One session of heated tobacco use injures blood vessels and damages DNA

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by European Society of Cardiology

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Just one session of heated tobacco product use results in measurable damage to the blood vessels, according to a study published today (Tuesday) in the European Journal of Preventive Cardiology.

Researchers carried out detailed assessments of blood samples, blood pressure and how well blood vessels functioned in healthy smokers before and after they used two tobacco sticks back-to-back in a tobacco heating device.

They say their results challenge claims that these products are substantially less harmful to the cardiovascular system than conventional cigarettes and highlight the need to consider all nicotine-containing products in public health policies.

The research was led by Dr. Lea Strohm from the University Medical Center Mainz, Germany. She said, "Heated tobacco products, such as IQOS, which heat tobacco rather than burn it, are often marketed as less harmful alternatives to conventional cigarettes. However, independent evidence on their immediate effects on cardiovascular health, and the body as a whole, remains limited."

The research included a group of 30 adult smokers, with an average age of 34, who were otherwise healthy. Participants gave blood samples, had their blood pressure measured and had their blood vessels assessed with an ultrasound scan of the main artery in the right arm. Participants then used a heated tobacco product, and the same set of tests was repeated.

Comparing measurements taken before and after use, the researchers identified several changes. First, systolic blood pressure increased by 3 millimeters of mercury. Second, blood vessel function decreased by 11%, as measured by flow-mediated dilation, which shows how much an artery widens in response to increased blood flow.

Finally, there were also signs that oxygen delivery around the body was reduced. Venous O₂ saturation, the percentage of oxygen bound to hemoglobin in blood returning to the heart, fell from around 71% to around 46%.

Researchers also found DNA damage to blood cells and an "oxidative stress response," a sign that the cells are trying to defend themselves against damage.

Strohm added, "Our findings demonstrate that these products are not biologically inert. Acute exposure was sufficient to induce vascular dysfunction, metabolic disturbances and genetic damage in otherwise healthy smokers. These results challenge claims that heated tobacco products are substantially less harmful to the cardiovascular system than conventional cigarettes.

"This study provides a clear, controlled look at the immediate cardiovascular impact of heated tobacco use, but larger long-term studies are still needed to understand how long these effects last."

Co-author professor Thomas Münzel, of the University Medical Center Mainz, Germany, said, "These findings are in line with the conclusions of our recent expert review in the European Heart Journal. No nicotine-containing product, whether smoked, heated, vaped or absorbed, can be considered safe for the heart and blood vessels."

Münzel concluded, "Heated tobacco produces fewer combustion products, but it still delivers nicotine, which impairs the lining of the blood vessels, raises blood pressure and promotes atherosclerosis. Policymakers must stop distinguishing between 'burned' and 'unburned' nicotine and regulate all nicotine products under one framework, with flavor restrictions, advertising bans and smoke-free laws that cover every product."

Publication details

Cardiovascular and metabolic acute effects of heated tobacco products in healthy smokers, European Journal of Preventive Cardiology (2026). DOI: 10.1093/eurjpc/zwag524

Journal information: European Journal of Preventive Cardiology , European Heart Journal

Key medical concepts

DNA DamageSystolic blood pressure

Clinical categories

CardiologyPreventive medicineCommon illnesses & PreventionHealthy living Provided by European Society of Cardiology Who's behind this story?

Swati Mestri

Swati Mestri holds a bachelor's degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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