Are heated tobacco merchandise a brand new well being danger?

A brand new sort of tobacco product is discovering rising numbers of customers all over the world, however there are nonetheless critical questions on the way it impacts human well being.

Having smoked for almost 30 years for the reason that age of 13, IT guide and freelance author Ben Taylor was intrigued by the sound of heated tobacco merchandise.

Making an attempt to change from cigarettes to vapes hadn’t labored for Taylor. “Vaping liquids at all times left me wanting,” he posted on his weblog. So he determined to attempt IQOS, a modern, pen-shaped digital machine that heats sticks of rolled tobacco, developed by the American multinational tobacco firm Philip Morris Worldwide (PMI).

Quite than burning tobacco, these units warmth it to a temperature excessive sufficient to create a vapour however not smoke.

For Taylor, it did not fairly replicate the expertise of smoking a cigarette, but it surely got here a lot nearer than vaping – the opposite well-liked cigarette different, which makes use of handheld pens to warmth a flavoured nicotine-containing liquid. “You possibly can inform you’re consuming actual tobacco,” Taylor wrote. Over time, he says, he got here to favor IQOS as a result of style, and the shortage of a lingering cigarette stench. He additionally says his beforehand near-permanent cough disappeared.

But they’re additionally changing into more and more widespread, with next-generation heated tobacco merchandise now obtainable in additional than 60 international locations. They’ve skilled significantly notable development in each Italy and Japan, the place they’ve been current since 2014. And this development is predicted to proceed as they begin to penetrate the market within the US.

So, is heated tobacco actually serving to individuals take pleasure in nicotine in a much less dangerous manner, or might or not it’s a brand new public well being disaster within the making?

IQOS and different units prefer it are the most recent iteration of an idea which the tobacco trade has been intermittently toying with for the previous 4 many years. In 1988, an American tobacco firm known as RJ Reynolds tried to commercialise the very first heated tobacco product, a tool known as Premier. Designed to look much like a standard cigarette in form and dimension, the Premier had a particularly designed carbon tip that customers would mild to warmth the tobacco. However regardless of a reported $300m (roughly £180m on the time) in funding, Premier was faraway from the market after simply six months as customers complained about its style and scent.

After varied reinventions, heated tobacco merchandise have began to take pleasure in business success previously decade with a brand new vary of digital units that use a number of strategies to vaporise their contents. Sometimes these contain encasing tobacco in both sticks, plugs, capsules or pods, that are then heated with an digital aspect. In addition to PMI’s IQOS, main manufacturers embody Ploom, made by Japan Tobacco Worldwide (JTI), and glo, made by British American Tobacco (BAT).

However unbiased researchers and public well being specialists argue that heated tobacco merchandise are nonetheless dangerous to human well being and urge customers to surrender tobacco altogether. They specific issues at a few of the advertising and marketing methods, saying that the usage of influencers and glamorous launch events might encourage heated tobacco use amongst younger individuals, who’re extra possible to not have smoked earlier than, which might make these merchandise a gateway to cigarettes. 

PMI, JTI and BAT all insist their merchandise are geared toward adults solely. PMI says it has a strong code of conduct that doesn’t permit advertising and marketing that appeals to minors comparable to cartoons, youth-orientated celebrities or fashions who’re or seem like underneath the age of 25. BAT mentioned they perform due diligence on any influencer partnerships to make sure that a big majority of their followers are over 18 years previous. JTI says it’s “dedicated to the precept that minors ought to by no means use or entry nicotine-containing merchandise”. It says it ensures it markets its heated tobacco merchandise in a “socially accountable manner” in accordance with relevant legal guidelines and guidelines.

However Silvano Gallus, an epidemiologist on the Mario Negri Institute for Pharmacological Analysis in Milan, believes that current people who smoke don’t seem like the primary viewers for these merchandise, regardless of the messaging from tobacco companies. He first began monitoring the rollout of heated tobacco merchandise greater than a decade in the past.

“We started to see the promotion of those merchandise in every single place with commercials, occasions and events, significantly geared toward younger individuals,” says Gallus, reflecting on the preliminary launch of heated tobacco within the cities of Milan and Nagoya, Japan. 

In 2019, PMI suspended a social media marketing campaign involving digital influencers after the information organisation Reuters revealed the corporate had been utilizing younger on-line personalities to market its merchandise, together with a 21-year-old girl, in breach of its personal code of conduct. PMI mentioned on the time that no legal guidelines had been damaged, however acknowledged that the marketing campaign failed to satisfy the corporate’s requirements.

Gallus claims that the customers of heated tobacco merchandise in Italy are typically younger, pointing to surveys which have described their use as widespread amongst adolescents. “They don’t seem to be 60-year-old hardcore people who smoke in search of an alternative choice to cigarettes,” he says. 

However there may be concern amongst public well being specialists that if younger individuals who have by no means smoked cigarettes actually are drawn to heated tobacco merchandise, it might introduce new teams of individuals to probably dangerous habits.

In 2024, Gallus and a bunch of fellow tobacco management researchers in Italy revealed a research primarily based on knowledge from greater than 3,000 Italians aged between 18 and 74, who they tracked for six months throughout 2020. They discovered that non-smokers who started utilizing heated tobacco merchandise had been 5.8 occasions as more likely to subsequently transition to smoking inside the six month research interval as individuals who had by no means used heated tobacco merchandise.

However PMI describes Gallus’ research as unreliable and says that heated tobacco can present a route out of smoking. Gallus and his colleagues acknowledge themselves that their research had a restricted pattern dimension and must be verified with bigger research. The outcomes might also have been impacted by the pandemic and widespread lockdowns which had been happening on the time.

Researchers like Gallus, nevertheless, view heated tobacco merchandise as a setback within the battle to drive down tobacco use and have accused the trade of cynically concentrating on younger individuals. They level to the truth that, so far, advertising and marketing for IQOS has appeared at music festivals and movie festivals in Europe, Asia and South America, alongside excessive profile partnerships with streetwear manufacturers and style designers.

It’s a concern echoed by the World Well being Group (WHO). In a 2023 abstract of proof, specialists on the WHO warned that the decrease price of heated tobacco sticks in comparison with a pack of cigarettes “undermines the progress made in decreasing use that was completed by making merchandise dearer”. The report, which was funded by Bloomberg Philanthropies, an organisation that invests closely in decreasing tobacco use, added that the advertising and marketing of heated tobacco merchandise typically mixed claims of diminished hurt relative to cigarettes with “the fervour for expertise of primarily younger individuals”.

In line with a report produced by the non-profit organisation Marketing campaign for Tobacco-Free Children – which additionally receives funding from Bloomberg Philanthropies – influencer-driven campaigns on social media platforms comparable to Instagram, Fb, TikTok, X (previously Twitter) and YouTube have additionally performed a key function in elevating the visibility of IQOS and different heated tobacco manufacturers. A research by researchers on the College of Rochester within the US additionally discovered that Instagram posts that includes heated tobacco merchandise typically place the units as way of life merchandise by displaying them alongside fashions, swimming swimming pools or a luxurious automotive. Posts with fashions or way of life components obtained larger engagement. 

PMI categorically denies advertising and marketing its heated tobacco merchandise to younger individuals and says it doesn’t have an official account on TikTok, whereas its account on X is used for buyer care solely. The corporate additionally says a minimum of 75% of the viewers have to be over the authorized age for buying tobacco merchandise at any third-party occasions it sponsors. PMI claims 82% of IQOS customers are over the age of 29, in accordance with its personal estimates.

Some research have additionally discovered that switching from cigarettes to heated tobacco will be useful in some individuals – comparable to sufferers with power lung illness. However different scientific analysis additionally means that heated tobacco merchandise are unlikely to be benign for our well being. 

In 2017, a bunch of Swiss scientists revealed a research disputing certainly one of PMI’s central advertising and marketing claims, particularly that IQOS is smoke-free due to the shortage of combustion or burning of the tobacco leaves. 

As a substitute, the researchers argue that the emissions from heated tobacco units ought to nonetheless be thought-about as “smoke” and will fall underneath indoor smoking bans in the identical manner as cigarettes. Their research confirmed that IQOS tobacco reaches round 330C (626F), a discovering supported by different research, whereas a standard cigarette reached round 684C (1,263F).

Of their subsequent evaluation of IQOS emissions, they concluded that the heated tobacco vapour additionally contained dangerous chemical substances which stem from pyrolysis – the time period for incomplete combustion – and thermogenic degradation, making it extra much like cigarette smoke than the corporate was claiming. “People who smoke and non-smokers want correct details about poisonous compounds launched in IQOS smoke,” the scientists wrote. 

PMI was fast to reply to the research, sending the authors a letter disputing most of the outcomes. A subsequent evaluation by the FDA additionally warned there have been “important analytical points” with the research that made it tough to match the degrees of dangerous and probably dangerous compounds from heated tobacco to these from cigarettes. PMI maintains that IQOS heats tobacco however doesn’t burn it.

Different analysis, nevertheless, has examined the kind and amount of poisons current within the vapours produced by heated tobacco.

On the Nationwide Technical College of Athens, chemical engineer Efthimios Zervas has spent a lot of the previous decade painstakingly analysing the chemical substances current within the fumes of merchandise together with IQOS and glo. He describes it as a sluggish and complicated course of as a result of the fumes emitted include many hundreds of various chemical substances, in combos that change vastly from one product to a different. 

“We attempt to research as a lot as we will, but it surely’s tough as a result of as quickly as we publish our outcomes, this product we have been analysing has both been modified or is now not in the marketplace,” he says. “So that you’re continually enjoying catch-up with the trade.”

Nonetheless, Zervas has drawn a variety of conclusions. As with cigarettes, he has discovered that heated tobacco merchandise launch excessive concentrations of advantageous particles, able to penetrating deep into the physique. Different research have recognized recognized toxins current within the gaseous emissions. Certainly, many toxins and carcinogens had been current at far decrease concentrations in heated tobacco vapours than in fumes from cigarettes. However Zervas has discovered others, comparable to carbonyl methylglyoxal, that he says are literally emitted in larger concentrations by heated tobacco merchandise. 

“There are poisonous merchandise in there, so we can’t say that these units are secure,” says Zervas.

Trade-backed research have additionally reported an extended checklist of compounds within the aerosols from heated tobacco – one research by BAT discovered greater than 120 whereas one other detected 205 compounds within the aerosols, together with 82 not seen in cigarette smoke. These embody compounds which can be the results of heating glycerol, which is likely one of the components in heated tobacco sticks. The WHO has known as for extra analysis to guage the impact of those compounds on human well being when inhaled on the comparatively excessive ranges in heated tobacco aerosols.

Such sentiments have been famous by regulators. Whereas the US Meals and Drug Administration (FDA) has authorised PMI to market a number of heated tobacco merchandise, it additionally declared that this “doesn’t imply these merchandise are secure nor FDA authorised”. The FDA additionally says, “There are not any secure tobacco merchandise, so those that don’t at present use tobacco merchandise, particularly younger individuals, shouldn’t begin.”

All three of the tobacco corporations the BBC spoke to acknowledge that it will be incorrect to say heated tobacco merchandise are secure or danger free. However they are saying analysis signifies that they supply a manner of decreasing publicity to dangerous compounds if people who smoke swap from cigarettes to heated tobacco merchandise.

“This basic precept underpins the promise that smoke-free merchandise like IQOS maintain for advancing world well being and additional validates PMI’s dedication to a smoke-free future,” says Moira Gilchrist, PMI’s world chief communications officer.

“The vast majority of danger related to cigarettes comes from the burning of tobacco and never the nicotine,” says a BAT spokesperson. “glo, whereas not danger free, doesn’t contain burning tobacco.” Footnotes of their response, nevertheless, added that their assertion assumes a whole swap from cigarette smoking and notes that their product is addictive and never danger free.

“JTI doesn’t market any of its merchandise together with heated tobacco merchandise as smoking cessation merchandise,” says a JTI spokesperson. “They’re an alternate for people who smoke in search of merchandise with the potential to cut back the dangers related to smoking.” 

There are some who query the science that main corporations are utilizing to advertise heated tobacco merchandise. The European Respiratory Society Tobacco Management Committee revealed a place paper in February 2024 on the topic. The paper states that, whereas the tobacco trade claims a 90-95% discount in dangerous and probably dangerous substances and toxicity for heated tobacco merchandise, this isn’t the total image. Unbiased analysis exhibits these merchandise emit substantial ranges of carcinogenic, tobacco-specific nitrosamines, irritants and potential carcinogens, in addition to comparable nicotine and tar ranges to an ordinary cigarette, the paper states.

Some researchers have additionally solid doubt on the scientific trials performed by tobacco corporations themselves. In 2022, a scientific evaluation by the College of Bathtub’s Tobacco Management Analysis Group – which receives funding from Bloomberg Philanthropies and are a part of STOP, a world tobacco trade watchdog – concluded that PMI’s scientific trials of its heated tobacco merchandise had been of poor high quality and at excessive danger of bias. 

PMI didn’t present a response to those allegations when requested by the BBC, but it surely characterised the College of Bathtub’s Tobacco Management Analysis Group as an “unreliable and inaccurate supply of data”. It didn’t present any additional proof to help this accusation.

With different types of smokeless tobacco additionally on the rise, which will be chewed, sucked or snuffed, many anti-tobacco lobbyists are pissed off by the shortage of progress. Staying forward of the proliferation of recent types of tobacco consumption is like enjoying a sport of “whack-a-mole”, says Sandra Mullin, senior vice-president of coverage, advocacy and communication at Important Methods, a global non-profit organisation that has partnered with governments all over the world to develop tobacco management insurance policies.

“I used to be in China in January, they usually confirmed us these new fashions of heated tobacco merchandise that do not appear to be tobacco, they appear to be a toy,” she says, including that she want to have extra knowledge that demonstrates whether or not there are critical well being impacts from such merchandise.

One facet that’s significantly worrying public well being officers, together with the WHO, is that these units may very well encourage individuals to eat extra tobacco. A 2022 systematic evaluation by researchers within the UK concluded that there was inadequate proof to indicate they assist individuals to give up smoking. The 2023 WHO report on heated tobacco additionally warns that the obtainable knowledge signifies that the majority people who smoke turn out to be twin customers and “don’t considerably cut back their danger from tobacco merchandise”.

“In case you’re not really decreasing tobacco consumption, it undoes any potential diminished hurt results, and the trade’s simply creating wealth from individuals twice over,” says Sophie Braznell, a researcher within the College of Bathtub’s Tobacco Management Analysis Group and a spokesperson for STOP.

PMI claims its personal knowledge demonstrates nearly all of IQOS customers have given up smoking. It estimates 72% of IQOS customers are individuals who have absolutely switched from cigarettes. JTI and BAT didn’t reply to questions on twin use of their merchandise.

However with IQOS returning to the US, beginning with the units occurring sale in Austin, Texas in March 2025, Yolonda Richardson, president and chief government of the Marketing campaign for Tobacco-Free Children, is anxious that extra individuals will turn out to be customers of a number of tobacco or nicotine merchandise. E-cigarettes stay well-liked amongst youthful individuals whereas nicotine pouches which can be positioned between the lip and gum at the moment are displaying indicators of rising in recognition, with the CDC reporting a considerable enhance in nationwide gross sales within the US since 2016.

Nevertheless, Richardson says that it might take a very long time earlier than the total well being penalties turn out to be obvious. Once they do, it is going to be exceedingly tough to pinpoint the underlying supply, as people can have been uncovered to totally different concentrations of nicotine in numerous kinds, in addition to various sources of tobacco.

Zervas argues that the onus ought to be on the tobacco trade to show that its merchandise should not harmful earlier than they’re capable of enter the market, moderately than the opposite manner spherical.

“It is like with meals or medicine,” he says. “We research them first and, in the event that they’re secure, we permit them. With the tobacco trade’s merchandise, we permit them into the market after which need to show they’re harmful, or very harmful.”

* This text was up to date on 2 Might 2025 to clarify that the FDA issued further authorisation for IQOS to be marketted within the US in 2020.

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