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Updated: Jun 2, 2025
Methods to Evaluate Cytotoxicity and Immunosuppression of Combustible Tobacco Product Preparations
Published on: January 10, 2015
Patterns of Use of Heated Tobacco Products: A Comprehensive Systematic Review
Marco Scala1, Giulia Dallera1, Giuseppe Gorini2
1Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS.
Introduction:
Relative or absolute safety of heated tobacco products (HTPs) remains unknown, while independent literature suggests that these products do not favor tobacco control. We conducted a comprehensive systematic review and meta-analysis to evaluate HTP usage patterns and the effect of HTP use on conventional tobacco smoking (use transitions).
Methods:
We used Pubmed/MEDLINE, Embase, and the Cochrane Library to identify all articles published up to February 2022 on HTP use. For the present review, we included all representative cross-sectional studies dealing with HTP use, and all prospective cohort studies or cross-sectional studies on conventional tobacco smoking transitions due to HTP use. From 610 non-duplicate articles, 76 were eligible (71 cross-sectional and 5 prospective cohort studies).
Results:
Compared with young adults, HTP use was less frequent among middle-aged (15 studies; pooled odds ratio [OR] 0.59; 95% confidence interval [CI], 0.48-0.74) and older adults (12 studies; OR 0.17; 95% CI, 0.07-0.38). HTP use was more frequent among former (6 studies; OR 2.73; 95% CI, 1.03-7.25) and current smokers (12 studies; OR 14.53; 95% CI, 6.34-33.31). Overall, 68.3% of HTP users were dual users (n = 26). Eight studies (including 5 cohorts) showed that HTP users were more likely than non-users to start conventional cigarette smoking (2 studies; OR 6.31; 95% CI, 4.13-9.65), whereas current cigarette smokers using HTPs were less likely to quit (4 studies; OR 0.84; 95% CI, 0.80-0.89).
Conclusion:
We found that HTPs are specifically popular among young generations. More than two out of three HTP users are dual users. Prospective studies consistently show that, in real life, HTPs are not effective smoking-cessation tools.
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