Heated tobacco: technology and nature of emissions
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Publication date: 2018-06-13
Tob. Prev. Cessation 2018;4(Supplement):A48
Tobacco industry launches worldwide campaigns to support the heated tobacco. No data showed that this product is more harmful than regular cigarette. We analyze 4 questions about emission of heated tobacco (formally heated not burn (hnb), but recent publication doesn’t speak anymore of “not burn”):

1 How work heated tobacco?

2 What is the exact nature of emission?

3 Are emissions less dangerous than regular cigarette one?

4 What is the influence of tobacco Industry communication on the heated tobacco emission? How tobacco is heated?

The old heated tobacco devices heated specially prepared tobacco by combustion of carbon product as in water pipe. The Revo® is the only device using this technology that remains marketed. The carbon product is burn. Emission contains CO and smoke. Very few data’s are available on emissions of this product and no risk reduction is proven in real use.

The three main electric devices use specific tobacco preparation. These products are IQOS® from PMI using Heets®, GLO® from BAT using Neostik® and Ploom® from JTI using Vapodes®. In each case the name of the device and the name of the specific tobacco use is different to offer, in some countries, the opportunity to get around the regulation on advertising, promotion and don’t paid excise tobacco taxes. The temperature of heat goes from 180°C for Ploom® to 340-350°C for IQOS®.

Emission: More 40 publications from PMI concern IQOS®. All the comparison of cigarettes emission are done using ISO 3308 norm but with the intensive Canadian pattern (HCI) of smoking.
The emission contains gases, including small concentration of carbon monoxide (CO), aldehydes, nitrosamines, black carbon and others solid particles. The solid non nicotine matter recover on filter during study of emission named tar according ISO for regular cigarette, are rename as Nicotine Free Dry Particle Mater (NFDPM) probably to avoid bad reputation of tar and protect market!
In smoking machine the level of toxic is usually more 10 times lower than observed with regular cigarette, but risk reduction is not yet demonstrates. All the PMI scientific publications announced a “potential” risk reduction, not an establish risk reduction. The nicotine delivery is sometime close to nicotine delivery of regular cigarettes, sometime lower, but in any case the nicotine is delivered in few minutes as from cigarette to produce cerebral shoot of nicotine. The produce is built to produce nicotine shoot to obtain by upregulation an increase of the number of nicotine receptor and increase tobacco dependence.
The clinical studies reported are conducted mainly in close controlled situations to control the total switch from standard tobacco to heated tobacco.
Published data in real world sustains more an tobacco risk increase than a risk reduction, because the number of complete switches from regular tobacco use to the IQOS® concern only 11% of those who use the device in Japan , with no risk reduction demonstrate, but the risk reduction may exist for these users. Most of users are dual users of regular tobacco and heated tobacco. It is clear than no benefit are expect from this dual use, but the main concern is the massive use of IQOS® by never smokers: 20% of users in the Japanese study2 and 51% of in the Italian one . Because of the strong promotion of the product the IQOS® is clearly a tobacco promotion product who increases the tobacco risk in real world.

Conclusions: Heated tobacco produces smoke and toxic emission. Heated tobacco is not a clean product. Heated tobacco is not a risk reduction product. A smoke-free world is a world without heated tobacco.
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