Impact of a systematic literature review on heated tobacco products

PhD Impact Story

Tobacco smoking is one of the biggest causes of death in the UK and increases the chance of developing more than 50 health conditions. Smokers could reduce these harms by switching to an alternative, such as nicotine vaping products or heated tobacco products (HTP). HTPs are electronic devices that heat tobacco without combustion and first arrived on the UK’s market in 2016 after being released in Japan, Italy and Switzerland in 2014.

The tobacco industry promotes these products as a safer choice, but outside of the industry there had been no review of the scientific evidence for this. PhD student Erikas Simonavičius and his colleagues investigated this claim by producing the first independent literature review on HTPs.

The aim of the review was to inform researchers and the public about the safety of the new heated tobacco products and of their potential to significantly reduce the harm for smokers who are not able to stop smoking altogether.

The initial review was published as a chapter on HTPs in the 2018 evidence review of e-cigarettes and heated tobacco products, commissioned by Public Health England (PHE). The PHE review informed policy makers, researchers and the public about HTPs’ harm reduction potential and limitations. It was then referenced in the green paper on health prevention in the 2020s for England, which highlighted potential harms and benefits associated with HTP use. 

The PHE review was also picked up outside of the UK, being referenced by the New Zealand government’s website advising smokers how stopping smoking, or switching to using alternative products, could improve their health.

Worldwide media coverage

An updated literature review was published in Tobacco Control, the leading international journal on tobacco policy. Three and a half years after its publication in September 2018, the review is highly cited with over 200 citations recorded in Google Scholar. The findings were referenced in the World Health Organization report on the global tobacco epidemic.

It has attracted international media attention, helping to inform the public about HTPs more widely. The review was reported in New Scientist, an English magazine that has nearly 1 million worldwide readers every week, in Süddeutsche Zeitung, a daily newspaper in Germany reaching 1.25 million readers per issue, in the Cancer Research UK science blog and in the Wikipedia page on HTPs, which is visited 500 times per day.

Further collaborations: Wikipedia and Cochrane

The publication instigated collaborations with other tobacco control researchers. Erikas and his colleagues were invited to join the Society’s for Research on Nicotine and Tobacco initiative aiming to improve the accuracy of the Wikipedia page on HTP. They were also offered to collaborate in the development of a Cochrane literature review on HTP use for smoking cessation and reducing smoking prevalence; the review has been published on the Cochrane database in January 2022.

This work has led to a substantial increase in awareness and knowledge amongst scientists, policymakers and the public around the safety and potential of heated tobacco products to reduce health risks associated with smoking.

Image credit: Yohei Inaba



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