Effects of Heated Tobacco Products compared to Conventional Cigarettes on Cardiovascular System: Protocol for a Systematic Review

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Published Aug 16, 2025
https://doi.org/10.62438/tunismed.v103i8.4776
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Vol. 103 No. 8 (2025): Tunis Med Aug 2025

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Soumaya Ben Saad
Respiratory department C. Abderahmen Mami Hospital. Ariana. Tunisia. El Manar University
Nidhal BALOUMI
Respiratory department 4. Abderahmen Mami Hospital. Ariana. El Manar University
Amani BEN MANSOUR
Respiratory department C. Abderahmen Mami Hospital. Ariana. Tunisia. El Manar University
Chahida HARIZI
o Department of preventive medecine. Abderahmen Mami Hospital. Ariana o El Manar University

Abstract

Introduction
Heated tobacco products (HTPs) are increasingly marketed as a potentially less harmful alternative to conventional cigarettes. However, their cardiovascular effects compared to traditional smoking remain controversial. This protocol outlines the methodology for a systematic review aiming to assess the cardiovascular impact of HTPs in comparison to conventional cigarette smoking.


Methods
This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and is registered with the International Prospective Register of Systematic Reviews (PROSPERO:CRD42024594334). We will search electronic databases, including PubMed, Embase, Web of Science, Cochrane Library, and others, from inception to march 2025 . The search strategy will use medical subject heading (MeSH) terms such as "heated tobacco products" AND "cardiovascular health" AND "conventional cigarettes." Eligible studies will include randomized controlled trials and observational studies reporting on cardiovascular outcomes in adult HTP users compared to conventional smokers. Studies will be screened independently by two reviewers for inclusion, and data will be extracted using standardized forms. Quality assessment will utilize Cochrane Risk of Bias tools (MINORS and CONSORT), and evidence strength will be graded with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. Data synthesis will include meta-analysis and meta-regression performed using SPSS version 2023.


Conclusions
This systematic review will provide a comprehensive synthesis of evidence on the cardiovascular effects of HTPs compared to conventional smoking. The findings aim to inform clinical guidelines, regulatory policies, and future research directions in tobacco harm reduction.

Keywords:

Adult, Smoker, Heated tobacco products, Cigarette, Cardiovascular complications, Heart failure, Stroke, Blood pressure

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