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Rev Mal Respir. 2018 Nov 11. pii: S0761-8425(18)30363-2. doi: 10.1016/j.rmr.2018.10.010. [Epub ahead of print]

[Systematic analysis of the scientific literature on heated tobacco].

[Article in French]

Author information

Service de pharmacologie, Pitié-Salpêtrière, AP-HP, 75013 Paris, France; Consultation de médecine, hôpital Marmottan, 75017 Paris, France; Consultation de tabacologie, institut Arthur-Vernes, 75006 Paris, France; Paris sans tabac, 14, avenue Bosquet, 75007 Paris, France. Electronic address:
Paris sans tabac, 14, avenue Bosquet, 75007 Paris, France.



The tobacco industry (TI) reports that heated tobacco reduces risk of tobacco use and will replace cigarettes. An analysis of the scientific literature was conducted in order to enlighten professionals and decision-makers.


After a Medline query in February 2018, a systematic analysis was conducted.


Of the 100 papers published in 2008-2018, 75 have authors affiliated or linked to TI. Emissions contain gases, droplets and solid particles, so are smokes. The main products are: THS2.2 (Iqos®) which heats mini-cigarettes at 340°C, the THP1.0 (Glo®) which heats at 240°C sticks delivering about half as much nicotine, Ploom® which uses reconstituted tobacco microcapsules heated at 180°C. Under the experimental conditions, there is a reduction of toxic emissions and biological effects, but the expected risk reduction is not demonstrated. Symptoms related to passive smoking are described. The 4 epidemiological articles report that heated tobacco is used in 10 to 45% of cases by non-smokers and demonstrate the effectiveness of TI promotion campaigns. Thus, the THS2.2 is more a gateway to smoking (20%) than an exit door (11%); moreover, it is not expected risk reduction among the 69% who are mixed users.


While reducing emissions is documented, reducing the risk to the smoker who switches to heated-tobacco remains to be demonstrated. On the other hand, the worsening of the global tobacco risk related to the promotion of the products by the TI is anticipated, justifying that the authorities take the appropriate measures to control the promotion of heated tobacco.


Carbon monoxide; Heated tobacco; Industrie du tabac; Marketing; Monoxyde de carbone; New tobacco product; Nouveau produit du tabac; Risk reduction; Réduction du risque; Tabac chauffé; Tobacco industry


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