared to the reference 3R4F cigarette. Further, IQOS emissions contain carbon particles, which fit definition of both aerosol and smoke. Continual reheating of deposited tar in the IQOS device will occur with real-life use, likely leading to generation of even higher concentrations of HPHCs and particulate matter. Despite IQOS not exceeding 350 °C, local hot spots could exist, causing formation of species (phenol/cresols, PAHs). It is recommended that the impact of repeated use to determine the levels of black carbon (insoluble organic matter) in the particulate matter, and the extent to which compounds in IQOS emissions are formed by pyrolysis need to be assessed rigorously. To address whether uneven temperature profiles in heat sticks can lead to potential hot spots that could, for example, lead to PAH formation, it is recommended that pyrolysis studies on tobacco and other constituents of HTPs are required in conjunction with more effort on heating tobacco blends under controlled temperature/time conditions.

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Unburned Tobacco Cigarette Smoke Alters Rat Ultrastructural Lung Airways and DNA

Cited by 22 publications

References 51 publications

Exposure to Heated Tobacco Products Aerosol Causes Acute Stress Responses in the Lung of Mouse

Exposure to Heated Tobacco Products Aerosol Causes Acute Stress Responses in the Lung of Mouse

Understanding the long-term policy influence strategies of the tobacco industry: two contemporary case studies

Should IQOS Emissions Be Considered as Smoke and Harmful to Health? A Review of the Chemical Evidence

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