# Heated Tobacco Products: Emerging Health Outcomes and Insights into Oxidative Stress and Pro-Inflammatory-Driving Mechanisms

**Authors:** Camilla Morosini, Fabio Vivarelli, Moreno Paolini, Donatella Canistro

PMC · DOI: 10.3390/antiox15010008 · Antioxidants · 2025-12-20

## TL;DR

Heated tobacco products may reduce some harms of smoking but still pose health risks like oxidative stress and inflammation.

## Contribution

This review highlights new insights into the health risks of heated tobacco products, particularly oxidative stress and inflammation.

## Key findings

- HTPs increase oxidative stress similar to conventional cigarette smoke.
- HTP exposure is linked to potential respiratory and cardiovascular risks.
- HTPs may negatively affect male and female fertility based on animal studies.

## Abstract

With over 8 million deaths annually, smoking remains one of the most impactful global public health burdens. Heated tobacco products (HTPs) offer smokers the possibility of inhaling nicotine by heating tobacco, resulting in a significant reduction in the levels of toxic and potentially toxic compounds released. However, a growing number of studies indicate that exposure to HTPs increases oxidative stress and triggers pathophysiological changes, mirroring cellular mechanisms well-documented in conventional cigarette smoke exposure. In particular, evidence from animal models suggests that the use of heated tobacco products (HTPs) may represent a risk factor for respiratory and cardiovascular diseases, as well as a potential contributor to reduced male and female fertility. The following review summarizes the current state of knowledge on HTP toxicity, focusing on both preclinical and emerging clinical data on the health impact of HTP use and the putative harm reduction aspects.

## Full-text entities

- **Diseases:** Inflammatory (MESH:D007249), smoking (MESH:D015208), respiratory and cardiovascular diseases (MESH:D012140), deaths (MESH:D003643), toxicity (MESH:D064420)
- **Chemicals:** nicotine (MESH:D009538), HTP (-)
- **Species:** Nicotiana tabacum (American tobacco, species) [taxon 4097]

## Full text

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## Figures

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## References

109 references — full list in the complete paper: https://tomesphere.com/paper/PMC12838347/full.md

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Source: https://tomesphere.com/paper/PMC12838347