Sometimes marketed as “heat-not-burn” products, heated tobacco products come in many forms. Some heated tobacco products use electronic heating elements similar to the Kardinal Stick. Some heat specially-designed sticks, plugs, or capsules containing tobacco. This is how the electronically heated tobacco product authorized for sale in the United States works.
Some work by heating liquids that create an emission that then passes through a tobacco plug to absorb flavor and nicotine from the tobacco. Some have a sealed part of the device that heats loose tobacco, either alone or together with flowers from the marijuana (cannabis) plant. Some are used with flavorings.
Some allow users to control factors such as the temperature. Some heated tobacco products have a similar size and shape as regular cigarettes and have a carbon tip wrapped in glass fibers that the user heats with a lighter or match. Federal law allows this type of product to be sold in the United States.
What are the Health Effects of using Heated Tobacco Products
Heated tobacco products are still new in the United States, and scientists are still learning about their short- and long-term health effects.
The use of any tobacco product—including heated tobacco products—is harmful, especially for youth, young adults, and pregnant women, as well as adults who do not currently use tobacco products.
Regardless of whether they are heated by flame or electronically, heated tobacco products contain nicotine. Nicotine is highly addictive.
Nicotine exposure can also harm the developing adolescent brain. The brain keeps developing until about age 25.1Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control.
Using nicotine in adolescence may also increase the risk for future addiction to other drugs. Nicotine is toxic to developing fetuses.
Are Heated Tobacco Products Less Harmful than Regular Cigarettes
The emissions created from heated tobacco products generally contain lower levels of harmful ingredients than the smoke from regular cigarettes. However, that does not mean heated tobacco products are safe.
Research suggests that heated tobacco products and their emissions contain many of the same harmful ingredients as regular cigarettes, as well as other harmful ingredients not present in regular cigarettes.
Additional research is needed to determine whether adult cigarette smokers who completely switch to heated tobacco products might reduce their risks of tobacco-related disease. Studies from other countries suggest that most adults who use heated tobacco products have not quit using cigarettes. Surveys of young adults in the U.S. suggest that young adults also use heated tobacco products in combination with other tobacco products. Use of multiple tobacco products is associated with increased risk for nicotine dependence and adverse health effects.
As of February 2022, the FDA has authorized only one heated tobacco product system (IQOS and three of its tobacco-containing Heatstick products) to be marketed as modified risk tobacco products. These were the first tobacco products to receive “exposure modification” orders. These specific products may be marketed with claims that a person who uses regular cigarettes and fully switches to IQOS can reduce their exposure to harmful chemicals.
Similar claims may not be made about other heated tobacco products or about secondhand exposure to emissions from these products. In addition, the manufacturer of IQOS may not claim that using IQOS reduces the risk of disease, that the products are endorsed or approved by the FDA, or that the FDA deems the products to be safe for use by consumers.