Given the impact of smoking on individuals and National Healthcare Systems, it has become
necessary for the continuous evaluation of tobacco products, especially when they are claimed
or perceived as being less harmful than conventional cigarettes (CCs), and coexisting conflict
of interests. The objective of the present manuscript was to perform a complete and updated
narrative review of scientific literature on the assessment of harmful and potentially harmful
constituents (HPHCs) and the biological and clinical impact from the newest available heatedtobacco
products (HTPs), in comparison with CCs. A total of 52 studies (46 from the review and
6 manually found) were finally analyzed. Despite some existing differences among the studies,
most of them point to a reduction of the emissions of HPHCs as well as exposure to toxicants,
and thus in the biological and clinical impact with HTPs when compared with CCs. In the scenario
where individuals decide to continue smoking, HTPs seem to be a better option than CCs.
Further prospective, independent studies should replicate the existing experiments in order to
corroborate the conclusions raised in the original studies. Moreover, long-term investigations
(decades) are also needed to obtain more compelling safety information of HTPs.
Authors
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José Miguel Rodríguez González-Moro - Servicio de Neumología. Hospital Universitario “Príncipe de Asturias”, Alcalá de Henares, Madrid. / Universidad de Alcalá de Henares. Madrid
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Patricia Ortega - Directora Médica. Meisys. Madrid
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Ramón Bover Freire - Unidad de Insuficiencia Cardiaca, Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain / CIBERCV
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Enrique Grande - Servicio de Oncología Médica. MD Anderson Cáncer Center. Madrid
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María Luisa Romero - Centro de Salud “Estrecho de Corea”. Madrid
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Vivencio Barrios - Universidad de Alcalá de Henares. Madrid / Servicio de Cardiología. Hospital Universitario “Ramón y Cajal”. Madrid
Keywords:
Heated-tobacco products; narrative review; biological impact; biomarker; harmful constituents.