Background: Cigarette smoke (CS) is causally linked to the development of cardiovascular diseases (CVD) Tobacco harm reduction, by virtue of substituting cigarettes with less harmful products, is a complementary approach to current strategies for smokers who would otherwise continue to smoke The Tobacco Heating System (THS) 2 2 is a novel tobacco product that heats tobacco instead of burning it, never allowing the temperature to exceed 350°C, thereby preventing the combustion process from occurring and producing substantially lower levels of toxicants than CS Methods: The program includes in vitro/in vivo toxicology testing methods that follow OECD guidelines and Good Laboratory Practice, a systems toxicology approach, and randomised, controlled clinical studies that follow the principles of Good Clinical Practice Results: The effects of THS aerosol on the adhesion of monocytic cells to human coronary endothelial cells in vitro are significantly reduced Switching to THS halted the progression of CS-induced atherosclerotic changes in ApoE-/- mice in vivo Biomarkers linked to the development of smoking-related diseases were analysed following a 6-month randomised, controlled clinical study with THS, which demonstrated a consistent improvement of biomarkers in different pathophysiologic pathways leading to atherosclerosis Conclusions: The evidence available to date indicates that switching to THS has the potential to reduce the risk of smoking-related diseases such as CVD As a next step, PMI will complement its THS assessment program with cardiovascular outcome studies intended to further support the clinical benefits of switching to THS over continuous smoking
Assessing the Impact of Switching to the Tobacco Heating System on Cardiovascular Disease: Translating Basic Science Into Clinical Benefit