Newswise — Catania, 17 December 2021 - Thousands of studies with different and often inconsistent results have so far been the primary snag to evaluate the toxicity of e-cigarettes.

An issue that has impacted Tobacco Harm Reduction internationally, prompting the CoEHAR to undertake an innovative and complex assessment. Researchers working with the Sbarro Health Research Organization (SHRO) and the Sbarro Institute for Cancer Research and Molecular Medicine at Temple University, directed by Antonio Giordano, MD, PhD, are coauthors of the study. 

“Validating specific and high-quality-standard studies in this field is our mission,” said Riccardo Polosa, CoEHAR Founder. “Thanks to the study, we set an additional milestone on scientific research by defining effective methodological standards for research on e-cigarettes.” 

In the last two years, the CoEHAR Replica project confirmed the results obtained from the major international studies. It also validated with additional techniques their outcomes under independent conditions.

The study "Electronic nicotine delivery systems exhibit reduced bronchial epithelial cells toxicity compared to a cigarette: the Replica Project," published in a journal of the Nature group establishes an international standard in the evaluation of the relative toxicity of human bronchial epithelial cells exposed to cigarette smoke and aerosol from e-cigarettes.

“Our data validate many of the international studies on e-cigarettes,” explains Prof. Giovanni Li Volti, CoEHAR director and project leader of the Replica project. “From now on we can provide clear and consistent data to help disseminate correct information on harm reduction. In doing so we are also capable of unlocking new paths for effective and safer cessation programs.” 

The study

International researchers of the Replica project from Italy, Greece, Oman, the USA and Serbia aimed to replicate three major international studies, testing them independently.

Exposure protocols for tests comply with international standards (ISO, CORESTA and HCI), and experimental conditions used in vitro were consistent with those of the smoker.

Firstly, the researcher evaluated diverse smoke toxicity from conventional cigarettes and the volatile component with no nicotine. Therefore, they assess that acute toxicity is mainly induced (about 80%) by the volatile components rather than nicotine. Secondly, researchers exposed different cell cultures to the same amount of nicotine from different products (classic cigarettes, electronic cigarettes) to demonstrate no toxicity associated with the aerosol of electronic cigarettes.

Scientists performed a further comparison between the aerosol from e-cigarettes and heated tobacco products showing no cytotoxic effect on bronchial cells on both products.

“This is a fundamental step for the international research on the electronic cigarettes,” stressed prof. Massimo Caruso, CoEHAR researcher involved in the Replica project. “In doing so, we developed shared research standards replicable in the future to avoid the proliferation of scientific studies with inaccurate and ineffective methodologies.” 

CoEHAR - Center of Excellence for the acceleration of HArm Reduction 

CoEHAR is a University research centre that includes the existing “Centro per la Prevenzione e la Cura del tabagismo (CPCT)”, as well as the clinical setting of a local CRO and a selected network of cell and molecular biology as well as microbiology laboratories. Thanks to their great expertise in the field, 85 University of Catania’s academics have just constituted the Center of Excellence for the acceleration of HArm Reduction (CoEHAR). 

CoEHAR mission is to accelerate efforts to study and reduce health impacts and deaths from smoking locally nationally and globally through use of approved pharmacological approaches as well as innovative technology. 

Harm Reduction is the principle topic of CoEHAR activity. The Center promotes a multidisciplinary and revolutionary approach and identify strategies and tools to stop smoking. Internationalization is exchange of knowledge. 


About the Sbarro Health Research Organization

The Sbarro Health Research Organization (SHRO) is non-profit charity committed to funding excellence in basic genetic research to cure and diagnose cancer, cardiovascular diseases, diabetes and other chronic illnesses and to foster the training of young doctors in a spirit of professionalism and humanism. To learn more about the SHRO please visit

Journal Link: Nature