Heated Tobacco Products: Emerging Health Outcomes and Insights into Oxidative Stress and Pro-Inflammatory-Driving Mechanisms

With over 8 million deaths annually, smoking remains one of the most impactful global public health burdens. Heated tobacco products (HTPs) offer smokers the possibility of inhaling nicotine by heating tobacco, resulting in a significant reduction in the levels of toxic and potentially toxic compounds released. However, a growing number of studies indicate that exposure to HTPs increases oxidative stress and triggers pathophysiological changes, mirroring cellular mechanisms well-documented in conventional cigarette smoke exposure. In particular, evidence from animal models suggests that the use of heated tobacco products (HTPs) may represent a risk factor for respiratory and cardiovascular diseases, as well as a potential contributor to reduced male and female fertility. The following review summarizes the current state of knowledge on HTP toxicity, focusing on both preclinical and emerging clinical data on the health impact of HTP use and the putative harm reduction aspects.