Heated tobacco products, also known as ‘heat-not-burn’ products, produce aerosols containing nicotine and other chemicals, which are inhaled by users. Unlike e-cigarettes, which heat ‘e-liquids’ and may or may not contain nicotine and typically do not contain tobacco, heated tobacco products heat tobacco to produce vapour. Along with tobacco, they also contain non-tobacco additives, and are often flavoured. Heated tobacco products mimic the behaviour of smoking conventional cigarettes.1
Heated tobacco products heat tobacco up to 350°C (compared with 600°C in conventional cigarettes) using battery-powered heating-systems, which produces the vapour.1 Due to the lower temperature, manufacturers claim that the harmful products of combustion are avoided.2 That is, the user purportedly gets the ‘harm reduction’ component of an e-cigarette along with the mouth/throat feel of a conventional cigarette.3
The heating-system enclosed in a device can be an external heat source to aerosolise nicotine from specially designed cigarettes (such as Philip Morris’ iQOS and British American Tobacco’s Glo), or a heated sealed chamber to aerosolise nicotine directly from tobacco leaf (such as Japan Tobacco’s Ploom and Pax Labs’ Pax). The user draws on the mouthpiece to inhale the aerosol, and the device requires regular charging.1 For example, the iQOS only operates for 6 minutes, at which time it automatically shuts off. A maximum of 14 puffs can be taken from each iQOS heatstick.3
To date, there is a dearth of reliable, independent research regarding the potential risk reduction or health benefits of switching from conventional cigarettes to heated tobacco products (see Section 18B.3). There is also insufficient evidence regarding their usefulness as a smoking cessation aid vs. their likelihood to be used concurrently with cigarettes, or their potential to attract young never smokers or serve as a ‘gateway’ to combustible cigarettes (see Section 18B.4). These issues have led to public health experts and major health bodies generally calling for caution around their introduction, use, and regulation (see Section 18B.7).
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References
1. World Health Organization. Heated tobacco products (HTPs) information sheet. 2017. Available from: http://www.who.int/tobacco/publications/prod_regulation/heated-tobacco-products/en/
2. McNeill A, Brose L, Calder R, Bauld L, and Robson D, Evidence review of e-cigarettes and heated tobacco products 2018. A report commissioned by Public Health England. London: Public Health England; 2018. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/680964/Evidence_review_of_e-cigarettes_and_heated_tobacco_products_2018.pdf.
3. Davis B, Williams M, and Talbot P. iQOS: Evidence of pyrolysis and release of a toxicant from plastic. Tobacco Control, 2018. Available from: http://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2018/02/20/tobaccocontrol-2017-054104.full.pdf