Vaping expert Farsalinos blasts American Heart Association for ‘bizarre’ research

When the American Heart Association (AHA) recently released new research claiming that the smoke from Heat-not-Burn (HnB) technology is just as deadly as that of conventional cigarettes, vaping advocates were immediately skeptical.  The AHA regularly takes financial donations from Big Pharma, including Pfizer, GlaxoSmithKline, and Bristol-Myers Squibb.  Their previous studies regarding vaping are often refuted by many members of the scientific community.  The HnB report seems to be no different. 

Vapers are not always supportive of HnB technology, perhaps because these newfangled systems look and behave very much like vaping devices but with one significant difference.  Heat-not-Burn systems “heat” real tobacco leaves rather than burning them, as with combustible cigarettes.  Vaping, on the other hand, is 100% tobacco-free.   The last thing that vaping advocates want is to be mistakenly associated with a Big Tobacco product. 


However, when one pro-vaping expert in the proper protocols of scientific research techniques reviewed the AHA study, he immediately took issue with several of the related conclusions.  Dr. Konstantinos Farsalinos is from the Onassis Cardiac Surgery Centre in Athens, Greece, and he has been down this road many times in the past.  When the American Urological Association (AUA) published a report in May 2017 claiming that vaping leads to bladder cancer, Farsalinos took to the media to debunk those allegations, as well.

Overview of the AHA study on HnB technology

Research conducted by the AHA involves the exposure of HnB aerosols to rats while monitoring the effects on Flow-Mediated Dilatation (FMD), which measures one’s level of endothelial function or dysfunction.   The rats were exposed to the aerosol at 15-second intervals by way of a nose cone.  The experiment was then duplicated using the smoke from a Marlboro cigarette.  Each rat was exposed to these procedures a total of ten times over a five-minute period, first with the HnB aerosol and then with the cigarette smoke.   The AHA concludes that the comparative levels are identical.

“Acute exposure to iQOS aerosol can substantially impair endothelial function in rats comparably to cigarette smoke despite the absence of combustion. Use of HNB tobacco products does not necessarily avoid the adverse cardiovascular effects of smoking cigarettes.”

The AHA research study entitled Abstract 16035: Impairment of Endothelial Function by Inhalation of Heat-Not-Burn Tobacco Aerosol is published on organizational website. 

Dr. Farsalinos’ views of the AHA study

Dr. Farsalinos finds these conclusions to be inaccurate or perhaps even intentionally misrepresented.  In his professional blog, Farsalinos claims that the primary objectives of the study, evaluation of the FMD levels, “have no prognostic value” and that the AHA is perhaps trying to instill public fear where none is warranted.  He also suggests that some critical information is missing from the AHA study.

“Although FMD (and other measures of vascular function) have no prognostic value when measured after an acute exposure, the abstract itself could be considered alarming and create some concern. Of course, there has been some publicity on it already. But we all know that “the devil is in the detail”. In this case, some critical information omitted from the abstract is mentioned in the press statement (and in the presented poster to which I have access).”
“The poster mentions some very interesting information. For the same exposure in terms of duration and puff number, IQOS delivered 4.5 times MORE nicotine to the mice compared to tobacco cigarettes. So, the comparison was between exposure to the tobacco cigarette resulting in 15 ng/mL plasma nicotine levels, versus exposure to the IQOS resulting in 70ng/mL plasma nicotine levels. This creates two fundamental problems with this study, which makes the conclusions of the abstract and press statement problematic.”

Dr. Farsalinos explains that the study is not valid because the comparable levels of exposure to HnB aerosols and Marlboro cigarette smoke were not equivalent.  Somehow, the HnB technology exposed the rats to 450% more nicotine than the combustible cigarettes.  Secondly, the fact that the HnB technology was even able to deliver such massive nicotine levels while the Marlboro did not is “not only bizarre but also contrary to all available evidence.”

Last June, Farsalinos published his own research regarding the nicotine exposure rates of HnB aerosols. The results show that the nicotine levels produced by HnB technology is significantly higher than conventional cig-a-like devices but lower than the smoke of combustible cigarettes.  How the AHA determined that HnB aerosols are 4.5 times higher in nicotine than Marlboro cigarette smoke is a major cause of concern and likely a red flag that the study cannot be trusted.


Leave a comment

Please note, comments must be approved before they are published