A recent review examines the benefits and risks of heated tobacco.
Products for heating tobacco are made to do so without burning or emitting smoke. Following the 2016 release of an electronic device called IQOS, the demand for these products skyrocketed in Japan. Although heated tobacco products are now sold in many nations, there are still uncertainties regarding their impact on health and cigarette smoking, so we looked into the data.
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Eleven studies involving more than 2,600 participants are included in our latest review. The main finding is that individuals who shifted from smoking cigarettes to heated tobacco were exposed to fewer dangerous chemicals than those who continued to smoke, but they were exposed to more of these toxins than those who gave up tobacco use completely.
This reduced exposure was observed for several toxic substances associated with heart disease, cancer, and respiratory issues. This suggests that switching from cigarettes to heated tobacco may lower the risk of contracting these illnesses, but further research is needed to make this determination. The studies were all brief, and people usually take some time to develop diseases linked to tobacco use.
Nevertheless, the data to date supports the unique dangers associated with smoking. We know that inhaling the toxic chemicals produced by burning tobacco is the primary cause of the harmful effects of cigarettes, which kill half of all regular smokers. We would anticipate that the risk would be lower for heated tobacco products because they are made to prevent burning tobacco.
If heated tobacco products lower risk and assist users in quitting regular cigarettes without drawing in users who would not otherwise use tobacco products, then public health could benefit.
We were unable to locate any research examining the possibility of helping smokers quit by providing them with heated tobacco products. However, we discovered two Japanese studies examining the impact of IQOS on cigarette sales. Both discovered that the introduction of IQOS hastened the decline in cigarette sales, indicating that heated tobacco products may take the place of cigarettes rather than enhance them.
However, it’s also possible that fewer people stopped smoking because most people reduced their use but didn’t completely give up. Giving up smoking completely yields greater health benefits than cutting back on cigarettes.
A comparison with electronic cigarettes
Another category of nicotine products that has seen significant growth in popularity recently is e-cigarettes, also known as vapes. Products that contain heated tobacco leaf are heated, while e-cigarettes heat a liquid that usually contains nicotine. The science and regulations governing these products differ greatly. Since e-cigarettes have been around longer than heated tobacco, the advantages and disadvantages of using them have been better documented.
E-cigarettes, as opposed to heated tobacco, have been demonstrated to assist users in quitting traditional cigarettes. If e-cigarettes clear the required regulatory hurdles, they might even be made available to smokers in the UK in the not-too-distant future.
However, some nations, like Japan, have put in place regulations that effectively forbid the selling of nicotine-containing e-cigarettes, even though heated tobacco products are still easily accessible. Since heated tobacco is the only available potentially lower-risk alternative to cigarettes, this may help to explain why it has become so popular in Japan. In nations like the US and the UK, where the e-cigarette industry was well-established when IQOS launched, heated tobacco use is still uncommon.
Products from the cigarette industry, which has a history of manipulating science to downplay the dangers of cigarettes, dominate the heated tobacco market. On the other hand, a large number of e-cigarette producers are independent of cigarette companies. While e-cigarettes have been the subject of numerous independent studies, all the safety studies regarding heated tobacco in our review were carried out by cigarette manufacturers.
The hunt for cigarettes that aren’t as dangerous
According to tobacco companies, they have been looking for a less harmful cigarette for decades. Certain attempts, like cigarette filters with ventilation holes added, have backfired.
The e-cigarette emerged as the first non-pharmaceutical nicotine substitute that gained widespread appeal among smokers worldwide. However, e-cigarettes are free of tobacco, and many of their producers are independent of cigarette companies. Instead, a large number of tobacco companies concentrated on creating heated tobacco devices, a market that they could control more tightly thanks to patents.
Sales of electronic heated tobacco devices shot up in South Korea and Japan in 2014 after Philip Morris International brought IQOS to test markets. This was followed by the introduction of similar devices by other tobacco companies. Currently, some of the most well-known are Ploom by Japan Tobacco International and Glo by British American Tobacco.
The majority of studies on the safety of heated tobacco originate from Philip Morris International, which filed an application to market IQOS in the US as a “reduced exposure” and “reduced risk” tobacco product. The US approved the marketing of IQOS as a reduced exposure product in 2019. “Completely switching from conventional cigarettes to the IQOS system significantly reduces your body’s exposure to harmful or potentially harmful chemicals,” the review’s findings stated.
“The evidence is not sufficient to demonstrate substantiation of either of the claims about the reduced risk of tobacco-related disease or harm,” according to the rejection letter for the reduced risk application. To be certain about the health effects of heated tobacco use, more research is required.
