Smoke-free alternatives, better options than cigarettes—scientific study
A SCIENTIFIC study suggests that smoke-free alternatives like heated tobacco products (HTPs) and electronic cigarettes (e-cigarettes) could be better alternatives to smoking.
The research, presented at the 7th Summit on Tobacco Harm Reduction: Novel Products, Research & Policy, indicates that switching from traditional cigarettes to these alternatives may have less damaging effects on blood vessels.
According to the study led by Dr. Kallirrhoe Kourea, a cardiologist at Atikon Hospital in Greece, switching to HTPs or e-cigarettes may help prevent plaque buildup in the arteries.
Dr. Kourea explained that the study focused on the impact of both traditional cigarettes and alternative smoking products on the endothelial glycocalyx, a protective layer of cells lining the blood vessels. This layer plays a crucial role in maintaining cardiovascular health.
Dr. Lorenzo Mata Jr., president of Quit For Good, a non-profit organization in the Philippines that promotes harm reduction, discussed the broader implications of the study’s findings. He said the primary health risks linked to smoking come from the harmful substances created when tobacco is burned, not from nicotine itself.
“Smoke-free products like HTPs provide a less harmful option for those who cannot quit tobacco entirely,” said Dr. Mata. He suggested that individuals looking to reduce the negative health effects of smoking might benefit from switching to these alternatives.
Heated tobacco products (HTPs), unlike traditional cigarettes, heat tobacco rather than burn it. This heating process prevents the production of smoke and ash, which contain thousands of harmful chemicals released during combustion. A well-known HTP brand in the Philippines is IQOS, which has been available since 2020.
The study conducted in Greece involved 150 participants, including 50 current smokers who were randomized to use either HTPs or e-cigarettes, along with a control group of 50 traditional smokers. Researchers monitored the condition of the endothelial glycocalyx, using a device that measured capillary diameters and blood vessel function.
The results revealed that continued smoking of traditional cigarettes led to further damage to the endothelial glycocalyx, but those who switched to e-cigarettes showed no significant change in the glycocalyx. Individuals who switched to heated tobacco products experienced modest improvements in their blood vessel health.
“Although previous research has shown that HTPs and e-cigarettes contain fewer harmful chemicals than traditional cigarettes, the long-term effects on blood vessel health are still uncertain,” said Dr. Kourea. She highlighted the need for further studies to fully understand the benefits of these alternatives.
The findings were discussed during a session titled “The Case of Nicotine Use in Greece – Behavioral and Clinical Data,” chaired by Dr. Angelos Hatzakis and Dr. Ignatios Ikonomidis at the summit organized by SCOHRE, a group that supports harm reduction as a way to improve public health.
“These findings suggest that alternative smoking products like HTPs and e-cigarettes could offer cardiovascular benefits for smokers,” said Dr. Ikonomidis, a cardiology professor. He said that while more research is necessary, the results so far are encouraging for smokers who want to quit but struggle with nicotine addiction.
Dr. Ikonomidis also pointed to early findings from a larger multicenter study across 37 European countries, which showed positive effects on lung function and arterial elasticity among users of HTPs and e-cigarettes. These results align with data from the Cochrane database, which found no negative cardiac events among HTP users over a two-year period.
One key point highlighted in the study is that while nicotine levels were similar across users of traditional cigarettes, e-cigarettes, and HTPs, the harmful effects were only observed in those who smoked combustible cigarettes. This suggests that the toxic substances in cigarette smoke, rather than nicotine, are primarily responsible for the health risks.
“This is a very interesting study that opens the door for using various biomarkers to assess long-term effects and their association with clinical conditions,” said Dr. Hatzakis.
While smoke-free alternatives may not be entirely risk-free, the study adds to a growing body of evidence suggesting that they may be a less harmful option for smokers looking to reduce their health risks.
