Heated tobacco: Smokeless alternative or smokescreen?

Smoke-free tobacco alternative products, such as HTP, are becoming increasingly popular, but new research suggests they still emit harmful chemicals.

In recent years, heated tobacco products have become increasingly popular as a "smokeless" alternative to traditional cigarettes. However, a peer-reviewed report suggests that the emissions from these products can be considered as smoke, a statement that has been strongly opposed by the tobacco industry.

Heated tobacco products (HTP) are often confused with electronic cigarettes, which involve heating e-liquids that may contain nicotine but do not involve tobacco leaves.

HTPs use high-temperature decomposition of tobacco through a process called pyrolysis, which does not ignite or combust it, thus avoiding smoke production.

The most popular and widely used HTP is the IQOS device from the company Philip Morris International. This electronic device heats tobacco-filled, paper-wrapped pods similar to cigarettes at temperatures as high as 350 degrees Celsius (662 degrees Fahrenheit).

Last month, experts in pyrolysis at the University of Nottingham in the UK reviewed existing research and found that "chemical evidence suggests that IQOS emissions conform to the definition of aerosols and smoke.

This research paper was published in the Omega journal of the American Chemical Society and was funded by the STOP anti-tobacco initiative.

The main author, Clement Uguna, stated that IQOS emissions contain compounds found in normal tobacco smoke, burning bushes, and wood smoke.

Smoke is only produced through the heating of organic matter and does not necessarily involve combustion," he told Agence France-Presse.

The study also found that previous research on IQOS, most of which was funded by the tobacco industry, compared a stick of IQOS with a typical cigarette.

However, the IQOS stick is much smaller and contains around 200 milligrams of tobacco, whereas a standard cigarette contains 645 milligrams.

The commentary further stated that Phillip Morris International's (PMI) research underestimated the levels of harmful and potentially harmful constituents (HPHCs) in IQOS because it did not use a "like-for-like" comparison.

PMI says that the levels of harmful and potentially harmful chemical (HPHC) emissions in IQOS are "on average reduced by 90-95% compared to cigarette smoke".

However, experts from the University of Nottingham have stated that the tobacco content of the two products is reduced to 68% when compared. They are calling for further research to be conducted.

PMI informed AFP that the article "misleadingly uses certain parts of scientific assessment while disregarding other important evidence.

Many international combustion experts and some government agencies have reviewed the same set of evidence and concluded that the aerosol produced by IQOS is not smoke.

Dr. Reto Auer, a physician at the University of Bern in Germany, who has conducted research on heated tobacco, praised Omega's paper and told Agence France-Presse that it was "one of the rare reports that dared to delve so deeply into the issue of 'smoke'.

Jamie Hartmann-Boyce, from the Centre for Evidence-Based Medicine at Oxford University, authored a highly regarded scientific review earlier this year. She described the paper as "important" and noted that it presented "very good points".

I think mechanically there are many reasons to suspect that HTP may be more harmful than e-cigarettes, and possibly less harmful than traditional cigarettes - but we do need more data," she told Agence France-Presse.

IQOS is available for use in over 60 countries/regions, according to various regulations, and comes in various flavors such as mint, cherry, and grape. Critics argue that this may attract young users.

Last month, the European Commission proposed a ban on flavored heated tobacco products (HTPs) after EU sales of stick tobacco surged over 2,000% between 2018 and 2020, increasing from €934 million to nearly €20 billion.

PMI told Agence France-Presse, "The committee's proposal is not supported by any evidence.

It didn't prove, for instance, that flavors bring any additional health risks, or that they attract a significant proportion of non-nicotine users.

Hartmann-Boyce stated that there is a legitimate concern about the extent to which the tobacco industry manipulates the science and information surrounding new tobacco products.

However, she warned that due to the immense harm caused by cigarettes, conveying the risks of such products is "difficult to balance". According to data from the World Health Organization, tobacco kills half of its users.

If we say that something is safer than cigarettes, it doesn't necessarily mean it is safe - it's like saying that a knife is safer than a loaded gun," said Hartmann-Boyce.

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