Switching to HTP Improves Health of COPD Patients Who Cannot Quit Smoking – Manila Bulletin

Patients with chronic obstructive pulmonary disease (COPD) who abstained from smoking or significantly reduced their cigarette consumption by switching to heated tobacco products (PTH) showed consistent improvements in respiratory symptoms, exercise tolerance , quality of life and rate of disease exacerbations.


This was the main conclusion of a groundbreaking study by a team of Italian researchers published in March 2021 in the scientific journal Internal and Emergency Medicine. This is the first-ever study to describe the long-term health effects of using HTP in patients with COPD.

COPD refers to a group of diseases that include emphysema and chronic bronchitis, which cause blocked air flow and difficulty breathing. It is the third leading cause of death in the world. The most popular HTP brand in the world and in the Philippines is IQOS, an electronic device that heats sticks filled with tobacco wrapped in paper to generate an aerosol containing nicotine. Because tobacco is not burned, the levels of harmful chemicals produced by IQOS are significantly lower than in combustible cigarette smoke.

“It is well known that smoking is an important risk factor for COPD and abstaining from smoking is the only evidence-based intervention that improves the prognosis for COPD,” according to the study’s lead author, Professor Riccardo. Polosa, full professor of internal medicine at the University of Catania.

However, according to the study, most smokers with COPD fail in their attempts to quit. Approved therapies such as nicotine replacement therapy (NRT), bupropion, and varenicline have only limited success in terms of sustained cessation in COPD patients who smoke. These patients have difficulty completely stopping nicotine use and may require prolonged treatment and / or prolonged use of nicotine to achieve long-standing abstinence from smoking.

“An alternative pragmatic approach for patients with COPD who have difficulty quitting smoking is to replace conventional cigarettes with combustion-free nicotine delivery alternatives to achieve significant health gains,” Professor Polosa wrote.

“While not without risk, new clinical evidence suggests that … the use of e-cigarettes in COPD patients may help COPD patients to quit smoking long-term with health gains clinically relevant. More recently, [HTPs have] was introduced for cigarette substitution, which is also gaining popularity and acceptance by consumers around the world, ”he noted.

The study noted that in July 2020, the United States Food and Drug Administration (FDA) authorized the marketing of IQOS as Modified Risk Tobacco Products (MRTPs), the first tobacco product to be legally marketed with the claim of reducing consumer exposure to harmful and potentially dangerous products. harmful chemicals when completely switching from conventional cigarettes.

“Since HTP has been shown to generate chemicals that are significantly less toxic and potentially harmful than conventional cigarettes, it is hypothesized that when replacing cigarettes with combustible tobacco [with] With HTP clinically important health improvements can be observed, ”said Professor Polosa.

Study method and results

The study monitored health parameters for 3 years in COPD patients who drastically reduced or stopped smoking after switching to HTP. Changes in daily smoking, annualized disease exacerbations (worsening of symptoms), indices of lung function, patient-reported results (COPD assessment test scores) and walking distance of 6 minutes (6 MWD) from baseline were measured in COPD patients using PTs at 12 hours 24 and 36 months.

The COPD Assessment Test (CAT) is a patient-completed questionnaire assessing all aspects of the impact of COPD, including cough, sputum, shortness of breath, chest tightness, confidence, activity, sleep and energy levels. The 6MWD is a test that measures how far a patient can walk quickly on a flat surface and lasts in 6 minutes.

These parameters in COPD patients who switched to HTP were compared to a group of COPD patients of the same age and sex who continued to smoke. Complete data sets were available for 38 patients (19 in each group). Patients who switched to HTP experienced a substantial decrease in annualized exacerbations of COPD.

In addition, substantial and clinically significant improvements in CAT and 6MWD scores were identified at all three time points in the HTP cohort. No significant changes were seen in COPD patients who continued to smoke.

Improve health, change lives

“One of the main reasons I have become an advocate for tobacco harm reduction is that many patients have improved their health and changed their lives after switching to non-burning nicotine alternatives. Hearing patients express their gratitude is the most revitalizing experience in my medical profession, ”said Professor Polosa, founder of the Center of Excellence for Accelerating Harm Reduction.

Professor Polosa presented the results of their new study during the In Focus: Tobacco Harm Reduction webinar hosted by the Global Tobacco & Nicotine Forum (GTNF) Trust on April 27, 2021. The webinar featured experts from public health, the industry and public policy that presented “whole-of-government” and “whole-of-government” approaches similar to those adopted by the United Nations to assess the science on tobacco risk reduction products and to address the challenges and opportunities that lie ahead.



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