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Tobacco products with a twist of modernity resurface in the American market, yet solid proof of their safety is scarce.

Tobacco manufacturers promote heated products as less harmful than cigarettes; however, these items may still endanger users' health, a new assessment I contributed to in Tobacco Control indicates. The evidence regarding their health risks for smokers is occasionally inconsistent, conflicting,...

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Tobacco products with a twist of modernity resurface in the American market, yet solid proof of their safety is scarce.

Heating up tobacco products isn't just some trend peddled by tobacco corporations; it's a questionable alternative to smoking, claims Jamie Hartmann-Boyce, Assist Professor of Health Promotion and Policy at UMass Amherst. A recent review, led by Boyce, published in the Journal of Tobacco Control, dives into the nitty-gritty of these heated products, revealing jumbled evidence regarding their health risks.

Electronic devices like IQOS, Ploom, Glo, and others heat tobacco, allowing users to inhale nicotine. Unlike e-cigarettes and vapes, they use actual tobacco leaf, making them a peculiar middle ground between traditional cigarettes and vaping devices.

The proof of health risks associated with heated tobacco products (HTPs) in smokers is sparse and sometimes contradictory, making sense of the situation a challenge. The available data, collected from 40 clinical trials with participants using HTPs for up to a year, showed alterations in 143 biomarkers related to heart disease and cancer. However, drawing conclusions from this data was difficult due to limitations in the evidence. Nearly three-quarters of the studies were funded by tobacco industries, and most were conducted in restricted settings, which may not reflect real-world use.

Researchers expected to see mostly favorable health effects when smokers switched to HTPs, but the results were inconsistent. While some studies suggested HTPs might reduce disease risks compared to smoking, others found no difference or even a potential increase in risk. Quitting smoking altogether has been found to deliver more consistently healthier outcomes.

Few studies have compared the effects of HTPs and e-cigarettes directly. However, numerous longer-term, independently-funded studies have demonstrated the potential of e-cigarettes to aid smokers in quitting and reducing their health risks.

It's essential to consider the situation—HTPs might not be the panacea tobacco companies make them out to be. In Japan, these products are widely used. Although IQOS disappeared from the US market following a patent infringement lawsuit, it re-emerged in Austin, Texas in 2025. IQOS, like most HTP brands, is owned by Philip Morris International, which champions it as a "better alternative" to cigarettes. However, the science is still inconclusive, for the science on whether HTPs are genuinely healthier remains uncertain.

Our findings fail to rule out the possibility that HTPs have fewer health risks than cigarettes, but they offer little support for such claims. The long-term health impacts of HTPs are yet to be understood, as are their role in the broader tobacco and nicotine market. Despite reducing harm compared to cigarettes, HTPs may not help smokers quit, and their exact place in the market is unclear.

The Conversation is an autonomous and charitable source of analysis, commentary, and news from academic experts.

  1. The national debate about heated tobacco products (HTPs) like IQOS, Ploom, Glo, and others, which heat tobacco instead of burning it, continues amid jumbled evidence regarding their health risks.
  2. AsAssist Professor of Health Promotion and Policy at UMass Amherst, Jamie Hartmann-Boyce argues that HTPs represent a questionable alternative to smoking.
  3. A recent review, led by Boyce and published in the Journal of Tobacco Control, reveals inconsistencies in the evidence about the health risks of HTPs.
  4. The proof of health risks associated with HTPs in smokers is often contradictory, making sense of the situation a challenge.
  5. In the health-and-wellness sphere, quitting smoking altogether has been found to deliver more consistently healthier outcomes than switching to HTPs.
  6. Despite tobacco corporations promoting HTPs as a "better alternative" to cigarettes, the science is still inconclusive about their health benefits.
  7. In some countries, like Japan, HTPs are widely used, but the long-term health impacts of these products are yet to be understood.
  8. As part of the fitness-and-exercise and nutrition discussions, it's essential to consider the health risks associated with HTPs andtheir role in helping smokers quit.
Tobacco industry promotions claim that heated tobacco products may be less hazardous than traditional cigarettes, but these products may still introduce health threats to users, as per a study we jointly authored, published in the Tobacco Control journal. The available evidence on their potential health hazards in smokers is often unreliable, inconsistent, and difficult to interpret.

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