1. McNeill, A. et al. "Evidence review of e-cigarettes and heated tobacco products 2018." Report commissioned by Public Health England (PHE). February 2018.
“The available evidence suggests that heated tobacco products may be considerably less harmful than tobacco cigarettes and more harmful than e-cigarettes.”
2. Office of Science Center for Tobacco Products Food and Drug Administration. "FDA Briefing Document." January, 2018 Meeting of the Tobacco Products Scientific Advisory Committee (TPSAC).
3. Federal Institute for Risk Assessment (BfR). “Levels of selected analytes in the emissions of ‘heat not burn’ tobacco products that are relevant to assess human health risks.” Arch Toxicology. 2018. doi: 10.1007/s00204-018-2215-y.
“...our data confirm absolute values for selected toxicants in the emissions of the analyzed HNB that are in agreement with data published by the manufacturer."
4. National Institute for Public Health and the Environment (RIVM). "Factsheet on novel tobacco products that are heated." May, 2018.
“The number of substances present in the air that is inhaled when using tobacco sticks with the [EHTP] is lower than in cigarette smoke, but that does not mean that the health risk of HTPs is equally lower."
5. Li, X. et al. “Chemical Analysis and Simulated Pyrolysis of Tobacco Heating System 2.2 Compared to Conventional Cigarettes.” Nicotine Tob. Res. Accepted Manuscript. 2018. doi: 10.1093/ntr/nty005.
“[EHTP] delivered fewer harmful constituents than the conventional cigarette 3R4F. Simulated pyrolysis results showed that the lower temperature, instead of specially designed ingredients contributed to the distinct shift."
6. Farsalinos, K. E. et al. “Nicotine Delivery to the Aerosol of a Heat-Not-Burn Tobacco Product: Comparison With a Tobacco Cigarette and E-Cigarettes.” Nicotine Tob. Res. 2017. doi: 10.1093/ntr/ntx138.
“The HnB [heat-not-burn] product delivers nicotine to the aerosol at levels higher than ECs [e-cigarettes] but lower than a tobacco cigarette when tested using Health Canada Intense puffing regime. No change in HnB nicotine delivery was observed at prolonged puff duration with the same puff volume, unlike ECs which deliver more nicotine with longer puff duration.”
7. Liu, X. et al “Heat-not-burn tobacco products: concerns from the Italian experience.” Tob. Control. 2018. doi: 10.1136/tobaccocontrol-2017-054054.
“We found that the absolute number of never smokers who have already tried [EHTP] in Italy is comparable to that of current smokers.”
8. Pacitto, A. et al. “Characterization of airborne particles emitted by an electrically heated tobacco smoking system.” Environ. Pollut. 240, 2018. pp 248-254. doi: 10.1016/j.envpol.2018.04.137. "The dose received by smokers in terms of non-volatile amount of particle surface area was equal to 1–2 mm2 per puff, i.e. up to 4-fold larger than that received by electronic cigarette vapers.”
9. Protano, C. et al. “Second-hand smoke exposure generated by new electronic devices (IQOS and e-cigs) and traditional cigarettes: submicron particle behavior in human respiratory system.” Ann. Ig. 28 (2) 2016. pp 109-112. doi: 10.7416/ai.2016.2089.
“During smoking, SMPs [submicronic particles] released by traditional cigarettes resulted four times higher than those released by electronic and heat-not-burn devices and remained high for at least one hour, while SMPs values returned immediately similar to background for electronic and heat-not-burn devices.”
10. Protano, C. et al. “Second-hand smoke generated by combustion and electronic smoking devices used in real scenarios: Ultrafine particle pollution and age-related dose assessment.” Environ. Int. 107, 2017. pp 190-195. doi: 10.1016/j.envint.2017.07.014.
“The doses due to second-hand smoke from electronic devices [including EHTP] were significantly lower, below 1.60×108particles/kg bw [body weight], than those due to combustion devices. Dosimetry estimates were 50% to 110% higher for [EHTP] than for e-cigarettes.”
11. Ruprecht, A. A. et al. “Environmental pollution and emission factors of electronic cigarettes, heat-not-burn tobacco products, and conventional cigarettes.” Aerosol Sci. Technol. 51 (6) 2017. pp 674-684. doi: 10.1080/02786826.2017.1300231.
“Overall, our results indicate that [EHTP] devices, while having substantially lower emissions of most toxic compounds compared to CC [combustible cigarettes], are still not risk-free.”
12. Veronese, C. et al. “Cigarette smoke, e-cig vapor and ‘heat-not-burn’: a comparison between the emissions of toxic compound.” Tabaccologia. 1, 2017. pp 17-23. ISSN: 1970-1195. (in Italian)
“The results of our studies show that the [EHTP] devices, while having lower emissions of the majority of the toxic components compared to traditional tobacco products, still cannot be defined as harmless or free of risk factors.”
13. Bekki, K. et al. “Comparison of Chemicals in Mainstream Smoke in Heat-not-burn Tobacco and Combustion Cigarettes.” J. UOEH. 39 (3) 2017. pp 201-207. doi: 10.7888/juoeh.39.201.
“The concentrations of nicotine in tobacco fillers and the mainstream smoke of [EHTP] were almost the same as those of conventional combustion cigarettes, while the concentration of TSNAs was one fifth and CO was one hundredth of those of conventional combustion cigarettes.”
14. Kamada, T. et al. “Acute eosinophilic pneumonia following heat-not-burn cigarette smoking.” Respirol. Case Rep. 4 (6) 2016. e00190. doi: 10.1002/rcr2.190.
“In the same way as a conventional cigarette, HC [heat-not-burn cigarettes] should be recognized as a potential cause of AEP [acute eosinophilic pneumonia].”
15. Tabuchi, T. et al. “Awareness and use of electronic cigarettes and heat-not-burn tobacco products in Japan.” Addiction. 111 (4) 2016. pp 706-713. doi: 10.1111/add.13231.
“Approximately half the respondents in a Japanese internet survey were aware of e-cigarettes and heat-not-burn tobacco products, 6.6% had ever used."
16. Tabuchi, T. et al. “Heat-not-burn tobacco product use in Japan: its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-urn tobacco aerosol.” Tob. Control. 2017. doi: 10.1136/tobaccocontrol-2017-053947.
“Tobacco control organisations and governments should continue to monitor HNB tobacco and consider how to regulate it, given its impending, likely rapid global diffusion.”
17. Auer, R. et al. “Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name.” JAMA Intern. Med. 177 (7). 2017. pp 1050- 1052. doi: 10.1001/jamainternmed.2017.1419.
“Volatile organic compounds, polycyclic aromatic hydrocarbons, and carbon monoxide were present in [EHTP] smoke. The temperature of the [EHTP] was lower (330 oC) than the conventional cigarette (684 oC). The [EHTP] smoke had 84% of the nicotine found in conventional cigarette smoke.”
Our public comment on this article’s methods in JAMA Internal Medicine can be found at: https://jamanetwork.com/ journals/jamainternalmedicine/article- abstract/2660130.
18. Forster, M. et al. (British American Tobacco) “Assessment of novel tobacco heating product THP1.0 Part 3: Comprehensive chemical characterization of harmful and potentially harmful aerosol emissions.” Reg. Toxicol. Pharmacol. 93, 2018. pp 14-33. doi: 10.1016/j.yrtph.2017.10.006.
"For purposes of quality assurance, the concentrations of the same measurands observed in emissions from a commercial tobacco heating product, THS [EHTP], were assessed and the observed results (Table 5) compared with values previously reported by Schaller et al., (2016).”
19. Haswell, L. E. et al. (British American Tobacco) "In vitro RNA-seq-based toxicogenomics assessment shows reduced biological effect of tobacco heating products when compared to cigarette smoke." Sci. Rep. 8, 2018. p 1145. doi: 10.1038/s41598-018-19627-0.
"In conclusion, THPs have a reduced impact on gene expression compared to 3R4F."
20. Stephens, W. E. “Comparing the cancer potencies of emissions from vapourised nicotine products including e-cigarettes with those of tobacco smoke.” Tob. Control. 27, 2018. pp 10-17. doi: 10.1093/ntr/nty005.
“Mean lifetime risks decline in the sequence: combustible cigarettes >> heat-not-burn >> e-cigarettes (normal power) ≥ nicotine inhaler.”
21. Taylor, M. et al. (British American Tobacco) “Assessment of novel tobacco heating product THP1.0 Part 6: A comparative in vitro study using contemporary screening approaches.” Reg. Toxicol. Pharmacol. 93, 2018. pp 62-70. doi: 10.1016/j.yrtph.2017.08.016.
“TPM [total particulate matter] from 3R4F tobacco products stimulated responses in the ARE RGA and multiple cellular acute response endpoints that could be assessed with an HCS [high content screening] approach and could show relatively little or no activity with two THP TPMs at comparable doses.”
22. Thorne, D. et al. (British American Tobacco) “Assessment of novel tobacco heating product THP1.0 Part 7: Comparative in vitro toxicological evaluation.” Reg. Toxicol. Pharmacol. 93, 2018. pp 71-83. doi: 10.1016/j.yrtph.2017.08.017.
"All the in vitro techniques employed produced a clear positive response [indicating cytotoxicity] with cigarette smoke and in contrast, a negative response [no or minimal cytotoxicity] to THPs at doses equivalent to or higher than a cigarette smoke test matrix."
23. Caputi T. L. et al. “They’re heating up: Internet search query trends reveal significant public interest in heat-not-burn tobacco products.” PLOS One. 12 (10) 2017. pp 1-7. doi: 10.1371/journal.pone.0185735.
“Our findings suggest that tobacco control leaders should prepare for substantial demand for these products when they are introduced to new markets and/or expanded in existing markets.”
24. Davis, B. et al. “iQOS: evidence of pyrolysis and release of a toxicant from plastic.” Tob. Control. 2018 doi: 10.1136/tobaccocontrol-2017-054104.
“This study found that the tobacco plug does char and that charring increases when the device is not cleaned between heatsticks. Release of formaldehyde cyanohydrin is a concern as it is highly toxic at very low concentrations."
Our response which has been shared with the author and the publication can be found at: https://www.pmiscience.com/ library/publication/analysis-of-polylactic- acid-filters-of-marlboro-heatsticks-response- to-the-article-entitled-iqos-evidence-of- pyrolysis-and-release-of-a-toxicant-from- plastic-by-davis-b-et-al-2018.