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Is heat-not-burn tobacco better for you?

A hand holds a heat-not-burn device in front of a dining table.

Oct. 26, 2020—There's a fairly new type of tobacco product on the market in the U.S. It's called heat-not-burn tobacco, heated tobacco or non-combusted tobacco. And it's sometimes marketed as a safer alternative to cigarettes. But there's more to the story than manufacturers might want you to think.

What is heated tobacco?

First, it's important to understand the difference between heat-not-burn tobacco and other tobacco products:

  • Traditional cigarettes burn tobacco to create smoke that is inhaled.
  • E-cigarettes, like JUUL and other vape devices, heat a liquid to create an inhalable aerosol that contains nicotine and flavorings.
  • Heat-not-burn products don't heat up a liquid. Instead, they heat tobacco, so the nicotine can be inhaled. But the tobacco doesn't get hot enough to burn.

One type of non-combusted cigarette has been on the market at various times since the 1990s. It uses a carbon tip wrapped in glass fibers to heat the tobacco without burning it. But a newer product, called the IQOS, uses an electronic device to heat tobacco-filled sticks, known as HeatSticks. It was just approved to be sold in the U.S. last year.

A safer smoke?

Because heat-not-burn devices don't burn the tobacco, the smoke produced may contain lower levels of harmful chemicals, according to the Centers for Disease Control and Prevention. But this does not make them safe.

The U.S. Food and Drug Administration (FDA) allows the company that makes IQOS to market its device as a "modified-risk tobacco product." It's also allowed to claim that switching completely from regular cigarettes to IQOS can reduce a person's exposure to harmful chemicals.

But these claims are based on research done by the tobacco industry. So more independent studies are needed. And in the meantime, the FDA says heat-not-burn devices are definitely not considered safe or an approved method of quitting smoking.

So what are the risks? Heated tobacco still contains nicotine, a highly addictive drug. And it contains many of the same cancer-causing chemicals found in traditional cigarettes, according to CDC. The secondhand smoke from heated tobacco may be harmful too.

And one recent study in the American Journal of Physiology–Heart and Circulatory Physiology suggests that heated tobacco may be bad for heart health. Its short-term effects on heart rate, blood pressure and arteries were similar to those in people who smoked regular cigarettes.

The American Academy of Pediatrics is also concerned that, like vaping, heat-not-burn products may become popular among kids due to the industry's marketing techniques, tempting nonsmoking teens to take up the risky habit.

No tobacco product is safe

That's the key takeaway when it comes to heat-not-burn tobacco products. If you don't use tobacco now, you shouldn't start using it—in any form. If you currently smoke and want to quit, talk to your doctor about quitting products that are approved by the FDA.

You can learn more about making a quit plan in our Smoking health topic center.

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