The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). Read more: 10 common questions about e-cigarettes answered Can heated tobacco help people quit smoking? Joinpoint regression was used to determine pre‐ and postintervention time points, which selects interruption based on outcome data. They also present post‐trend, after 2016 identified as key point, but no analysis of change in that trend. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Heating tobacco rather than burning is what sets IQOS apart from cigarettes, representing a better alternative than continuing to smoke. By heating rather than burning tobacco, IQOS emits 95% less harmful chemicals compared to cigarettes. 5

Blue, Green, Turquoise, Mauve and Sienna Caps HEETS are considered menthol tobacco flavours, as the predominant flavour note is mint or menthol. Blue are the traditional menthol flavour, while Mauve, Green and Turquoise incorporate notes of mint, fruit or citrus for a more nuanced and minty taste.But Stephens warns that the tobacco industry will try to push these products more aggressively all over the world. “The tobacco industry’s long-term future depends on the success of heat not burn and e-cigarettes, so they’re going to throw loads of money at this in any way they can.” The lowdown on heat not burn Birdsey J, Cornelius M, Jamal A, et al. Tobacco Product Use Among U.S. Middle and High School Students — National Youth Tobacco Survey, 2023. MMWR Morb Mortal Wkly Rep 2023; 72(44);1173–1182. HEETS are designed to last for the length of a single session; this equates to either 6 minutes or 14 puffs, whichever comes first, and is designed to be around the same length of time that it would take to smoke a cigarette. These figures are estimates based on the average user, so there's wiggle room! To make your HEETS last longer, try taking shorter gentle puffs to prolong your experience; harder and longer puffs may use up your HEETS faster. Amber, Teak, Russet and Sienna are the classic tobacco flavours, where the predominant flavour note is tobacco. Amber is the classic tobacco flavour, while the others introduce additional flavour notes like malt, oak or tea leaf for a richer taste.

Both heated tobacco and vaping are better alternatives to smoking and use electronic devices, the main difference between heated tobacco and vaping is what is used with the device itself. Heated tobacco is an alternative to smoking which uses real tobacco, whilst e-cigarettes contain no tobacco and use liquids instead. Wrong study design and outcome as formal interrupted or multiple time‐series not used to assess change in trends in smoking prevalence or cigarette sales. Method used to select interruption: interruption time point was selected depending on when IQOS was introduced to market in each prefecture Haziza C, La Bourdonnaye G, Donelli A, Poux V, Skiada D, Weitkunat R, et al. Favorable changes in biomarkers of potential harm to reduce the adverse health effects of smoking in smokers switching to the menthol Tobacco Heating System 2.2 for 3 months (Part 2). Nicotine & Tobacco Research 2019; 22( 4):549-59. [DOI: 10.1093/ntr/ntz084] [ PMC free article] [ PubMed] [ CrossRef] [ Google Scholar]

Understanding stress

Azagba S, Shan L. Heated Tobacco Products: Awareness and Ever Use Among U.S. Adults . American Journal of Preventive Medicine. 2021;60(5):684-691.

CI: confidence interval; COHb: carboxyhaemoglobin; MD: mean difference; NNAL: 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol; RCT: randomised controlled trial; RR: risk ratio. Tobacco heating systems do not use e-liquids; they heat real tobacco to produce a nicotine-containing tobacco vapour. Source: PMI study conducted under ISO standards simulating real-world scenarios and based on threshold limits established by existing air quality guidelines.Behavioural support: compensated for recording use of nicotine and tobacco products in interactive voice recording system diary Much of the research into the safety of heated tobacco comes from Philip Morris International, which applied for IQOS to be sold as a “reduced exposure” and “reduced risk” tobacco product in the US. In 2019, the US allowed IQOS to be marketed as a reduced exposure product. Their review concluded that “switching completely from conventional cigarettes to the IQOS system significantly reduces your body’s exposure to harmful or potentially harmful chemicals”. Randomised (7:7:7:7:4 ratio) to use a EHCSS‐K6 electronic HTP, EHCSS‐K3 electronic HTP, continue smoking Marlboro cigarettes, switch to Lark1 cigarettes, or become abstinent Quote: "The work reported in this publication involved a candidate reduced risk product developed by PMI Research & Development. All authors are employees of PMI". Attrition was low across all groups, with only 1 participant failing to complete follow‐up in each study arm.

In a country like Japan, use of heat not burn products is relatively high,” says Stephens. “But in Japan, nicotine-containing e-cigarettes are illegal, whereas in the UK they have been actively promoted by public health bodies. This may be one reason that heat not burn is less popular in the UK. They’re also more expensive than e-cigarettes, and much newer to the market.” IQOS heated tobacco is designed for adult smokers only; like vaping, we encourage users not to use these devices if they do not already smoke. That said, IQOS produces 95% less harmful chemicals compared to cigarettes, including 98% less carbon monoxide (CO). These figures do not represent reductions in risk; smoking alternatives are not risk-free. We didn’t find any studies looking at whether giving smokers heated tobacco products helped them stop smoking. But we found two Japanese studies looking at how cigarette sales changed after IQOS entered the market. Both found that falls in cigarette sales sped up after the IQOS launch, suggesting that heated tobacco products might replace rather than complement cigarettes.

Is heated tobacco the same as an e-cigarette?

Stephens says there are still a lot of unanswered questions about the short and long-term health impacts of using heated tobacco, and that longer-term studies are needed. But even if these products are less harmful than cigarettes, he wouldn’t recommend them. Quote: "All authors are current employees of RAI Services Company or R.J. Reynolds Tobacco Company".