Heat-Not-Burn Tobacco Products: The Devil in Disguise or a Considerable Risk Reduction?

  • Dirk W Lachenmeier Epidemiological Research Unit
  • Peter Anderson Institute of Health and Society
  • Jürgen Rehm Institute for Mental Health Policy Research
Keywords: tobacco products, smoking, cigarettes, nicotine, risk assessment, carcinogens

Abstract

Background: Heat-not-burn (HNB) tobacco products are not burnt but instead are inserted into a tobacco-heating system, which heats the tobacco at temperatures below that required to initiate combustion. This mechanism potentially results in significantly reduced concentrations of heat-generated toxicants in the inhalable aerosol.
Method: The margin of exposure (MOE) approach was applied for quantitative risk assessment. The MOE is defined as the ratio between the toxicological threshold and the estimated human intake of the same compound. The higher the MOE, the lower the risk of a compound.
Findings: The MOEs were increased by factors of 3 to 415 for the most toxic compounds in tobacco smoke, comparing use of HNB with smoking conventional tobacco products. The combined MOE for all compounds was increased 23-fold, excluding nicotine, or 10-fold including nicotine. Thus, the overall risk for cumulative toxic effects was markedly lower for HNB products.
Conclusions: HNB tobacco reduced the risk of exposure to 9 out of the 20 most toxic compounds in tobacco beyond an MOE threshold of 10,000. While our results show that use of HNB products leads to a considerable risk reduction compared to conventional tobacco, the products cannot be considered completely “risk-free” due to risk of exposure to the remaining toxicants with MOE below the threshold.

Author Biographies

Dirk W Lachenmeier, Epidemiological Research Unit

Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie and Psychotherapie, Dresden

Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Karlsruhe

Peter Anderson, Institute of Health and Society
Institute of Health and Society, Newcastle University, Newcastle
Jürgen Rehm, Institute for Mental Health Policy Research

Epidemiological Research Unit, Technische Universität Dresden, Klinische Psychologie and Psychotherapie, Dresden, Germany

Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto

Dalla Lana School of Public Health and Department of Psychiatry, University of Toronto

Published
2018-10-07
How to Cite
Lachenmeier, D. W., Anderson, P., & Rehm, J. (2018). Heat-Not-Burn Tobacco Products: The Devil in Disguise or a Considerable Risk Reduction?. The International Journal of Alcohol and Drug Research, 7(2), 8-11. https://doi.org/10.7895/ijadr.250
Section
Papers