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Ben Taylor, an IT consultant and freelance writer, smoked for nearly 30 years starting at age 13. He tried switching from cigarettes to vaping but found the liquids unsatisfying. On his blog, he explained how vaping never fully met his needs. That disappointment led him to try IQOS, a pen-shaped device that heats, rather than burns, rolled tobacco sticks. This product was developed by Philip Morris International (PMI), a global tobacco company.

Although IQOS didn’t feel exactly like smoking, Taylor felt it came much closer than vaping ever did. “It actually tastes like real tobacco,” he wrote. Over time, he began to prefer the device due to its flavour and lack of lingering cigarette smell. He even noticed that his chronic cough disappeared after switching.

Tobacco Firms Promote Heated Devices as Lower-Risk Alternatives

Tobacco companies describe heated tobacco as a safer option than traditional cigarettes. Their internal studies show reduced levels of known harmful compounds. However, public health experts warn that these products still pose dangers to both users and bystanders. Many scientists stress that heated tobacco remains too new for its long-term effects to be fully understood.

Heated tobacco products are now available in over 60 countries and growing in popularity, especially in Japan and Italy. Their expansion into the United States is already underway, with sales beginning in Austin, Texas.

Heated Tobacco Has a Long History of Reinvention

Heated tobacco isn’t new. Back in 1988, RJ Reynolds launched the Premier, a device with a carbon tip that heated tobacco. Despite a $300 million investment, the product failed after only six months due to complaints about taste and smell. Decades later, newer electronic versions such as PMI’s IQOS, Japan Tobacco International’s Ploom, and British American Tobacco’s glo have finally achieved commercial success.

These new models feature sleek designs and aggressive marketing campaigns, including influencer promotions and celebrity endorsements. In 2019, stars like Jamiroquai and Monica Cruz appeared at product launches in Madrid and Milan. BAT has employed similar strategies, including influencer partnerships and events at Formula 1 races.

US Market Slowly Embraces Heated Tobacco

Heated tobacco remains relatively obscure in the US. A survey of 40,000 American adults revealed just 8% awareness and 0.5% actual usage. But IQOS is re-entering the market following FDA authorizations granted in 2019 and extended in 2020. The company now sells products in Austin, Texas.

PMI insists these products provide a smoke-free future by heating, not burning, tobacco. The company claims 22 million adults have quit smoking and now use its heated devices. PMI aims to generate two-thirds of its revenue from non-combustible products by 2030.

Independent Experts Raise Concerns Over Youth Appeal

Despite corporate assurances, researchers and health officials argue heated tobacco still harms human health. They criticize marketing campaigns for attracting young people, especially those who never previously smoked. These devices might become a gateway to regular cigarette use.

Tobacco firms assert that their marketing targets adults and includes measures to prevent youth exposure. PMI, BAT, and JTI all outline policies barring youth-oriented advertising. They insist they promote their products responsibly and follow applicable laws.

However, Silvano Gallus, an epidemiologist from the Mario Negri Institute in Milan, believes these products primarily target young users. He recalls promotional events in Milan and Nagoya where campaigns focused on youth engagement. In 2019, a Reuters investigation exposed PMI’s use of a 21-year-old influencer, violating their own code of conduct. PMI acknowledged the lapse but denied breaking any laws.

Gallus’s surveys indicate high use among Italian adolescents, contradicting company claims that IQOS attracts older smokers. PMI counters with Japanese government data from 2021 showing youth use below 2%. Nonetheless, researchers fear that appealing to non-smokers introduces new groups to harmful habits.

Heated Tobacco May Lead Non-Smokers to Start Smoking

In 2024, Gallus and fellow researchers tracked over 3,000 Italians aged 18–74 during 2020. Their findings revealed that non-smokers who began using heated tobacco were nearly six times more likely to start smoking.

Gallus warns that heated tobacco acts as a stepping stone to cigarette use. Although the study’s limited sample size and pandemic context affect its reliability, the trend worries experts. Critics argue the tobacco industry exploits younger demographics under the guise of harm reduction.

Heated Tobacco Marketing Mirrors Lifestyle Branding

Heated tobacco products are often promoted as luxury items. Marketing visuals include models, pools, and luxury cars, creating strong appeal among younger audiences. A study from the University of Rochester found such lifestyle-themed posts received the most engagement on Instagram.

Tobacco companies deny marketing to youth. PMI says it has no official TikTok presence and uses its X (formerly Twitter) account solely for customer care. The company also claims 82% of its IQOS users are over 29.

But health experts argue the focus on youth appeal distracts from a deeper concern—the long-term health effects remain largely unknown. Most emission studies have been industry-funded, raising questions about bias. Though these studies confirm lower toxin levels compared to cigarettes, researchers caution against interpreting them as risk-free.

Swiss and Greek Studies Highlight Harmful Emissions

In 2017, Swiss researchers challenged PMI’s claim that IQOS is smoke-free. They found that heating tobacco to 330°C still released harmful chemicals. These emissions came from pyrolysis and thermogenic degradation, processes similar to partial combustion. They concluded IQOS vapour should be regulated like cigarette smoke.

PMI disputed the study and the US FDA later criticized its analytical methods. However, other studies continued investigating chemical emissions. Efthimios Zervas from the National Technical University of Athens found fine particles and several toxins in heated tobacco vapours. Some substances, like carbonyl methylglyoxal, appeared in higher concentrations than in cigarette smoke.

Zervas insists these devices are not safe. He highlights how tobacco products constantly evolve, making scientific assessment difficult. Products often change before researchers finish analysing them.

Industry Research Lists Dozens of Aerosol Compounds

BAT studies have identified more than 120 compounds in heated tobacco emissions. One study discovered 205 compounds, 82 of which do not appear in cigarette smoke. These new substances include by-products from heating glycerol. The WHO calls for more research to assess how these compounds affect human health.

Regulatory agencies like the US FDA have approved some heated tobacco products for sale but explicitly state that approval does not imply safety. The FDA reiterates that no tobacco product is truly safe and discourages non-users—especially youths—from trying them.

Heated Tobacco: Reduced Exposure or Continued Risk?

Tobacco companies admit their products are not risk-free but argue they reduce exposure to harmful substances. PMI frames IQOS as central to a global push toward smoke-free alternatives. BAT and JTI acknowledge that nicotine remains addictive, even if heated tobacco avoids combustion.

Some experts question the science behind these claims. A 2024 paper by the European Respiratory Society disputes the 90–95% risk reduction promoted by the industry. The study found heated tobacco emits significant levels of irritants, carcinogens, and nicotine similar to regular cigarettes.

A 2022 review by the University of Bath’s Tobacco Control Research Group labelled PMI’s clinical trials as poor quality and highly biased. PMI rejected the group as unreliable without offering supporting evidence.

Dual Use Undermines Health Gains

Other smokeless products such as nicotine pouches and chewable tobacco are also gaining popularity. Sandra Mullin of Vital Strategies compares regulating them to a game of “whack-a-mole”. She warns that new designs increasingly resemble toys, raising further concerns about youth uptake.

WHO warns that heated tobacco may promote dual use—where individuals use both cigarettes and heated tobacco—reducing any potential health benefits. A 2022 UK review found insufficient evidence that heated tobacco helps people quit smoking.

Gallus and colleagues reviewed 26 studies since 2022 and found that two-thirds of heated tobacco users were also cigarette smokers. According to their analysis, dual use increases health risks and mortality.

Sophie Braznell of the University of Bath’s tobacco watchdog STOP says dual users face amplified risks and increased industry profits. PMI claims its own data shows 72% of IQOS users have completely stopped smoking. JTI and BAT declined to comment on dual usage statistics.

Public Health Remains in the Crosshairs

As IQOS returns to the US market, public health advocates express concern over growing nicotine product diversity. E-cigarettes still dominate youth markets, while sales of nicotine pouches continue to surge.

Yolonda Richardson, president of the Campaign for Tobacco-Free Kids, believes tracking future health impacts will be difficult due to varied nicotine exposure and tobacco types.

Zervas believes the burden of proof lies with the tobacco industry. “We test drugs and food before they enter the market,” he says. “Why do we wait to prove danger with tobacco?”