@Article{Kopa-Stojak2026,
journal="Alergologia Polska - Polish Journal of Allergology",
issn="2353-3854",
volume="13",
number="3",
year="2026",
title="Harmfulness of traditional and alternative tobacco and nicotine products: focusing on cardiovascular, metabolic, respiratory and cancer risk",
abstract="      Use of tobacco products is the major risk of cardiovascular, metabolic and respiratory diseases and cancers, which pose a serious burden and challenge to the healthcare system. The following work attempts to summarize the harmfulness of traditional and novel tobacco and nicotine products, especially for the risk of cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM) and cancer among users of such products. Recent epidemiological studies confirmed that the most harmful products are conventional cigarettes (CCs). Cigars and waterpipes are less harmful than CCs, with a moderate to high risk of CVD, COPD, MetS, T2DM and cancers. Snuff tobacco and snus, due to a moderate risk of CVD, low risk of COPD, moderate to high risk of T2DM and MetS and moderate risk of site-specific cancers, are less harmful than traditional tobacco products. Heat-not-burn (HnB) cigarettes are less harmful than traditional and smokeless tobacco products, with a low to moderate risk of tobacco-related disease. E-cigarettes (ECs) pose a moderate risk of CVD, COPD, MetS, T2DM and cancers, therefore they are classified as less harmful than traditional and smokeless tobacco products. Due to limited and no evidence on the association between TF-ONPs and the risk of COPD, CVD, MetS, T2DM and cancer, such products are classified as the least harmful. However, due to the short time of such product availability and the fact that these diseases develop over long periods, long-term epidemiological and population-based studies are constantly needed to clearly determine their impact on the health-related outcomes.  ",
author="Kopa-Stojak, Paulina
and Pawliczak, Rafał",
pages="243--252",
doi="10.5114/pja.2026.164684",
url="http://dx.doi.org/10.5114/pja.2026.164684"
}