Smokeless cigarette safety remains a
mystery as research funding dries up
Researchers can’t afford large-scale studies to see if heat-not-burn devices carry risks
A
lack of funding is stymieing research into the
safety of smokeless tobacco as researchers
turn down corporate money.
More knowledge is needed at a time when debate
has heated up over the potential risks of these
products. Marketed as safer than cigarettes because
they don’t burn the tobacco, the product has divided
the public health community.
The dilemma for researchers is that, while cash
is being offered for studies, it is coming from the big
tobacco companies. By accepting corporate funding,
scientists leave themselves open to criticism for being
on their payroll. With limited non-corporate funding,
only small-scale studies are being published as a result.
One of these, published last year in ERJ Open
Research, found that new heated tobacco devices,
known as heat-not-burn (HNB), are no less toxic to
human lung cells than ordinary cigarette smoke.
“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,” said
Dr Pawan Sharma, a researcher at the University of
Technology Sydney (UTS), at the launch of the study.
“These devices that heat solid tobacco are relatively
new, and it will be decades before we will fully
understand their effects on human health,” he said.
Dr Sharma now plans to study the effects of nicotine
devices on more sophisticated models of lung tissue
and in mice.
Other studies published over the last two years
have concluded that HNB devices release more toxic
substances than expected, including some of the
cancer-causing chemicals found in cigarettes.
Despite its risks, some academic proponents
maintain smokeless tobacco should be seen as a better
alternative than cigarette smoking for those who can’t
kick the habit.
“E-cigarettes and HNB products are not harmless.
However, they are almost certainly lower risk than
cigarettes for current smokers,” wrote Dr Marita Hefler,
a researcher from the Menzies School of Health, in an
editorial in BMJ Tobacco Control.
However, more research is needed to further unravel
HNB’s potential impact on airway remodelling, oxidative
stress, infections, and inflammation in people who use
the device.
According to Dr Brian Oliver, head of the Respiratory
Research Group at UTS, lung researchers do not doubt
that smokeless tobacco is unsafe to use.
“The problem is that if you have incomplete
combustion of anything, the toxic profile that’s released
GlobalHealthAndTravel.com
is actually worse than full combustion. That intuitively
makes me think there’s going to be some issues there,”
he told Global Health Asia-Pacific.
But given the shortage of funding, science will
need more time to prove the safety and hazards of
smokeless tobacco. While tobacco companies will be
willing to offer financial support, few other organisations
are going to pay for research that gives answers that
most academics already know.
“If McDonald’s were to announce tomorrow that
their burgers will contain half the amount of fat, do
you think anyone is going to fund your research into
whether it is safer not to eat burgers? There are so
many reasons why this isn’t an exciting area of funding
at the moment,” he said.
MARCH 2020
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