Introduction
premature deaths
HEAT
According to the World Health Organization, smoking is endemic, with more than 1.1 billion smokers worldwide, resulting in approximately 7 million premature deaths every year [Achieving cessation is challenging, because quit rates are low, relapse rates are high, and many smokers wish to continue to smoke [Substitution of combustible tobacco cigarettes with less harmful combustion-free nicotine delivery alternatives (NDAs), such as electronic cigarettes (ECs) and heated tobacco products (HTPs), is now a relatively new option available to smokers [ECs operate by heating an element that vaporizes a solution. HTPs consist of a holder that electronically transfers controlled heat to tobacco sticks that generate a nicotine-containing aerosol. Since the emission aerosols of combustion-free NDAs are produced at a much lower vaporizing/heating temperature compared to that of combustion (which generally starts above 400 °C), they contain less harmful and potentially harmful chemicals than tobacco smoke [Although not completely risk free, EC and HTP use may help respiratory patients to achieve sustained abstinence from cigarette smoking, with clinically relevant health gains [HTPs often mimic a hand-to-mouth experience that is very similar to that of conventional tobacco cigarettes. By mimicking the experience of tobacco smoking and its associated rituals, the use of HTPs can provide adequate compensatory physical and behavioral effects [It is not clear if HTPs provide a more gratifying smoking experience compared to ECs, and a direct comparison between the 2 types of products has never been investigated. With this in mind, we conducted a prospective randomized noninferiority switching trial to compare effectiveness, tolerability, and product satisfaction/adoption between HTPs and refillable ECs among people who smoke and do not intend to quit.