Hot on the heels of e-cigarettes, tobacco heating devices are the latest way for smokers to get a nicotine fix, without the smoke. Manufacturers are hailing their benefits — obviously — but health experts say they may not be as safe as it seems.
Geneva – Ryan Sparrow puts a small stick of tobacco in his device, heats it up quickly by pressing a button and then places the filter to his mouth and inhales with obvious relish.
Sparrow has a clearer conscience than when he was still smoking regular cigarettes. These days, he gets his nicotine fix from his IQOS device, which is made by PMI, the international arm of Marlboro cigarette maker Philip Morris. Sparrow works for PMI in Switzerland.
The company hails its IQOS tobacco heating device as a brilliant invention. It has produced studies showing that heating tobacco, instead of burning it, eliminates nearly all cancer-causing substances.
The World Health Organization (WHO), however, is not convinced.
Other cigarette alternatives, such as electronic cigarettes, which heat liquid nicotine, have existed for years. “They are banned in about 30 countries and are regulated in 60 countries,” says Vinayak Prasad, who’s responsible for monitoring tobacco use for the WHO.
That means there are rules dictating where e-cigarettes can be used and to whom they can be sold. But heating tobacco, instead of burning it, is a relatively new concept, and countries are still trying to figure out how to regulate it.
“It’s the invisible elephant in the room,” says Prasad.
In Switzerland, for example, the tax on a pack of tobacco sticks meant for heating is 12 per cent, compared with 50 per cent on a pack of normal cigarettes.
The reason? The new product is taxed as pipe tobacco. However, the price for the two packs is about the same – which means the profit on the new product is 50 per cent higher than with normal cigarettes, says the WHO.
The organization estimates that profits from heated tobacco products will soar from 2.1 billion dollars in 2016 to 17.9 billion dollars in 2021. In addition to Philip Morris, other firms making the products include Japan Tobacco International and British American Tobacco.
There are an estimated 1 billion smokers around the world, with 7 million people dying every year due to smoking, according to the WHO.
“Our position is clear: All tobacco products are dangerous,” says Prasad.
Philp Morris doesn’t deny that. “Our products are not without risk and contain nicotine, which can be addictive,” says Moira Gilchrist, who’s responsible for “scientific and public communications” at PMI.
But PMI exclusively targets adult smokers. For them, the IQOS device is a healthier alternative to smoking and helps them to quit. “Compared with traditional cigarettes, the IQOS vapour contains far fewer harmful chemicals. Our products are smoke-free,” explains Gilchrist.
However, researchers led by Reto Auer at the University of Bern wrote in a 2017 study that the IQOS isn’t actually smoke-free. Auer explains that there’s no complete combustion, but instead carbonization.
He says his study found that the smoke produced by IQOS contains the same substances as cigarette smoke, albeit in smaller amounts. Philip Morris has responded by questioning the results and Auer’s expertise, and calling for the study to be retracted – but so far to no avail.
“Such devices are like transportable toasters: A blackened piece of toast also makes smoke and is unhealthy,” says Auer.
The WHO’s Prasad also sees it that way: “To say that there is no burning is simply false. It might be possible that people who heat tobacco instead of using cigarettes are exposed to fewer dangerous substances, but that doesn’t mean the product is not dangerous,” he says.
Elsewhere in Europe, the jury is also out on the new devices. In Britain, one cancer research foundation recommends e-cigarettes as a way to help people who want to stop smoking and who have had no luck with other quitting methods.
But the government is rather sceptical about tobacco heating devices. “The available evidence suggests that heated tobacco products may be considerably less harmful than tobacco cigarettes and more harmful than e-cigarettes,” wrote Public Health England in 2018.