Smoking Topography, Nicotine Kinetics, and Subjective Smoking Experience of Mentholated and Non-Mentholated Heated Tobacco Products in Occasional Smokers

Abstract

Background: Heated tobacco products (HTPs) are marketed as reduced-harm alternatives to conventional cigarettes (CCs) and are increasingly used by young adults and occasional smokers. However, their acute nicotine delivery and user experience remain insufficiently studied in occasional smokers without established cigarette or nicotine dependence. Additives such as menthol-known to reduce sensory irritation and facilitate inhalation-may further influence initiation and product appeal, particularly in naïve users. Methods: In a crossover study with three separate study days, n = 15 occasional smokers without established cigarette or nicotine dependence consumed a mentholated HTP (mHTP), a non-mentholated HTP (nmHTP), and a conventional cigarette (CC) under ad libitum conditions during a 30 min observation. We measured plasma nicotine concentrations, smoking topography, cardiovascular parameters, and subjective effects (mCEQ). Results: Nicotine pharmacokinetics (Cmax, AUC) were comparable across products (Cmax 7.8-8.5 ng/mL; AUC 2.3-2.8 ng·min/mL [geometric means]; no significant differences), even though participants had no prior experience with HTPs. Compared to CCs, HTPs were associated with longer puff durations (2.09 s mHTP/2.00 s nmHTP vs. 1.78 s CC), higher puff volumes (mean: 68.06/68.16 vs. 43.76 mL; total: 949.80/897.73 vs. 522.41 mL), and greater flow rates (mean 37.49/38.25 vs. 27.68 mL/s; peak 63.24/63.69 vs. 44.38 mL/s). Subjective effects did not differ significantly between products (mCEQ subscale examples: satisfaction 3.00-3.33/7; reward 2.81-3.31/7; craving reduction 5.07-5.60/7). Cardiovascular parameters such as heart rate or systolic blood pressure showed with no between-product differences (HR p = 0.518; SBP p = 0.109) and no differences in their change over time between products (HR p = 0.807; SBP p = 0.734). No differences were observed between mHTP and nmHTP. Conclusion: HTPs can deliver nicotine and evoke user experiences similar to CCs, even in non-dependent users. The more intensive inhalation behavior observed with HTPs may reflect compensatory use and merits further investigation. Although no menthol-specific effects were observed, methodological constraints may have limited their detectability.

Keywords: heated tobacco products; menthol; nicotine pharmacokinetics; non-dependent users; puffing topography; subjective effects.

Figure A1

Individual plasma nicotine curves. (a) Mentholated heated tobacco product (mHTP). (b) Non-mentholated heated tobacco product (nmHTP). (c) Conventional cigarette (CC).

Figure A2

Subjective adverse effects on a scale from 0 (none) to 10 (strong). (a) Baseline ratings before product use. (b) Ratings after product use. (c) Ratings at the end of the testing period.

Figure 1

Study design with time points for the measurements.

Figure 2

Participant flow in the randomized crossover study. (assessed 19; randomized 17; sequences 6/5/6; discontinued 2 due to vasovagal syncope; analyzed 15).

Figure 3

Puffing behavior (Data are shown as mean and 95% CI). (a) Average puff volume (b) Average flow per puff.

Figure 4

Plasma nicotine curves (arithmetic means and 95% CI). (a) Whole testing time, 0–30 min. (b) Acute phase, 0–7 min.

Figure 5

Cardiovascular effects (means and 95% CI). (a) Systolic blood pressure. (b) Heart rate.