Two Different Heated Tobacco Products vs. Cigarettes: Comparison of Nicotine Delivery and Subjective Effects in Experienced Users

Heated tobacco products (HTPs) produce aerosol using a different mechanism than tobacco cigarettes, leading to lower emissions of some harmful substances, but also of nicotine as reported by some independent studies. Lower nicotine delivery could lead to compensatory puffing when product use does not sufficiently satisfy cravings. Thus, this three-arm crossover study was conducted to characterize the potential of two different HTPs to deliver nicotine and satisfy cravings compared with conventional cigarettes in users who had already switched to HTPs. Fifteen active, non-exclusive HTP users consumed the study products according to a pre-directed puffing protocol. At predetermined time points, venous blood was sampled and the subjective effects of consumption were assessed. Nicotine delivery by both HTPs was comparable, but significantly lower than that by conventional cigarettes, suggesting a lower addictive potential. Cravings were reduced by all products, with no statistically significant differences between them, despite the different nicotine deliveries. This indicated that HTPs do not necessarily need high nicotine deliveries with high addictive potential, as are characteristic of tobacco cigarettes. These results were followed up on with an ad libitum use study.

Automated summary

Heated tobacco products (HTPs) produce lower emissions of harmful substances compared to tobacco cigarettes, but may also deliver lower levels of nicotine. This study aimed to compare the nicotine delivery and satisfaction of two different HTPs with conventional cigarettes in users who had switched to HTPs. The results showed that both HTPs delivered comparable levels of nicotine, but significantly lower than conventional cigarettes, suggesting a lower addictive potential. Despite the different nicotine delivery, cravings were reduced by all products, indicating that HTPs do not necessarily require high nicotine levels to satisfy cravings like tobacco cigarettes do. These findings were further supported by an ad libitum use study.