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What Is IQOS, and How Is It Different from Vaping or Smoking?


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IQOS, a new device that heats tobacco rather than burns it, has arrived in the United States. It’s being deceptively marketed as a safer alternative to vaping and smoking. Getty Images
  • Smoking giants Philip Morris and Altria have launched IQOS, a “HeatStick” that heats up rather than burns tobacco, for sale in the United States.
  • This new e-cigarette-like product is pitched to consumers as a safer alternative to vaping.
  • Medical experts say it’s too soon to declare this a safer choice, and the long-term medical risks associated with IQOS are still unknown.
  • Doctors say that, as with any tobacco product, the health risks are still high.

In the middle of a national public health crisis surrounding vaping, a new product that just hit the market is pitching itself as a safer alternative.

The makers of a so-called “HeatStick” claim their technology that “heats” tobacco is safer than competitors that “burn” it.

While this kind of smoking device might sound better in theory, doctors are warning that new technology always brings with it unknown, understudied health risks.

The jury is still out on exactly how these devices could affect health. But experts stress any tobacco-based product still poses serious health risks.

On Friday, Oct. 4, IQOS, a HeatStick brand, officially hit the United States. It’s now being sold at its first location, a mall in the greater Atlanta metro area, CNN reports, with plans in place to expand throughout the United States in the near future.

The brand has been available in 49 other countries since 2014.

IQOS looks like other e-cigarettes. It’s a long, pen-shaped device. It was first developed by tobacco companies Altria and Philip Morris when they were still one company.

Philip Morris has been distributing the product internationally, and Altria is marketing it domestically through an agreement between the two, CNBC reports.

U.S. distribution was made possible after IQOS was approved for sale by the Food and Drug Administration (FDA) earlier this year, according to a press release.

The companies say the device heats tobacco at a lower temperature than products such as traditional cigarettes, which burn the substance. They say this process releases fewer toxins to the body.

While heating rather than burning tobacco products “may produce different levels of toxins,” Dr. Michael Ong, MD, PhD, professor in residence of medicine and health policy and management at UCLA Health, told Healthline there are “likely still health risks that are not yet fully known” due to the product’s newness.

“It would be difficult to say that these are safer than other tobacco products on the market. The FDA is still reviewing the Modified Risk Tobacco Product application, so its availability in the U.S. isn’t because it’s been determined to be a ‘safer’ product,” Ong said.

Dr. Humberto Choi, a pulmonologist who leads the smoking cessation program at Cleveland Clinic, echoes these thoughts, stressing that the way IQOS is being marketed “sounds like a similar strategy” used by companies that previously pitched cigarettes and e-cigarettes to the public.

He explains that vaping devices heat a liquid that contains nicotine, among other substances. This new product instead heats tobacco-filled sticks.

Choi says it’s “premature” for anyone to make the claim that heating is safer than burning tobacco, “especially considering all the hundreds of cases of severe lung injury related to vaping.”

“An important misconception that is important to highlight is the fact that ‘vaping’ is actually not vapor. It’s an aerosol. The difference is that vapor is just a gas phase of something that is liquid or solid. Aerosol is a gas mixed with particles,” Choi said. “It’s possible that by heating a nicotine stick, aerosols will be formed and inhaled, similar to what happens to any electronic cigarette.”

The dangers of vaping have been in the national headlines in recent months.

The Centers for Disease Control and Prevention (CDC) reports that so far this year, there have been 1,299 cases of vaping-related lung illnesses in the United States, and 26 deaths have been confirmed in 21 states.

The majority of these cases have been tied to products that contain tetrahydrocannabinol (THC).

Traditional cigarette smoking causes more than 480,000 deaths each year — or almost 1 in every 5 deaths in the United States, according to the CDC.

Ong says that for people concerned about the new IQOS product, it’s important to understand that using it is essentially entering the unknown, since the definitive health risks have yet to be established.

He also stresses that even the claim that heating versus burning releases different levels of chemicals is also in question, adding that “this is dependent on how the product is used and cleaned in practice.”

CNN reports that IQOS is already in use by more than 11 million people around the world, a sign of a trend that gives doctors pause.

“We should expect to see continued development of new tobacco products beyond traditional cigarettes,” Ong said.

For Choi, the ever-growing popularity of e-cigarettes and related products like IQOS is a “worrisome trend.”

“It means that their marketing is being effective, and people are being exposed to risks that we’re not fully aware of at the moment,” he said.



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