A Systematic Review and Meta-Analysis on Human Biomarkers of Exposure from Heated Tobacco Products Compared to Conventional Cigarettes among Adult Smokers
Joan Dymphna P Reaño1,2*, Marie Barrientos-Regala1,2, Reginald P Arimado1, Rafael R Castillo1,2
1CardioMetabolic Research Unit (CaMeRU), FAME Leaders Academy, Makati City, Philippines
2Section of Adult Cardiology, Department of Internal Medicine, Manila Doctors Hospital, Manila, Philippines
*Corresponding Author: Joan Dymphna P Reaño, MD, CardioMetabolic Research Unit (CaMeRU), FAME Leaders Academy, Makati City, Philippines and Section of Adult Cardiology, Department of Internal Medicine, Manila Doctors Hospital, Manila, Philippines; Email: jreano@fla.ph
Published Date: 12-08-2022
Copyright© 2022 by Reaño JDP, et al. All rights reserved. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
How to Cite this paper?
Citation: Reaño JDP, et al. A Systematic Review and Meta-Analysis on Human Biomarkers of Exposure from Heated Tobacco Products Compared to Conventional Cigarettes among Adult Smokers. Jour Clin Med Res. 2022;3(2):1-27.
| Received 14 Jul, 2022 | Accepted 05 Aug, 2022 | Published 12 Aug, 2022 |
Abstract
Introduction: The health effects of Heated Tobacco Products (HTP), which are non-combustible alternatives to Conventional Cigarettes (CC), may be assessed by the measurement of Biomarkers of Exposure (BoE).
Methods: This meta-analysis aims to compare the BoE levels between HTP and CC. Systematic computerized search was performed using Pubmed, Google Scholar, and Cochrane database. The studies included randomized controlled trials that evaluated the effectiveness of HTP compared to CC in reducing human BoE. Two reviewers independently appraised each study. Any disparity in assessment was settled by an independent adjudicator.
Results: Data from the trials included in this study (N=1,193) showed that there was a significant difference in the levels of BoEs between HTP and CC. The levels of carboxyhemoglobin [-2.0 (95% CI -3.08 to -0.92), Z=3.64, p=0.00001], 4-aminobiphenyl [-1.67 (95% CI -2.36 to -0.99), Z=4.80, p=0.00001], 3-hydroxypropylmercaptapuric acid [-1.09 (95% CI -1.54 to -0.63), Z=4.70, p= 0.00001], N-nitrosonornicotine [-0.95 (95% CI -1.49 to -0.41), Z=3.46, p=0.0005], 4-(methylnitrosamino)-1-(3-pyridyl)- 1-butanol [-1.30 (95% CI -1.72 to -0.89), Z=6.18, p=0.00001], Total Nicotine Equivalents [-0.85 (95% CI -1.36 to -0.34), Z=3.24,p=0.001], Benzo[a]pyrene [-1.70 (95% CI -2.08 to -1.33), Z=8.92, p=0.00001], and S-phenylmercapturic acid [-1.18 (95% CI -1.36 to -0.99), Z=12.36, p= 0.0001] among the participants were significantly reduced in those who used HTP as compared to those who smoked CC.
Conclusion: The study showed that the use of HTP could significantly reduce exposure to harmful substances compared to CCs using BoEs that are assessed to be most suitable and practical for tobacco product regulation.
Keywords
Heated Tobacco Products; Cigarettes; Biomarkers of Exposure; Smokers
