Evaluation of subclinical respiratory tract inflammation in heavy smokers who switch to a cigarette-like nicotine delivery device that primarily heats tobacco

Stephen I. Rennard, Takeshi Umino, Tajuddin Millatmal, David M. Daughton, Lidia S. Manouilova, Fred A. Ullrich, Kashinath D. Patil, Debra Romberger, Anthony A. Floreani, James R. Anderson

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27 Scopus citations


Cigarette smoking remains a major public health problem. For smokers who cannot or do not wish to quit, few option exist to reduce health risks. A cigarette-like nicotine delivery device that heats rather than burns tobacco might deliver nicotine with fewer toxins. The current study was designed to determine whether asymptomatic heavy smokers who did not wish to quit had improvement in lower respiratory tract inflammation after switching to Eclipse, a cigarette-like nicotine delivery device that primarily heats rather than burns tobacco. Twelve smokers of at least 40 cigarettes daily, asymptomatic and in good health, underwent paired bronchoscopies, bronchoalveolar lavages and endobronchial biopsies before and after 2 months of using Eclipse. Eight normal non-smoking individuals were evaluated on one occasion for comparison. Inflammation was assessed by direct inspection and by cytological parameters. Goblet cell metaplasia was assessed histologically. Compared to non-smokers, smokers had increased visible inflammation, increased recovery of inflammatory cells and increased percentage of goblet cells. There were significant reductions in all these parameters following a switch to Eclipse use, although the improvement did not reach the normal range. No significant differences were observed in peripheral blood measures. Nicotine levels were generally maintained, and exhaled carbon monoxide (CO) levels trended strongly upward. One individual experienced a transient twofold increase in CO and concurrently experienced transient headaches. Eclipse use may be a strategy to reduce the health risks for heavy smokers unwilling or unable to quit.

Original languageEnglish (US)
Pages (from-to)467-476
Number of pages10
JournalNicotine and Tobacco Research
Issue number4
Publication statusPublished - Nov 1 2002


ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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