heat not burn products

Heat not burn products use compressed tobacco in a ‘mini-cigarette’ form in a vapouriser. Current prevalence in the UK is likely to be extremely low.

Position statement

More research is needed to understand the relative health harms from using the product and any wider social effects on smoking habits. Independent research is required for a position to be gained on the relative harms of heat not burn products as well as any potential social harms in renormalizing tobacco usage and acting a as a gateway to tobacco for non-smokers. Although current usage of the products is extremely low, trends need to be regularly monitored.

Summary

Heat not burn products were first sold in the UK in 2016. Current prevalence of heat not burn products in the UK and Wales is estimated to be extremely low (<1%). The products may be less harmful than smoking tobacco, since they do not involve the combustion of tobacco. However, there is currently insufficient research to back this claim. Any research to-date on this issue has been undertaken by the tobacco industry, and independent research and a medical evidence review from the UK government is required to gain a position on the relative harms of this product. Research is also required to understand any potential social harms of this product, in renormalizing tobacco usage and acting a as a gateway to tobacco for non-smokers.

Key points

The first heat not burn product on the UK market was Ploom, released by Japan Tobacco International (JTI) in 2014. Phillip Morris International (PMI) began selling its heat not burn product, IQOS, in the UK in late 2016. Other tobacco transnationals have also developed heat not burn devices, such as British American Tobacco (BAT) which have Glo and iFuse as part of their portfolio, however these have yet to be launched officially in the UK. Whilst there are other devices in the UK market that can vapourise tobacco leaf which are not produced by the tobacco transnationals, they do not appear to be widely used at present.

What is a heat not burn product?

Heat not burn products use compressed tobacco in a ‘mini-cigarette’ form in a vapouriser. Unlike electronic cigarettes which vapourise nicotine suspended in a liquid, a heat not burn device heats and vapourises actual tobacco, meaning they must be considered as tobacco products. Unlike ordinary cigarettes, however, no combustion of the tobacco takes place.

Prevalence of heat not burn products

Sales of heat not burn products are substantial and rapidly growing in Japan, accounting for 5.5% of the cigarette market according to the most recent estimates. At present in the UK, however, knowledge and usage of heat not burn products is low. According to a 2017 YouGov survey¹ on behalf of ASH only 11% of a sample of GB adults had heard of heat not burn devices, whilst the most recent Smoking Toolkit Study (STS)² found a very low usage of heat not burn products among their sample (<1% of past year smokers). This is likely to change in the future as these devices become more commonplace in the market.

Consequences of using heat not burn products

Given much of the harm caused by smoking is a result of the by-products of tobacco combustion it is possible that heat not burn products will be proved to be less harmful than smoked tobacco, given they do not possess this combustion element. At present however there is insufficient evidence to reach this conclusion. Almost all the research on heat not burn that currently exists has been undertaken by the tobacco industry. Because of the long record of tobacco industry manipulation and deceit over scientific and medical evidence the UK Government will need expert advice on the emerging evidence on heat not burn and other novel tobacco products.

Many within the public health community are calling on the UK Government to establish an independent expert committee to examine not just the toxicity of heat not burn devices relative to conventional tobacco cigarettes, but also the broader health and related social impacts of heat not burn products. For instance, do they act as a gateway to tobacco smoking among non–smokers?; and/or do they renormalise smoking as an activity? Further independent research is required to provide answers to these questions.

What is a heat not burn product?

¹ The survey was carried out online by YouGov for ASH; the total sample size was 12,696 adults. Fieldwork was undertaken between 16th February 2017 and 19th March 2017. The figures have been weighted and are representative of all GB adults (aged 18+). The sample was split in half, with half asked about awareness of ‘heat not burn’ as a category.

² Each monthly wave involves a new sample of approximately 1,800 respondents and detailed questions are asked of the approximately 500 respondents who report having smoked in the past year (‘last-year smokers’).