Lüdicke F, Ansari SM, Lama N, et al. - In this study of 984 adult American smokers, researchers examined whether switching to the heat-not-burn Tobacco Heating System 2.2 (THS) among cigarette smokers results in favorable changes in 8 co-primary endpoints (HDL-C, WBC, FEV₁%pred, COHb, Total NNAL, sICAM-1, 11-DTX-B2, 8-epi-PGF2α) which are indicative of biological and functional effects. Furthermore, they quantified these biomarkers of exposure (BoExp): MHBMA, 3-HPMA, Total NNN, CEMA, 3-OH-B[a]P, HMPMA, Total 1-OHP, NEQ, and CO exhaled. Randomization of participants to continued smoking of their preferred cigarette brand (n = 496) or to using THS (IQOS brand; n = 488) for 6 months, was done. Observations revealed achievement of favorable change 6 months after baseline in terms of statistically significant improvements in 5 of 8 biomarkers of effect (HDL-C, WBC, FEV₁%pred, COHb, Total NNAL) when smokers switched to THS compared with those who continued to smoke cigarettes. Likewise, there was marked reduction in BoExp. Findings thereby support disease risk reduction potential for smokers switching to THS instead of continuing to smoke cigarettes.