Acute effects of heated tobacco smoking: a single-center study

The idea of heated tobacco products (HTPs) is to deliver nicotine to the consumer by heating the tobacco rather than burning it, possibly causing less release of many harmful and potentially harmful chemical constituents (HPHCs), including carbon monoxide (CO). This prospective observational study targets studying the acute effects of HTPs regarding exhaled CO, serum cotinine level, and pulmonary function. A total of 91 participants were included; 46 current traditional cigarette smokers were instructed not to smoke for a minimum of 12 hours before the study (not following the smoking cessation program) and then divided into two groups. Group 1 contained 23 participants who smoked their usual cigarette brands, and Group 2 consisted of 23 participants who smoked the I-Quit-Ordinary-Smoking tobacco sticks. Group 3 is the control group, including 45 normal healthy non-smoker participants. All participants were subjected to the subsequent thorough medical history and clinical examination, followed by assessment of the following parameters before smoking as well as 5 minutes after smoking (either heated tobacco or traditional cigarettes according to their groups): oxygen saturation (SpO₂), heart rate (HR), measurement of exhaled CO, spirometry, and blood sample for serum cotinine level (which was assessed 5 minutes as well as 30 minutes after smoking). The study's findings showed that after smoking cigarettes, the amount of CO in the air was higher (mean 32.83±16.73 standard deviation) than after smoking heated tobacco, which was statistically significant. Serum cotinine levels also went up after smoking in both groups, but they were slightly higher after HTPs than after conventional cigarettes (CCs). Spirometry and SpO2 levels went down after smoking in groups 1 and 2, while HR levels went up after smoking in both groups, with a p-value of less than 0.001. We concluded that the HTPs have acute respiratory and cardiovascular effects similar to CCs but with less exhaled CO.