Work

The respiratory health effects of heated tobacco product aerosols in a primary human airway epithelial cell model

Year: 2026

Type: article

Abstract: INTRODUCTION: Heated-tobacco products (HTPs) are electronic devices that "heat" a processed tobacco/chemical mixture to produce an inhalable emission. They are advertised as a reduced-risk alternative to cigarette smoking. The aim of our research was to assess their potential health impacts using a 3D human airway model. METHODS: Primary human airway epithelial cells (n = 9, aged 11-21 years) were grown at air-liquid interface. Cultures were then exposed for 1 h to the emissions from one of three current HTPs (Philip Morris International IQOS3 Duo, British American Tobacco glo and Japan Tobacco International Ploom S). Air and cigarette smoke were used as controls. Emission physico-chemical characteristics were analyzed and cytotoxicity, permeability, differential gene expression, morphology, and inflammatory mediator release were assessed. RESULTS: HTP emissions contained a range of toxic chemicals, some at higher concentrations than in cigarette smoke. Particle size spectra showed smaller average particle size but also fewer particles overall for HTPs compared with cigarette smoke. Ploom and glo led to the most direct cellular damage, with decreased viability, decreased barrier integrity, and increased airway permeability compared to air controls. Cigarette smoke caused the greatest increased mediator response and change in gene expression, with IQOS causing the second greatest change in gene expression. Conversely, exposure to HTP emissions decreased mediator response (compared with air). CONCLUSIONS: Based on the results from our study, HTPs are not reduced-risk alternative to cigarettes but instead pose an alternative risk. IMPLICATIONS: The implications of this research are that because heated-tobacco products (HTP) exposure elicits damage at the cellular level, and because HTPs deliver less nicotine per puff, users could increase consumption and cumulative toxic exposure. HTPs should not be considered reduced-risk; regulatory oversight, clear public-health warnings, and further research on long-term effects are warranted.

Source: Nicotine & Tobacco Research

DOI: 10.1093/ntr/ntag062

Authors: Katherine R Landwehr, Luke J Berry, Emma E Catchpole, Anthony Kicic, Alexander N Larcombe

Institutions: The Kids Research Institute Australia, The University of Western Australia, Curtin University, Princess Margaret Hospital for Children, Perth Children's Hospital

Language: English

Topic: Smoking Behavior and Cessation

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $5,392