Tasmanian-led study suggests e-cigarettes and heat-not-burn products are as equally toxic to lungs

Published in the European Respiratory Journal of Open Research, the study is the first of its kind to directly compare heat-not-burn products with e-cigarettes and traditional tobacco cigarettes. 

Led by the University of Tasmania’s Respiratory Translational Research Group’s Sukhwinder Sohal, the study found that all three methods of smoking resulted in damage to lung cells. 

Dr Sohal said despite a limited knowledge of potential health implications, the popularity and growth of vaping had increased at an alarming rate – particularly among younger generations. 

“Smoking is one of the leading causes of death and disability globally, and with the introduction of e-cigarettes in the last decade, the trend of nicotine uptake is not going to slow down in near future,” he said.

“In Tasmania we have high smoking rates particularly in the lower socio-economic areas. These new electronic devices are promoted as less toxic and safer compared to traditional tobacco smoke, but they are equally damaging.

“The latest addition in this emerging trend is the planned and vigorous introduction of HnB devices. They are commonly cited as next generation products and we know very little about the health effects of these new devices, so we produced [an] innovative experimental design to compare them with cigarette smoking and e-cig vaping.”

The sale of e-cigarettes containing nicotine is not legal anywhere in Australia, with conflicting scientific agreement on their safety. 

While e-cigarettes do not burn tobacco, they often contain nicotine which is inhaled among other chemicals as a vapour. 

HnB devices heat solid tobacco at a temperature lower than a conventional cigarette. 

In collaboration with researchers at the University of Technology Sydney, the Woolcock Institute of Medical Research and the National Institute of Pharmaceutical Education and Research, the study tested the effects of all three nicotine sources on two different lung cell types.

After exposing the cells to similar concentrations of cigarette smoke extract, e-cigarette vapour and HnB aerosol vapours, Dr Sohal said the newer products proved to be no less toxic than conventional cigarettes. 

Dr Sohal, whose research is supported by the Clifford Craig Foundation, said he hoped the study would stimulate further research on all electronic smoking devices. 

“It took us nearly five decades to understand the damaging effects of cigarette smoke and we don’t yet know the long-term impact of using e-cigarettes,” he said. 

“These devices that heat tobacco are relatively new and it will be decades before we will fully understand their effects on human health.

“What we do know is that damage to these two types of lung cells contribute to diseases such as asthma, COPD and increases the risk of pneumonia and other lung infections so we should not assume that these are a safer option.”