Assessing the Impact of Switching to the Tobacco Heating System on Cardiovascular Events: Translating Basic Science into Clinical Benefit

      Pater, C.
      Conference date
      Mar 3, 2019
      Conference name
      The 6th International Conference on Prehypertension, Hypertension, Metabolic Disorders and Cardiovascular Disease 2019

      Introduction: Cigarette smoking contributes to the development of cardiovascular disease (CVD). Philip Morris International’s (PMI) Tobacco Heating System (THS) is a novel tobacco product that heats tobacco instead of burning it, thereby generating lower levels of harmful and potentially harmful constituents (cardiovascular toxicants are reduced by more than 92%) compared with cigarette smoke (CS). Methods: Philip Morris International’s (PMI) assessment program aims to demonstrate that switching to THS has the potential to reduce the risk of smoking-related diseases versus continued smoking. The program includes in vitro/in vivo toxicology studies that follow OECD guidelines, Good Laboratory Practice, and a systems toxicology approach, and randomized, clinical studies following the principles of Good Clinical Practice. Results: The effects of THS aerosol on the adhesion of monocytic cells to human coronary endothelial cells are significantly reduced, and switching to THS halted the progression of CS-induced atherosclerotic changes in ApoE-/- mice. Endpoints linked to the development of smoking-related disease were analyzed following a sixmonth randomized, controlled clinical study with THS that demonstrated a consistent improvement of endpoints in different pathophysiologic pathways leading to atherosclerosis. Conclusions: The evidence available to date indicates that switching to THS has the potential to reduce the risk of CVD. As a next step, PMI will be complementing its THS assessment program with cardiovascular outcome studies intended to demonstrate the clinical benefit of switching to THS (e.g., reduction in the risk of cardiovascular death, myocardial infraction, and stroke) as compared with continuous smoking. This cardiovascular outcome study program will improve primary and secondary CVD prevention in clinical practice.