There are various brands of heat-not-burn tobacco products and while their appearances and components differ, their concept stays the same. The electronic devices aerosolize tobacco that can be inhaled without combustion either directly by heating up cigarette-like tobacco sticks or indirectly by heating up a liquid that passes through tobacco capsules.1,2 They are not the same as vapes. Vapes use e-juice (containing chemicals, flavourings and often nicotine), whereas heat-not-burn tobacco products use tobacco or tobacco capsules (containing chemicals and nicotine).2 While vapes are less harmful than smoking cigarettes, the same cannot be said for heat-not-burn products. These products are new to the Canadian market and long-term health effects from their use are not known.
Not enough is known about the safety of heat-not-burn tobacco products compared to smoking conventional cigarettes. Consider the pros and cons below and YOU be the judge.
- Because there is no combustion or smoke, heat-not-burn tobacco products release lower levels of carbon monoxide, tar, and other cancer-causing chemicals than regular cigarettes.4
- Compared to cigarette emissions, those from heat-not-burn tobacco products do not stay in the air for as long.5
- Even though the harmful chemicals are released at lower levels in a lab setting, they’re the same ones as those in regular cigarettes6 and may not mean lower risks in real life.7
- Heat-not-burn tobacco products can be just as harmful for your heart as regular cigarettes.8
- Non-users can be exposed to harmful substances through second-hand smoke.3,4,5
- Since heat-not-burn products may not deliver nicotine as well as regular cigarettes, 6,9 this may lead to increased use to get the same level of nicotine.
- As a nicotine delivery device,6,9 non-smokers using heat-not-burn tobacco products could get addicted to nicotine, more so than using vapes.3
- Heat-not-burn tobacco products may lead to other risks including causing fires and explosions and nicotine poisoning in children.3
The verdict is clear. Although heat-not-burn tobacco products may release fewer chemicals, there is no evidence to suggest that they could be less harmful than smoking regular cigarettes. Certainly, they are not completely harmless. Because heat-not-burn tobacco products still contain nicotine and other cancer-causing chemicals, they should be avoided, especially among non-smokers.
- Ontario Tobacco Research Unit. (2016). Heat-not-burn tobacco products: claims and science. Retrieved September 27, 2017 from http://otru.org/heat-not-burn-tobacco-products-claims-and-science/
- Truth Initiative. (2017). What are “heat-not-burn” cigarettes? Retrieved October 17, 2017 from https://truthinitiative.org/news/what-are-heat-not-burn-cigarettes
- Max, W., Lempert, L., Sung, H., Lightwood, J., Wang, Y., & Yao, T. (2017). Philip Morris’s Population Health Impact Model Based on Questionable Assumptions and Insufficient Health Impact Measures Does Not Adequately Support its MRTP Application. Retrieved December 19th, 2017 from https://tobacco.ucsf.edu/pm%E2%80%99s-population-health-impact-model-iqos-underestimates-impact-iqos-and-does-not-show-population-benefit
- Bekki, K., Inaba, Y., Uchiyama, S., & Kunugita, N. (2017). Comparison of chemicals in mainstream smoke in heat-not-burn tobacco and combustion cigarettes. Journal of UOEH, 29, 201-207.
- Protano, C., Manigrasso, M., Avino, P., Sernia, S. & Vitali, M. (2016). Second-hand smoke exposure generated by new electronic devices (IQOS® and e-cigs) and traditional cigarettes: submicron particle behaviour in human respiratory system. Annali Di Igiene, 28, 109-112.
- Auer, R., Concha-Lozano, N., & Jacot-Sadowski, I. (2017). Heat-not-burn tobacco cigarettes smoke by any other name. JAMA Internal Medicine, 177, 1050-1052.
- World Health Organization. (2017). Heat-Not-Burn tobacco products information sheet. Retrieved December 19, 2017 from http://www.who.int/tobacco/publications/prod_regulation/heat-not-burn-products-information-sheet/en/
- Springer, M.L., Nabavizadeh, P., & Mohammadi, L. (2017). UCSF public comment on PMI MRTP application: Evidence that IQOS hurts vascular function as much as a cigarette. Retrieved December 19, 2017 from https://tobacco.ucsf.edu/ucsf-public-comment-pmi-mrtp-application-evidence-iqos-hurts-vascular-fuction-much-cigarette
- Farsalinos, K.E., Yannovits, N., Sarri, T., Voudris, V., & Poulas K. (2017). Nicotine delivery to the aerosol of a heat-not-burn tobacco product: comparison with a tobacco cigarette and e-cigarettes. Nicotine & Tobacco Research. Advanced online publication.doi.org/10.1093/ntr/ntx138