Smokeless Tobacco - HnB

HnB = Heat not Burn HTP = Heated Tobacco Product THP = Tobacco Heating Product

Studies, Surveys, Papers, and Case Studies

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Suggested studies to add to this page

2023: Aerosol emissions from Heated Tobacco Products: a review focusing on carbonyls, analytical methods and experimental quality

  • Roberto A. Sussman, Federica Sipala, Rosalia Emma, Simone Ronsisvalle (Pre-print)
  • We provide an extensive review of 17 independent and industry-funded studies targeting carbonyls in aerosol emissions of Heated Tobacco Products (HTPs), focusing on quality criteria based on the reproducibility of experiments, appropriate analytic methods, and puffing regimes. Most revised studies complied with these requirements, but some were unreproducible, while others failed to consider analytical variables that may have affected the results and/or produced unrealistic comparisons.
  • We also provide a review of the literature on physicochemical properties of heated tobacco and HTP aerosols, as well as the evaluation of HTPs by regulatory agencies, addressing various critiques of their relative safety profile.
  • The outcomes from the revised studies and regulatory evaluations tend to agree with and converge to a general consensus that HTP aerosols expose users to significantly lower levels of toxicity than tobacco smoke.

Twitter thread with HnB info

2023: Comparing the Effectiveness, Tolerability, and Acceptability of Heated Tobacco Products and Refillable Electronic Cigarettes for Cigarette Substitution (CEASEFIRE): Randomized Controlled Trial

  • Switching to HTPs elicited a marked reduction in cigarette consumption among people who smoke and do not intend to quit, which was comparable to refillable ECs. User experience and risk perception were similar between the HTPs and ECs under investigation. HTPs may be a useful addition to the arsenal of reduced-risk alternatives for tobacco cigarettes and may contribute to smoking cessation. However, longer follow-up studies are required to confirm significant and prolonged abstinence from smoking and to determine whether our results can be generalized outside smoking cessation services offering high levels of support.
  • There is no right or ideal product - it's the one people want to use instead of cigarettes at the time, and in the situation, they want to use it.

2021 Changes in biomarkers after 180 days of tobacco heating product use: a randomised trial

2021 Systematic review of biomarker findings from clinical studies of electronic cigarettes and heated tobacco products

2021 Comparison of the chemical composition of aerosols from heated tobacco products, electronic cigarettes and tobacco cigarettes and their toxic impacts on the human bronchial epithelial BEAS-2B cells

2020 Comparison of the chemical composition of aerosols from heated tobacco products, electronic cigarettes and tobacco cigarettes and their toxic impacts on the human bronchial epithelial BEAS-2B cells

  • We first report that HTP (Heated Tobacco Product) delivers slightly less nicotine and emits much lower amounts of carbonyl and PAH compounds than tobacco cigarettes.
  • However, HTP emissions still contain carcinogenic compounds (e.g. formaldehyde, acetaldehyde and benzo[a]pyrene) and the amounts of carbonyls and PAHs in HTP aerosols are higher than in e-cig vapours.
  • In accordance with the levels of toxic compounds in each aerosol, HTP aerosol exhibits reduced cytotoxicity compared to cigarette smoke but higher than e-cig vapours (vapors).
  • HTP and e-cig have the potential to increase oxidative stress and inflammatory response, in a manner very similar to that of cigarette smoke, but only after a more intensive exposure. In addition, our data support that e-cig use at higher power settings emit higher carbonyl and PAH compounds and, consequently, generate more oxidative stress.
  • Finally, this study contributes to a better understanding of HTP and e-cig emission properties and their related toxicological impacts and provides important data needed for risk assessment purposes, by demonstrating that HTP might be less harmful than tobacco cigarettes but considerably more harmful than e-cig.
  • PDF Version
  • Citation: Dusautoir R, Zarcone G, Verriele M, Garc¸on G, Fronval I, Beauval N, Allorge D, Riffault V, Locoge N, Lo-Guidice J-Marc, Antherieu S, Comparison of the ´ chemical composition of aerosols from heated tobacco products, electronic cigarettes and tobacco cigarettes and their toxic impacts on the human bronchial epithelial BEAS-2B cells, Journal of Hazardous Materials (2020), doi: 10.1016/j.jhazmat.2020.123417
  • Acknowledgement: This work was supported by the French Institute of Cancer (INCa) and the French Institute for Public Health Research (IResP): Contracts n°INCa_11505 and n°INCa_13648.


2018 Carbonyl emissions from a novel heated tobacco product (IQOS): comparison with an e-cigarette and a tobacco cigarette

  • The IQOS heated tobacco product emits substantially lower levels of carbonyls than a commercial tobacco cigarette but higher levels than an e-cigarette.
  • PDF Version
  • Citation: Farsalinos KE, Yannovits N, Sarri T, Voudris V, Poulas K, Leischow SJ. Carbonyl emissions from a novel heated tobacco product (IQOS): comparison with an e-cigarette and a tobacco cigarette. Addiction. 2018 Nov;113(11):2099-2106. doi: 10.1111/add.14365. Epub 2018 Jul 10. PMID: 29920842.
  • Keywords: Carbonyls; electronic cigarettes; harm reduction; heated tobacco products; nicotine; smoking.

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