In this episode of Science Lab, we break down new clinical evidence on how Heated Tobacco Products (HTPs) compare to traditional cigarettes in terms of respiratory health. Using biomarker data, symptom tracking, and real-world study outcomes, she explains what happens when smokers switch completely to HTPs — and how this transition may influence the incidence and severity of respiratory symptoms.
Transcription:
00:06 - 01:42
[Gizelle Baker]
Hello everybody and welcome to our second science lab today and I think the second of the conference altogether. We have a great opportunity to learn from these sessions because everybody is sharing science in an open way. And the way we're going to run the conversations today is everybody has a presentation. So the presentation will go first, and then we'll open the floor to the presenters to give a little debrief or summary of their presentation. And then we'll open it to the floor for Q&A. And then hopefully if I manage to manage the time correctly, we will have some time at the very end to have a group Q&A across all of the topics covered today. Our fourth presenter will hopefully run through those doors before it's time for him to speak. But if not, we will have the conversation without him. We'll get to see his presentation no matter what. So our first presentations are going to be by Yuki Kimura, but he is unable to attend today, so we have Karen who will be here to do the facilitation and the Q&A at the end of the session. This presentation is done slightly different. It's actually in two parts, looking at heated tobacco product use behaviors and the incidence of respiratory disease, and broken into part one and part two. The way we're going to run it is we're going to play the video for both parts together and then open it up afterwards. So I'm going to say let's play the first video or the first two videos.
01:49 - 11:29
[Video]
Hello, everyone, and thank you for joining me for this presentation, the title of which is Association Between Heated Tablet Product Use Behavior and the Incidence of Respiratory Symptoms, Internet-Based Cross-Sectional Study in Japan, Part 1. Since the majority of HTP users are former adult smokers, information about the user's smoking history and health status before HTP use is needed when assessing the potential health effects of HTP use. To obtain this information, a cross-sectional study was conducted in 2023. The result was published in the paper in 2024. This study showed that it is necessary to take into account the effects of smoking history before HTP use. This presentation is a follow-up to this paper and the first part of two presentations. I'd like to report on the relationship between HTP use behavior and the incidence of outcomes. It especially focuses on the daily amount of HTP use as the HTP use behavior. The most significant feature of this study is to confirm whether the outcome occurs after or before HTP use. The total incidence is sum of all most recent occurrences of the outcome after age 20, including occurrences before or after HTP use. In this study, the outcomes include respiratory disease symptoms. In this report, I present combined respiratory symptoms, which combines the incidence of five different symptoms as an example of an outcome. to analyze the association between the amount of tobacco use and the incidence of outcomes, utilizing the data from this study. The number of daily use of HTP sticks used and the Brinkman index, which measures smoking amount before HTP use, are categorized into four groups. This slide shows the distribution of daily tobacco use amount. The number of tobacco use per day didn't change significantly before and after the switch to HTP, and the CC group tended to have a higher Brinkman index than the HTP group. The largest number of participants fell into Category 2 for daily usage and Brinkman index before HTP use. This slide shows the relationship between amount of daily tobacco use and incidence of outcome. As shown in Figure 3, dose-response relationship was observed between the total incidence and the amount of HTP use per day. However, When outcomes that occurs before HTP use, which reflects the effects of path smoking, were excluded, as shown in Figure 5, the dose-response relationship with that outcome disappeared. This is likely due to the effect of path smoking, as shown in Figure 4, which shows a dose-response relationship between total incidence and path smoking. The same relationship was observed with the amount of daily tobacco used for outcomes other than combined respiratory symptoms. As shown in Table 5, by removing the effects of past smoking, the dose-response relationship with outcome disappeared. Finally, summary and conclusion. For exclusive HTTP users, the most common number of use per day was 10 to 20 sticks, and the number of use per day didn't change significantly before and after the switch to HTTP. A dose-response relationship was found between the total incidence in HTP group and the amount of daily HTP use. However, our results suggest that this relationship is largely due to smoking history before HTP use, as a dose-response relationship was also observed between the total incidence and the amount of smoking history before HTP use. Thank you for your attention. Since the majority of HTP users are former adult smokers, information about the user's smoking history and health status before HTP use is needed when assessing the potential health effects of HTP use. To obtain this information, a cross-sectional study was conducted in 2023. The results were published in a paper in 2024. This study shows that it is necessary to take into account the effects of smoking history before HTP use. This presentation is a follow-up to this paper and the second part of two presentations. I'd like to report on the relationship between HTP use behavior and the incidence of outcomes. It especially focuses on the difference of brands in HTP as the HTP use behavior. The most significant feature of this study is to confirm whether the outcome occurs after or before HTP use. The total incidence is sum of most recent occurrences of the outcome after age 20, including occurrences before or after HTP use. In this study, the outcomes include respiratory diseases and symptoms. In this report, I present combined respiratory symptoms, which combine the incidence of five different symptoms as an example of outcome. To analyze the association between the difference of product and the incidence of outcomes, utilizing the data from this study, The incidence of outcome was calculated for each product including cigarette and examined the difference by ANOVA. This slide shows the distribution of product use. Table 1 shows the distribution of product use in HTTP group. Exclusive HTTP users tend to use only one product rather than multiple products. As for the amount of use, differences were observed in amount of daily HTP use and past smoking before HTP use among products. This slide shows the incidence of combined respiratory symptoms by products. After adjusting the effects of smoking history, the incidence of outcome in each product decreased. For example, in product HTPA, 9.7 to 4.59. As shown in Figure 3, while the statistically significant difference in the adjusted incidence was found between HTP and CC group, there are no significant differences among HTP groups, and their incidence was at the same level as NS group. The same trend was observed for outcomes other than combined respiratory symptoms. As shown in Table 6, by removing the effects of past smoking, statistically significant difference was found among HTP and CC group. There was no significant difference among brands in HTP group. Finally, summary and conclusion. Differences were found in the amount of daily HTP use and past smoking before HTP use among products, while the statistically significant difference in the adjusted incidence was found between HTP and CC group. There were no significant differences among the HTP group and their incidence was at the same level as the NS group. This finding suggests that the harm reduction potential of HCP is comparable across products that heat but do not burn tobacco within the HCP category. Thank you for your attention.
11:31 - 11:36
[Gizelle Baker]
Thank you. And now we'll open the floor to Karen if you want to give your remarks. Thank you.
11:37 - 13:15
[Karin Jacobson]
So I'm very happy to be here and to represent my colleague Yuki Kimura and his work here today. So Kimura-san has really shown with his work why it's important to look at past smoking history when assessing health effects of HGP. And by doing this survey and looking at incidents incidence of outcomes, total incidence that someone reports, and the incidence of outcomes after using, after switching to HTTP, we do see that there is an impact, actually. So in the first case, when it was looking at daily product use categorized as use of different numbers of sticks per day, the different categories, first we see looking at total number of incidents according to the use categories, there seems to be a relationship. But when we only look at number of incidents after switching or after use of, after switching to use of HDP, we see that there is no dose relationship anymore. Also looking at the different brands, looking at total incidence of symptoms gives one picture. But when you actually correct and you only look at the number of incidents after HTP use, you see that those numbers decrease. And this is the same across all the different brands of HTP. So it's really confirming then the harm reduction potential is comparable between these different HTPs. And I'm happy to take any questions. Thank you.
13:18 - 13:19
[Gizelle Baker]
Can open it up for questions.
13:30 - 13:41
[Attendee]
My question about the second presentation. The symptoms had been decreased whenever he shifted to HIV.
13:42 - 13:45
[Karin Jacobson]
The incident, so the reported symptoms.
13:46 - 13:46
[Attendee]
Yeah.
13:46 - 14:04
[Karin Jacobson]
So if you looked at the total number of symptoms or diseases reported, that number was higher than if you looked total. But when you looked only after the ones that had been reported after the switch to HTP use, you saw that the number decreased.
14:05 - 14:06
[Attendee]
Yeah. Thank you.
14:08 - 14:09
[Gizelle Baker]
And then we have somebody in the audience.
14:10 - 14:25
[Attendee]
Hi, are there plans to do or repeat this so you have multiple time points, so you're repeating the study over time? Multiple cross-sectional studies over time.
14:25 - 14:47
[Karin Jacobson]
Yes, thank you. I don't know actually if that's in the plans at the moment. So this first study was done between, the survey was run 2022 to 2023 during three months. Yes, it could also be repeated, but I don't have insight in the plans at the moment, sorry.
14:53 - 15:12
[Gizelle Baker]
Do we have any more questions? Well, maybe while you're coming up with questions, I have one. When you're looking at the amount used and then the other ones with the types of products used, which is a better indicator of the relationship with the symptoms?
15:13 - 16:12
[Karin Jacobson]
Well, I think they addressed different aspects. So for the amount of use, as you could see, there was also the looking at total incidence of symptoms according to the Brinkman Index. The Brinkman Index is this level of smoking. It tells you something about the level of smoking. You have the number of cigarettes per day multiplied by the years of cigarette smoking. And there you could see those relationship response. So that's one thing for the daily amount of use. When it comes to looking at the different brands, as you say, this doesn't it really shows that these are results that we see across the brands. So it speaks more to the category. It speaks more about the harm reduction potential of the category of heated tobacco products. And here, again, we could see a significant difference in the number of symptoms between cigarette smoking and HTP use.