Heated tobacco products: are they safer than cigarettes?
Risky SubstancesKey points
- The tobacco is heated rather than burned, but it is still a tobacco product with nicotine.
- Levels of some toxicants are lower than in cigarettes, but not zero.
- Most studies were funded by the tobacco industry.
- The best choice for health is quitting tobacco and nicotine entirely.
What they are
Heated tobacco products, also called heat-not-burn products, heat sticks of processed tobacco to about 350°C (660°F), producing an aerosol that contains nicotine without combustion.
What the research shows
A systematic review of 31 studies found that heated tobacco products expose users to lower levels of some harmful and potentially harmful constituents than cigarettes, but higher levels than e-cigarettes. Twenty of the 31 studies were funded by the tobacco industry, and independent long-term data were lacking (Simonavicius et al., 2019).
What really helps you quit
A Cochrane network meta-analysis found that varenicline and combination nicotine replacement therapy are among the most effective medications for quitting smoking (Cahill et al., 2013). Quitting completely brings the largest gains in life expectancy (Jha et al., 2013).
Frequently asked questions
Did the FDA say these products are safe?
No. The FDA authorized marketing of one heated tobacco system with a "reduced exposure" claim, but it explicitly does not mean the product is safe or FDA-approved.
Do heated tobacco products help people quit?
There is little good evidence that they help people stop using nicotine; many people end up using them alongside cigarettes.
Sources
- Simonavicius et al. (2019). Heat-not-burn tobacco products: a systematic literature review. Tobacco Control 28(5):582-594. doi:10.1136/tobaccocontrol-2018-054419
- Cahill et al. (2013). Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database of Systematic Reviews 2015(7). doi:10.1002/14651858.CD009329.pub2
- Jha et al. (2013). 21st-Century Hazards of Smoking and Benefits of Cessation in the United States. New England Journal of Medicine 368(4):341-350. doi:10.1056/NEJMsa1211128
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