INTRODUCTION IQOS HEETS are promoted as reduced risk alternatives to cigarettes. Although some studies have investigated the chemical composition of HEETS emissions, little is known on whether toxicant levels in such emissions are affected by different puffing parameters and flavor varieties. This has important implications when assessing actual human exposure, since IQOS users develop a specific and personalized puffing behavior and may use different HEETS variants. METHODS This study measured the levels of nicotine, Total Particulate Matter (TPM), carbonyl compounds and tobacco-Specific Nitrosamines (TSNAs) in the emissions of nine differently flavored HEETS and two cigarettes (1R6F and Marlboro Red, MR). Emissions from Yellow HEETS, 1R6F and MR were collected using the World Health Organization Intense (WHOI) smoking regime and four more intense smoking regimes. RESULTS Yellow HEETS aerosol contained lower levels of toxicants compared to 1R6F and MR smoke. More intense smoking regimes increased carbonyls release in cigarette smoke, whereas only higher puff frequency led to lower levels of toxicants in Yellow HEETS aerosol. Some HEETS varieties exhibited higher levels of formaldehyde and TSNAs in their aerosol compared to Yellow HEETS. CONCLUSIONS Puff frequency was identified as the only smoking parameter that significantly lowered the release of almost all toxicants in Yellow HEETS, whereas a combination of higher puff volume and puff duration led to increased levels of some carbonyls. Differences in toxicants levels between various commercially-available HEETS have important implications when assessing their health impact, as their consumption might induce different toxicant exposure and health effects. IMPLICATIONS HEETS release about half as much nicotine and substantially lower levels of toxicants compared to cigarettes. Literature data showed that puffing intensity is increased in cigarette smokers switching to HEETS, maybe in reaction to these lower nicotine levels. Our results show a differential impact of increased puff frequency, puff duration and puff volume in the release of toxicants from HEETS. Thus, industry-independent studies on puff topography are critical to make choices for the most relevant puffing regime for HTP regulation. Regulators should consider evaluating the health impact of multiple HEETS varieties, as the tobacco filler composition significantly affects the release of certain toxicants.

中文翻译：

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更强烈的吸烟参数和风味变化对加热烟草产品排放中有毒物质水平的影响。

简介 IQOS HEETS 被宣传为降低风险的香烟替代品。尽管一些研究调查了 HEETS 排放物的化学成分，但对于此类排放物中的有毒物质水平是否受到不同膨化参数和风味品种的影响，人们知之甚少。这在评估实际人类暴露时具有重要意义，因为 IQOS 用户会形成特定且个性化的吸烟行为，并且可能会使用不同的 HEETS 变体。方法 本研究测量了九种不同口味的 HEETS 和两种卷烟（1R6F 和万宝路红，MR）排放物中尼古丁、总颗粒物 (TPM)、羰基化合物和烟草特有亚硝胺 (TSNA) 的水平。Yellow HEETS、1R6F 和 MR 的排放量是使用世界卫生组织强烈吸烟制度 (WHOI) 和四种更强烈吸烟制度收集的。结果 与 1R6F 和 MR 烟雾相比，黄色 HEETS 气溶胶含有较低水平的有毒物质。更强烈的吸烟方式会增加香烟烟雾中羰基化合物的释放，而只有更高的抽吸频率才会导致黄色 HEETS 气溶胶中有毒物质的含​​量降低。与黄色 HEETS 相比，一些 HEETS 品种的气溶胶中甲醛和 TSNA 含量更高。结论 抽吸频率被认为是显着降低 Yellow HEETS 中几乎所有有毒物质释放量的唯一吸烟参数，而较高的抽吸量和抽吸持续时间的组合导致一些羰基化合物的水平增加。在评估其健康影响时，各种市售 HEETS 之间的毒物含量差异具有重要意义，因为食用它们可能会导致不同的毒物暴露和健康影响。影响 与香烟相比，HEETS 释放的尼古丁量约为香烟的一半，有毒物质的含​​量也大大降低。文献数据表明，改用 HEETS 的吸烟者的抽吸强度会增加，这可能是对尼古丁水平较低的反应。我们的结果表明，增加抽吸频率、抽吸持续时间和抽吸体积对 HEETS 中有毒物质的释放有不同的影响。因此，独立于行业的抽吸形貌研究对于选择与 HTP 调节最相关的抽吸机制至关重要。监管机构应考虑评估多个 HEETS 品种对健康的影响，因为烟草填料成分会显着影响某些有毒物质的释放。