“Heat not burn” tobacco devices as new tobacco industry products: health risks

Abstract

Increased tobacco control measures in recent years have directed the tobacco industry to develop alternative tobacco products, such as “heat not burn” (HnB) tobacco devices that are implied to be less hazardous than conventional cigarettes. There are extensive studies from manufacturers available, which show that the emissions of HnB tobacco devices have significantly lower levels of harmful substances compared to conventional cigarettes. In addition, manufacturers have published studies to investigate whether switching from a conventional tobacco cigarette to the HnB product reduces possible health risks. The purpose of this report is to review current studies by manufacturers and independent institutions as well as to discuss possible reduced health hazards. The German Federal Institute for Risk Assessment (BfR) has carried out its own studies of selected analytes in the emissions of one HnB product confirming the lower levels of harmful substances in the emissions. The results are consistent with data from other independent studies. The nicotine content in the emissions is in the same range as the nicotine emissions of conventional cigarettes, which suggests a comparable addictiveness and dependence potential. Manufacturers have reported mutagenic effects of emissions by HnB tobacco devices that, however, are considerably weaker compared to conventional cigarettes. Nevertheless, the use of the HnB tobacco product remains associated with health risks. Switching from conventional cigarettes to tobacco heaters can significantly reduce the consumer’s exposure to harmful substances. However, this article also illustrates that it is still unclear to what extent the reduced levels lead to lowered health risks. Therefore more independent studies, but also long-term studies, are needed.