The use of electronic devices for smoking tobacco is increasing rapidly, with many young people taking up smoking using these devices exclusively. The tobacco market is 3% covered by these devices, and this figure will increase to 30% by 2025 according to market analysts. Tobacco smoking is a known risk factor for several diseases, while the health effects of e-cigarettes, defined as a "modified risk product", are still ongoing.

Therefore, awareness of the consequences of tobacco use through heat-not-burn cigarettes is low, both within the scientific community and the public. Evidence is limited and much, often controversial, data has been released by the tobacco companies themselves.

Hence the need for observational studies aimed at understanding whether the health effects, now known from traditional cigarettes, can also be applied to the new heated tobacco devices.

A recent paper published in the European Journal of Clinical Investigation by a team of researchers from Sapienza University of Rome, National Research Council, the University of Turin, the Italian Institute for Genomic Medicine in Candiolo, Turin, and IRCCS Neuromed, observed changes in the profile of circulating microRNAs, the RNA molecules that play a pathogenic role in cancers and cardiovascular diseases, in smokers of traditional cigarettes as well as in smokers of e-cigarettes.

The trial was conducted on the sera of a very homogenous group of healthy, young smokers recruited between 2019 and 2020 for the SUR-VAPES Chronic study, conducted by Sapienza. The sample comprised of 20 subjects who exclusively used traditional combustion cigarettes, 20 who used heat-not-burn cigarettes, and 20 non-smoking subjects.

Analysing the outcomes, the researchers found changes in the profile of circulating microRNAs in the serum of both groups of smokers, with substantial overlap in the list of deregulated microRNAs and their targets. Approximately one third of the deregulated microRNAs were in common between smokers of traditional cigarettes and smokers of heated tobacco cigarettes.

The data show for the first time that even heat-not-burn cigarettes, which are considered modified risk products, affect circulating microRNAs in a similar way to traditional combustion cigarettes. Therefore, the consequences of the two types of smoking on circulating microRNAs are most likely overlapping.

"Our new observation has several implications," says Isotta Chimenti from the Department of Medical-Surgical Sciences and Biotechnology of Sapienza University. - The use of heated tobacco cigarettes cannot be considered safer than traditional combustion cigarettes because of the effects on circulating microRNAs, molecules with biological roles in endocrine signalling. This study therefore also draws attention to the use of modified risk products".

References: 

Effect of traditional or heat-not-burn cigarette smoking on circulating miRNAs in healthy subjects - V. Picchio, G. Ferrero, C. Cozzolino, B. Pardini, E. Floris, S. Tarallo, X. Dhori, C. Nocella, L. Loffredo, G. Biondi-Zoccai, R. Carnevale, G. Frati, I. Chimenti, F. Pagano - European Journal of Clinical Investigation 2023 DOI: 10.1111/eci.14140

Further Information

Isotta Chimenti 
Department of Medical-Surgical Sciences and Biotechnology
isotta.chimenti@uniroma1.it