Heated Tobacco Products and Cardiovascular Disease: A Narrative Review of Peer-Reviewed Publications

Cigarette smoking is a major risk factor for the development of cardiovascular disease (CVD). Cigarette smoke contains toxicants that cross the alveolar barrier into the blood stream and elicit systemic oxidative stress and inflammatory responses, which can lead to an abnormal lipid profile and affect normal vascular functions. These changes predispose smokers to the development and progression of atherosclerosis, leading to various types of CVDs, such as ischaemic heart disease, cerebrovascular disease, peripheral artery disease, and aortic aneurysm. While the best choice a smoker can make is to stop smoking altogether, unfortunately not all smokers make that choice. In recent years, alternative products to cigarettes have been developed to offer a better alternative to continuing to smoke. However, new products representing a better alternative must be scientifically substantiated to understand how they present less risk to users compared with cigarettes. This literature review summarises the results of in vitro, in vivo, and clinical studies that, taken together, show the CVD risk reduction potential of switching from cigarette smoking to these smoke-free products.