LSU Health New Orleans review suggests HNB tobacco products may threaten health

October 19, 2020

New Orleans, LA - A review of heat-not-burn (HNB) tobacco products from the laboratory of Dr. Jason Gardner, Professor of Physiology at LSU Health New Orleans School of Medicine, reports an association with elevated blood pressure, increased heart rate, cell death, and circulatory dysfunction shown by early studies. Additionally, chemicals found in the vapor produced by HNB devices have previously been shown to impair lung function, put users at risk of heart attack and stroke, cause cancers, increase circulating low-density lipoprotein ("bad cholesterol") and more. The review is published in the American Journal of Physiology-Heart and Circulatory Physiology, available online here.

Cigarette smoking continues to decline globally, but vaping is becoming more popular, especially among youth and young adults. Recent cases of vaping-associated lung injury may lead consumers to try new methods of nicotine consumption. Heat-not-burn products are newcomers to the U.S. market. They produce nicotine-containing vapor by heating tobacco at low temperatures. This is in contrast to cigarettes that use high temperatures to burn tobacco and produce smoke or e-cigarettes that heat e-liquid, which contains nicotine but not tobacco, to produce vapor.

Due to the novelty of these products, little research has been conducted on HNB devices. The Gardner lab compiled findings from dozens of human, animal, and cell culture studies to determine associated inhalants and potential health effects, with an emphasis on the heart, arteries, and veins. Findings suggest that HNB devices produce fewer pollutants than cigarettes, but it is unclear if these reductions are reflected in health outcomes of users.

"While relatively new to the U.S., heat-not-burn products have become popular in other countries including Japan, Italy, and Korea," notes lead author Nicholas Fried, an MD/PhD student in Dr. Gardner's laboratory. "These products are often touted as a replacement for cigarettes, but the evidence does not necessarily support that. Almost all Korean users of heat-not-burn products are also current cigarette smokers; nearly half of Italian users had never even smoked a cigarette. These trends worryingly suggest that heat-not-burn may be a compliment or gateway to cigarette smoking, rather than a 'healthy' replacement. More troubling, nearly 2% of high school students in the U.S. are already using HNB tobacco products, and surveys show that 25% of students are susceptible to trying them. There is potential for these devices to become a significant public health issue."

Dr. Gardner adds, "Heat-not-burn devices are marketed as a safer alternative to cigarettes for existing smokers. However, as we have learned from vaping and e-cigarettes, these products are very likely to be used by minors and never-smokers due to marketing, flavor options, and lack of social stigma that is found with traditional cigarettes."

The authors conclude, "Use of these products can lead to nicotine addiction and additional clinical, basic science, and epidemiological studies are needed to better understand the health effects of HNB products. This knowledge will assist consumers, physicians, lawmakers, and regulatory bodies in making informed decisions about these products."
The authors are supported by a grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health.

LSU Health Sciences Center New Orleans educates Louisiana's health care professionals. The state's flagship health sciences university, LSU Health New Orleans includes a School of Medicine with branch campuses in Baton Rouge and Lafayette, the state's only School of Dentistry, Louisiana's only public School of Public Health, and Schools of Allied Health Professions, Nursing, and Graduate Studies. LSU Health New Orleans faculty take care of patients in public and private hospitals and clinics throughout the region. In the vanguard of biosciences research in a number of areas in a worldwide arena, the LSU Health New Orleans research enterprise generates jobs and enormous economic impact. LSU Health New Orleans faculty have made lifesaving discoveries and continue to work to prevent, advance treatment, or cure disease. To learn more, visit,, or

Louisiana State University Health Sciences Center

Related Heart Attack Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Molecular imaging identifies link between heart and kidney inflammation after heart attack
Whole body positron emission tomography (PET) has, for the first time, illustrated the existence of inter-organ communication between the heart and kidneys via the immune system following acute myocardial infarction.

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.

New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.

A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.

Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.

Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.

Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.

How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.

Read More: Heart Attack News and Heart Attack Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to