Respiratory Failure Unit, Respiratory Medicine, Medical School, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
3rd Department of Surgery, Medical School, AHEPA University Hospital, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Medicina (Kaunas). 2020 Jun 12;56(6):292. doi: 10.3390/medicina56060292.
: During the last decade, conventional tobacco smoking is experiencing a decline and new smoking products have been introduced. IQOS ("I-Quit-Ordinary-Smoking") is a type of "heat-not-burn" (HNB) tobacco product. The impact of IQOS on respiratory health is currently not defined. The objectives of this study were to evaluate the acute effects of IQOS on pulmonary function in non-smokers and current smokers. Fifty male healthy non-smokers and current smokers with no known co-morbidity underwent an exhaled CO measurement, oximetry (SaO2%), pulmonary function tests (flows, volumes and diffusion capacity), and a measurement of respiratory resistances with an impulse oscillometry system (IOS) before and immediately after IQOS use. In the whole group of 50 participants, SaO2%, forced expiratory flow at 25% and 50% of vital capacity (FEF 25%, FEF 50%, respectively), peak expiratory flow (PEF), and diffusion lung capacity for carbon monoxide/VA (KCO) decreased significantly after IQOS use, whereas exhaled CO and airway resistance (R5 Hz, R10 Hz, r15 Hz, R20 Hz, R25 Hz, R35 Hz) increased. When the groups of smokers and non-smokers were compared, in both groups (all males, 25 smokers and 25 non-smokers), exhaled CO increased and SaO2% decreased after IQOS use ( < 0.001). In the group of non-smokers, PEF (pre 8.22 ± 2.06 vs. post 7.5 ± 2.16, = 0.001) and FEF 25% (pre 7.6 ± 1.89 vs. 7.14 ± 2.06, = 0.009) decreased significantly; respiratory resistances R20 Hz (pre 0.34 ± 0.1 vs. post 0.36 ± 0.09, = 0.09) and R25 Hz (pre 0.36 ± 0.1 vs. post 0.38 ± 0.09, = 0.08) increased almost significantly. In smokers, PEF (pre 7.69 ± 2.26 vs. post 7.12 ± 2.03, = 0.007) and expiratory reserve volume (ERV) (pre 1.57 ± 0.76 vs. post1.23 ± 0.48, = 0.03) decreased and R35 Hz (pre 0.36 ± 0.11 vs. post 0.39 ± 0.11, = 0.047) increased. The differences in the changes after the use of IQOS did not differ between groups. IQOS had an impact on exhaled CO, SaO2%, and airways function immediately after use. Even though these changes were rather small to be considered of major clinical importance, they should raise concerns regarding the long-term safety of this product. Further research is needed for the short- and long-term effects of IQOS, especially in patients with respiratory disease.
: 在过去的十年中，传统烟草吸烟正在减少，并且已经推出了新的吸烟产品。 IQOS（“我戒烟普通吸烟”）是一种“加热不燃烧”（HNB）烟草产品。 IQOS 对呼吸道健康的影响目前尚不清楚。本研究的目的是评估 IQOS 对非吸烟者和当前吸烟者肺功能的急性影响。 50 名健康的非吸烟者和当前吸烟者（无已知合并症）进行了呼气 CO 测量、血氧饱和度（SaO2%）、肺功能测试（流量、容量和扩散能力）以及使用 IQOS 前后的脉冲振荡系统（IOS）进行呼吸阻力测量。 在整个 50 名参与者组中，SaO2%、用力呼气流量在 25%和 50%肺活量（FEF 25%、FEF 50%，分别）、呼气峰流速（PEF）和一氧化碳/VA 的扩散肺容量（KCO）在 IQOS 使用后明显下降，而呼出的 CO 和气道阻力（R5 Hz、R10 Hz、r15 Hz、R20 Hz、R25 Hz、R35 Hz）增加。当比较吸烟者和非吸烟者两组时，两组（所有男性，25 名吸烟者和 25 名非吸烟者）在 IQOS 使用后呼出的 CO 增加，SaO2%下降（<0.001）。在非吸烟者组中，PEF（前 8.22 ± 2.06 与后 7.5 ± 2.16，=0.001）和 FEF 25%（前 7.6 ± 1.89 与 7.14 ± 2.06，=0.009）明显下降；呼吸阻力 R20 Hz（前 0.34 ± 0.1 与后 0.36 ± 0.09，=0.09）和 R25 Hz（前 0.36 ± 0.1 与后 0.38 ± 0.09，=0.08）几乎明显增加。在吸烟者中，PEF（前 7.69 ± 2.26 与后 7.12 ± 2.03，=0.007）和呼气储备量（ERV）（前 1.57 ± 0.76 与后 1.23 ± 0.48，=0.03）下降，R35 Hz（前 0.36 ± 0.11 与后 0.39 ± 0.11，=0.047）增加。使用 IQOS 后变化的差异在组间没有差异。 IQOS 使用后立即对呼气 CO、SaO2% 和气道功能产生影响。尽管这些变化小到可以认为具有主要的临床重要性，但它们应该引起人们对这种产品长期安全性的关注。需要进一步研究 IQOS 的短期和长期影响，特别是在患有呼吸道疾病的患者中。
