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Another study on human organotypic oral epithelial cultures showed that IQOS, compared to CS, yielded less cytotoxicity (significant after 48 h post-exposure), secretion of proinflammatory mediators, and gene expression perturbations related to apoptosis, necroptosis, senescence, xenobiotic metabolism, and oxidative stress 58

but only 10.9% of its population smokes, ranking it 33rd in the country for its smoking rate

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An analysis of the educational differences in the 1990s suggests little real decline in the education gap, especially among the white majority, but changes in attitudes and behavior often occur slowly