Impact of Heating Conventional Cigarettes With a Novel Device on Health-Related Biomarkers and Cigarette Use Patterns Among Chinese Adult Smokers Unwilling to Quit: A Pilot Randomized Controlled Trial

Introduction:
This text provides an analysis of a pilot randomized controlled trial examining the impact of heating conventional cigarettes with a novel heated tobacco product (HTP) device on biomarkers and cigarette use patterns among Chinese adult smokers unwilling to quit. It discusses the study design, key findings, and implications for tobacco harm reduction.

Key Points:

* The study was a 21-day, open-label, two-arm parallel-group, pilot RCT conducted in Beijing, China. Participants were randomized to either continue smoking conventional cigarettes (Control group) or switch to using heated conventional cigarettes by the novel HTP device (HTP device group).
* Health-related biomarkers, cigarette use patterns, and safety were assessed. Five biomarkers of exposure (BoEs) were measured at baseline and on day 7, while 13 biomarkers of biological effect (BoBEs) were measured at baseline and on day 21. Safety and acceptability were also evaluated.
* In the HTP device group, BoE levels decreased by 26.4% to 71.4% from baseline, while BoBE levels did not significantly change in either group. During the flexible use period, 56% of participants exclusively used heated conventional cigarettes, experiencing reduced cravings and withdrawal symptoms. However, dual users consumed more cigarettes.
* Mild to moderate device-related reactions were reported in 36% of users, and satisfaction, taste, and harm reduction belief scores averaged 7.4, 6.6, and 8.7 (out of 10), respectively.

Main Message:
The novel HTP device shows promise as a short-term harm reduction alternative for smokers unwilling to quit. The device can directly heat conventional cigarettes without the necessity for specifically designed tobacco products, potentially avoiding the potential additive risks of traditional HTPs. However, the device may lead to increased tobacco use among dual users. Further investigation is needed to confirm these preliminary findings and assess long-term impacts.

Shuilian Chu, Xiaobo Li, Di Zhang, Hang Jing, Lin Feng, Yingting Zuo, Jiachen Li, Haomiao Ma, Zhaohui Tong, Lirong Liang, Impact of Heating Conventional Cigarettes With a Novel Device on Health-Related Biomarkers and Cigarette Use Patterns Among Chinese Adult Smokers Unwilling to Quit: A Pilot Randomized Controlled Trial, Nicotine & Tobacco Research, Volume 27, Issue 5, May 2025, Pages 873–883, https://doi.org/10.1093/ntr/ntae177