Effects of heat-not-burn tobacco on health are different from conventional cigarrette

Background: Heat-not-burn (HNB) tobacco is one of new tobacco products, but its effects on health remains to be unknown. In the present study, we examined and compared respiratory, circulatory and metabolic changes between HNB tobacco users and conventional tobacco users. Subjects and Methods: For two years from 2016 to 2017, in all smokers examined annual health check-up at our health care center, we divided them into two groups, one is those who continued smoking only conventional cigarrete (continuer), and the other has completely changed cigarette for HNB tobacco during this period (changer). In each group, we compared the changes of body weight, white blood cell count (WBC), the pulmonary function data (forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak flow, etc), cardiovascular factors (blood pressure, urinary albumin excretion), lipids (high and low density lipoproteins (HDL, LDL), and triglyceride). Results: All subjects are male. Number, average age, smoking history of continuer and changer are 292, 152, 42.4, 40.1 years old, 18.6, 14.9 pack year, respectively. Statistical significance were recognized only in changers. FEV1 (45ml, p<0.01), peak flow (0.26L/sec, p<0.05), HDL (2.0 mg/dl, p<0.05), systolic blood pressure (2.5mmHg, p<0.01), diastolic blood pressure (2.6mmHg, p<0.01) have increased, while WBC has decreased (616/μl, p<0.01). No other data has changed significantly. Conclusions: Improvement of pulmonary functions and blood pressure elavations in changers suggest that HNB tobacco may have β agonistic like effects. WBC decrease was considered as the results of reduced systemic inflammation. HNB tobacco might be less harmful compared to cigarettes.