A new narrative review published in the peer-reviewed academic literature has examined the potential effects of next-generation nicotine products on heart health, suggesting they may pose substantially lower risks compared with continued cigarette smoking.
The analysis by Imperial Brands Science draws together extensive scientific evidence on vapes, oral nicotine pouches, and heated tobacco products, referencing more than 200 sources, including laboratory experiments, clinical trials, and population studies.
Smoking remains a leading cause of serious illness, including heart disease. The smoke from burning tobacco damages the lining of blood vessels, triggers inflammation, and promotes the build-up of fatty plaques in arteries, elevating the chances of heart attacks and strokes.
Next-generation nicotine products eliminate combustion and the resulting smoke. Research indicates their aerosols contain far fewer and lower levels of harmful chemicals than cigarette smoke.
What the review found
The review evaluated how switching away from cigarettes may lessen drivers of cardiovascular harm across several measures
- Lower exposure to toxicants: Switching from cigarettes to next-generation nicotine products is associated with substantial reductions in harmful chemicals linked to cardiovascular disease, with some body levels approaching those seen after complete smoking cessation.
- Reduced impact on blood vessels: Laboratory models demonstrate significantly less damage to vascular cells and fewer early changes linked to plaque formation in arteries.
- Improved biological indicators: Clinical studies show notable decreases in biomarkers of inflammation, oxidative stress, and blood clotting, processes known to contribute to heart disease.
- Consistent real-world trends: Population studies indicate that individuals who switch from cigarettes to next-generation nicotine products tend to experience a significantly lower risk of cardiovascular disease than those who keep smoking.
These findings align with the broader scientific understanding that removing combustion markedly reduces exposure to toxicants associated with smoking-related diseases. UK health bodies, including Public Health England and its successor, the Office for Health Improvement and Disparities, have previously noted that vaping products are substantially less harmful than smoking, though not risk-free.
Matthew Stevenson, Scientific Substantiation Senior Manager and co-author of the study, said: “The evidence in our latest review is clear; whether it’s in the lab, changes in people who switch to NGP, or patterns in larger populations, we see encouraging signs that the absence of cigarette smoke reduces the drivers of cardiovascular damage.”
Stevenson added: “While NGP are not risk-free and should be designed for and marketed to adults who smoke and existing nicotine consumers only, the current weight of evidence indicates a significant and meaningful reduction in cardiovascular risk factors compared with continued smoking, especially when cigarettes are fully replaced.”
Imperial Brands Science emphasises that these products are intended only for adult smokers and current nicotine users seeking alternatives. The review does not claim the products are harmless but points to evidence of harm-reduction potential when fully substituting cigarettes.
Experts independent of the industry have called for ongoing research. Long-term epidemiological data on cardiovascular outcomes from next-generation nicotine product use is still emerging, with most studies focusing on shorter-term biomarkers and exposure measures. Regulators and public health officials are particularly interested in how switching behaviours might influence overall population-level heart health, especially in the UK, where smoking rates have declined, but vaping prevalence has risen.
Cardiovascular disease remains one of the biggest killers in the UK. According to NHS data, it accounts for around a quarter of all deaths. Helping smokers quit or switch to less harmful alternatives forms a key part of tobacco control strategies.
The study calls for further independent research to build on these findings and support evidence-based regulation.