Toxicological effects related to a novel heated tobacco product

The tobacco epidemic is a public health burden. Nicotine-Delivery-Systems(NDS) are devices designed to help people replace conventional cigarette(CC) and among these devices we find electronic cigarettes(e-cig), which are classified as Electronic-NDS(ENDS). E-cigs use different technologies to vaporize a liquid or to heat the tobacco avoiding the combustion phenomenon(IQOS). The US Food and Drug Administration(FDA) has labelled IQOS as modified risk tobacco products(MRTPs), indirectly encouraging the perception of safety in the consumers, but IQOS smoke, although to a lesser extent than conventional, still presents a great deal of harmful or potentially harmful compounds. My PhD thesis aims to study the toxic effects related to IQOS exposure. I sought to answer the question of whether the toxic compounds released by IQOS, albeit in reduced concentrations, could lead to genotoxicity and damage to the airways and liver in vivo. At the University of Nottingham, I have investigated in vitro the effects generated by the IQOS, e-cigs and CC exposure on PBMCs and human lung epithelial cell line. Finally, at University of Milano–Bicocca, I have developed a in vivo Positron Emission computed Tomography(PET) imaging procedure meant to be applied to the monitoring of ENDS toxicity, particularly in the brain. These results indicate that IQOS is not a low-risk product in vivo, for primary target organs but also for secondary organs, although we have observed a small impact in vitro. Labelling as MRTP may mislead consumers who interpret “a lower level of toxic compounds” as an indication of “harmlessness” when there is a health risk for users. In the last part, I set up a methodology for studying temporal fluctuations of regional brain metabolism and connectivity derived from mice of different ages allowing researchers to obtain normative values in investigations of the efficacy or toxicity of substances at the functional level of the CNS.