Clinical Pharmacology of Electronic Nicotine Delivery Systems (ENDS): Implications for Benefits and Risks in the Promotion of the Combusted Tobacco Endgame.

regarding Heat-Not-Burn products:

1. Heat-Not-Burn products are likely less harmful than conventional cigarettes since they expose users to considerably lower levels of combustion-generated toxicants than cigarettes.
2. Most of the currently available research on Heat-Not-Burn products was manufacturer-funded, with findings from independent studies showing that exposure to many harmful constituents can be substantially lower.
3. However, Heat-Not-Burn emissions contain other potentially toxic substances at higher levels than conventional cigarettes.
4. A recent meta-analysis of population-based studies confirmed increased quitting with daily but decreased quitting with non-daily e-cigarette use.
5. Many participants who achieve smoking abstinence with e-cigarettes or Heat-Not-Burn products remain users for long periods. In the Hajek study, 18% of smokers quit using e-cigarettes, but 80% of those who quit smoking continued to use e-cigarettes at 1 year.
6. More studies are needed to better identify potential risks and benefits of Heat-Not-Burn technology compared to conventional cigarettes and other electronic nicotine delivery systems (ENDS).

Benowitz NL, St Helen G, Liakoni E. Clinical Pharmacology of Electronic Nicotine Delivery Systems (ENDS): Implications for Benefits and Risks in the Promotion of the Combusted Tobacco Endgame. Journal of clinical pharmacology. 2021;61 Suppl 2:S18-S36. doi:10.1002/jcph.1915