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Cooling off the heated controversy of a safer cigarette: heat-not-burn no better than traditional combustion cigarettes
  1. Irina Petrache1,2,
  2. Esther de Boer2
  1. 1 Department of Medicine, National Jewish Health, Denver, Colorado, USA
  2. 2 Department of Medicine, University of Colorado Denver, School of Medicine, Aurora, Colorado, USA
  1. Correspondence to Prof. Irina Petrache, Department of Medicine, National Jewish Health, Denver, CO 80206-2762, USA; petrachei{at}

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In response to overwhelming evidence of harmful effects of cigarette smoking, the tobacco industry launched heat-not-burn cigarettes (HNBC), a hybrid between traditional combustion cigarettes (TCCs) and electronic vaping devices. They marketed HNBC as a less harmful alternative to TCC due to absence of specific toxicants released by burning the tobacco. However, similar to TCC smoke, aerosols released by heating the tobacco (up to 350°C) in HNBC contain nicotine and harmful elements generated by incomplete combustion (pyrolysis) and thermogenic degradation of tobacco. The claims that these by-products are present in amounts too small to be harmful suggest that a threshold concentration for the toxic effects of heated tobacco by-products exists. This assertion requires further elucidation, due to a …

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  • Contributors IP and EdB wrote and edited this article.

  • Funding This study was funded by National Heart, Lung, and Blood Institute (HL144396).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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