Effect of I Quit Ordinary Smoking (IQOS) Use on Hepcidin and Iron Parameters in Comparison with Conventional Smoking

Background: IQOS (I Quit Ordinary Smoking) has been introduced as a “safer” alternative to traditional tobacco smoking. We aimed to determine how heated tobacco products influence iron metabolism by examining the impact of IQOS use and conventional cigarette smoking on hepcidin and iron-related parameters. Methods: In this cross-sectional study, an iron panel and hepcidin levels were measured in participants who were using IQOS for at least six months and compared with those of conventional smokers or non-smokers. Results: A total of 185 adults (18-40 years) of both sexes participated in the study, including 80 IQOS users, 49 cigarette smokers and 56 non-smokers. No significant differences were found in hemoglobin level, red blood cell count, mean corpuscular volume, white blood cell count, platelet count or total iron level between IQOS users and non-smokers in both sexes. However, ferritin levels were significantly higher in male IQOS users compared to non-smokers (P=0.022). Hepcidin levels were markedly higher in IQOS users (375.77 ± 98.59 pg/mL) compared with cigarette smokers (26.35 ± 8.81 pg/mL; P = 0.0001) and non-smokers (31.27 ± 7.78 pg/mL; P = 0.0001). No significant difference in unsaturated iron-binding capacity, total iron-binding capacity or transferrin saturation was found between IQOS users compared to non-smokers. Conclusion: IQOS use was associated with significantly elevated hepcidin levels and higher ferritin in males, suggesting a potential disruption of iron regulation compared to conventional smokers and non-smokers.