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Participants in this year-long ambulatory study were healthy smokers with a self-reported low intent to quit assigned either to continue smoking or switch to a THP; a group of smokers with a self-reported high intent to quit who abstained from tobacco use; and a group of never smokers. Various BoE and BoPH related to oxidative stress, cardiovascular and respiratory diseases and cancer were assessed at baseline and up to 360\u00a0days. Substantial and sustained reductions in BoE levels were found at 360\u00a0days for both participants who switched from smoking to THP use and participants who quit smoking, in many cases the reductions being of a similar order for both groups. The never smoker group typically had lower levels of the measured BoEs than either of these groups, and much lower levels than participants who continued to smoke. Several BoPHs were found to change in a favourable direction (towards never smoker levels) over the year study for participants who completely switched to THP or quit, while BoPHs such as soluble intercellular adhesion molecule-1 were found to change in an unfavourable direction (away from never smoker levels) in participants who continued to smoke. Our findings, alongside chemical and toxicological studies undertaken on the THP used in this study, lead to the conclusion that smokers who would have otherwise continued to smoke and instead switch entirely to the use of this THP, will reduce their exposure to tobacco smoke toxicants and as a consequence are reasonably likely to reduce disease risks compared to those continuing to smoke.<\/jats:p>","DOI":"10.1007\/s11739-022-03062-1","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T09:03:03Z","timestamp":1661763783000},"page":"2017-2030","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Changes in biomarkers of exposure and biomarkers of potential harm after 360\u00a0days in smokers who either continue to smoke, switch to a tobacco heating product or quit smoking"],"prefix":"10.1007","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7215-1225","authenticated-orcid":false,"given":"Nathan","family":"Gale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McEwan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Hardie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Proctor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,28]]},"reference":[{"key":"3062_CR1","volume-title":"The health consequences of smoking\u201450 years of progress: a report of the surgeon general","author":"National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health","year":"2014","unstructured":"National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health (2014) The health consequences of smoking\u201450 years of progress: a report of the surgeon general. 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(Investments) Limited, which was the sponsor and funding source of this study. JM was an employee of B.A.T. (Investments) Limited at the time of the study and is a current employee of Reynolds American Inc. CJP was an employee of B.A.T. (Investments) Limited at the time of the study and is currently contracted by B.A.T. (Investments) Limited to provide consultancy services. The B.A.T Group is the manufacturer and holder of the intellectual property rights of the investigational product used in this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was granted a Favourable Opinion (equivalent to Institutional Review Board approval) by NHS Health Research Authority Wales Research Ethics Committee 2 (reference number 17\/WA\/0212).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All participants provided written informed consent before enrolment into the study, including agreeing for the results to be published.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}