Electronic heated-tobacco products 'just as harmful as conventional cigarettes' study finds

Experts say that for heavy smokers, e-cigarettes or heated tobacco is “relatively less harmful” but is still detrimental to health

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Health experts in the UAE have warned of the risks of using heated tobacco products, just as newly published research has highlighted possible hazards.

Specialists say that although devices such as IQOS may be less damaging than conventional cigarettes, their use is still likely to be detrimental to health.

Prof Mohammed Al Hajjaj, a professor of medicine and pulmonary diseases at the University of Sharjah, said that “all forms of tobacco are harmful”.

“Whether it’s heated [tobacco] or e-cigarettes or regular or shisha or whatever, it should not be recommended or advised. It’s a clear recommendation and none are safe at all,” he said.

However, he said that for heavy smokers, e-cigarettes or heated tobacco is “relatively less harmful”.

“The problem is when people start to say these are not harmful, the youth who are not smokers start to use them, thinking they’re safe,” said Prof Al Hajjaj, who is president of the Saudi Thoracic Society.

IQOS is produced by Philip Morris International (PMI), which owns the Marlboro cigarette brand and says it is “designing a smoke-free future”.

The device is one of several heated tobacco products on the market, with others including glo from British American Tobacco.

Research published this week in the journal Tobacco Control indicates that IQOS users may take more puffs than people using conventional cigarettes, increasing their “intake of nicotine and other harmful chemicals”.


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It also warns that at temperatures well below the device’s maximum, a polymer-film filter used by IQOS releases a toxic substance called formaldehyde cyanohydrin, which is on an official American list of “extremely hazardous” chemicals. PMI disputes the findings.

The latest study is not the first to indicate that there are hazards linked to heated tobacco products, also known as heat-not-burn tobacco products.

In December, an advisory panel to the UK parliament said they produced fewer harmful substances than combustible cigarettes, but still generated potential carcinogens.

Dr Bassam Mahboub, head of Emirates Allergy and Respiratory Society, said there was a need to know more about the dangers of using heated tobacco products and other cigarette alternatives.

“We think it’s still harmful,” he said.

He said evidence shows that the best way to give up smoking is to go “cold turkey” and quit all products with nicotine, rather than to use alternatives to cigarettes.

IQOS is advertised on the web on UAE-dedicated shopping portals, although online availability currently appears to be limited or non-existent.

Authorities have seized e-cigarettes and e-shishas on sale in shops in Dubai. Salah Malkawi / The National

When it comes to e-cigarettes, the UAE bans sale and importation, although the products have been available online and in some stores. Authorities have seized e-cigarettes and e-shishas on sale in shops in Dubai, while in October Dubai Municipality told shopping malls to crack down on the use of e-cigarettes.

Simon Clark, the director of a UK-based smokers’ advocacy group called Forest, which is funded by tobacco companies including British American Tobacco, said heated tobacco products should be widely available because they help smokers to give up. In countries where heated tobacco is sold, “ex-smokers swear by it”.

“We’ve done some research with smokers that’s suggested e-cigarettes are too big a leap for a lot of smokers. They don’t really replicate the act of smoking and they don’t contain tobacco, so heated tobacco [is an alternative] because it incorporates tobacco,” he said.

“Common sense suggests because there’s no combustion, they’re going to be safer. At the moment we don’t know how much safer.”

In an online information sheet, the World Health Organisation said additional research was needed to substantiate the findings of tobacco industry-funded research that heated tobacco products were less harmful than cigarettes.

Earlier this month, a report by a public-health think-tank, Vital Strategies, and the American Cancer Society revealed that 2,983 people died from smoking in the UAE in 2016, more than 90 per cent of them men. Over 14 per cent of the men in the UAE smoke, along with 1.9 per cent of women.

In October a 100 per cent tax on tobacco products was introduced in the Emirates in an effort to cut consumption, although public health experts have since called for further measures against smoking.

How does heated tobacco work?

With IQOS, a tobacco stick is inserted into a battery-powered holder, which heats the stick to 350°C (compared to 600°C when a conventional cigarette burns) so that a vapour infused with nicotine is produced.

While still inserted in the holder, users puff on the tobacco stick as they would a traditional cigarette. Because the vapour contains nicotine, heated tobacco products are addictive.

At other times, the holder is kept in a pocket charger, which contains a larger battery and which itself has to be plugged into the mains to charge, much like a mobile phone.

Electronic cigarettes, which do not contain tobacco, involve the heating up of a liquid that only in some cases contains nicotine.