Your Health and Heat-not-Burn

Heat-not-Burn is called a safer alternative to traditional cigarettes, but is it really? On this page we will explore common questions about Heat-not-Burn and its effect on your health.

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Health

Why is Heat-not-Burn considered safer?

Heat-not-Burn is considered safer than traditional cigarette smoking because it works by heating the tobacco, rather than burning it. When tobacco is burned it releases harmful chemicals. With Heat-not-Burn the tobacco is heated enough to give the effects of the nicotine, but no harmful chemicals are released.

Is it actually safer?

‘Safer’ isn’t the right question. What we should be asking is ‘Is it less harmful?’

Unfortunately, because Heat-not-Burn is such new technology there are not enough long-term studies to conclusively determine that Heat-not-Burn is less harmful – but let’s look at the facts; Traditional cigarettes, when burned, release chemicals like carbon dioxide (toxic), arsenic (toxic), hydrogen cyanide (toxic), lead (toxic), and benzene (toxic). And that short list of chemicals is just scratching the surface of what’s in cigarette smoke – the smoke that you inhale.

Heat-not-Burn is processed differently so that when heated – not burned – it releases a flavorful vapor instead of smoke. Even the FDA has found data that supports the claim that Heat-not-Burn products reduce exposure to toxins compared to traditional cigarettes. The FDA stated that “[they] found that the aerosol produced by the IQOS Tobacco Heating System contains fewer toxic chemicals than cigarette smoke, and many of the toxins identified are present at lower levels than in cigarette smoke.”

SOURCE: https://www.fda.gov/news-events/press-announcements/fda-permits-sale-iqos-tobacco-heating-system-through-premarket-tobacco-product-application-pathway

Are there still risks associated with Heat-not-Burn?

Yes, there are still risks, but less risks than traditional smoking.

What are the risks?

Currently there’s very little research about the long-term effects of Heat-not-Burn, but right now we know that it is associated with;

tobacco related diseases, such as cancer

There is some debate about it being linked to hepatotoxicity, but currently there is no conclusive data regarding this claim.

What are the chemicals in Heat-not-Burn HeatSticks vs. traditional cigarettes?

Each brand of is different as is each flavor. Here is a variety of chemicals you can find in Heat-not-Burn vs. traditional cigarettes.

HeatSticks	Cigarettes
Glycerol	Glycerol
Glycerin	Glycerin
Propylene Glycol	Propylene Glycol
Flavorings	Ammonia
	Tripotassium Citrate
	Trisodium Citrate
	Diammonium phosphate
	Ammonium hydroxide
	Aldicarb (pesticide)
	Chlorpyrifos (pesticide)
	Cadmium
	Flavorings
	And up to 9000 other chemicals…

How safe are Heat-not-Burn Heatsticks?

To analyse the safety of HeatSticks we’ve broken a HeatStick down into two parts; the tobacco plug ingredients and the material (filters, paper, etc.).

Tobacco Plug Ingredients & Flavorings:*

Ingredient	Safety
Tobacco Plug
Tobacco	Tobacco is a natural substance that contains nicotine. Much of the danger associated with tobacco only apply when it is burnt. When tobacco burns it’s chemical make-up transforms which results in the creation of over 70 carcinogenic chemicals. Heat-not-Burn does not burn tobacco
Nicotine in Tobacco	If ingested in low doses, nicotine is safe. The idea that nicotine is dangerous has largely developed out of the fact that nicotine is addictive and is the reason people get hooked on smoking
Glycerol	Glycerol is a natural substance that comes from mixing vegetable oils and animal fats. It is generally recognized as safe by the FDA
Glycerin	The commercialized form of glycerol – for a product to be called ‘glycerin’ it must contain 95% glycerol. It is generally recognized as safe by the FDA
Propylene Glycol	Propylene glycol is a synthetic substance made by mixing glycerin and hydrogen. It is generally recognized as safe by the FDA
Water	100% safe
Cellulose	Cellulose is an organic substance that is derived from plants. It is generally recognized as safe by the FDA
Guar Gum	Guar gum is a natural substance that comes from guar beans. It is generally recognized as safe by the FDA
Sugar	Sugar is considered safe
Flavorings
Licorice Extract	Safe
Menthol	Safe
Peppermint Oil	Safe
Spearmint Oil	Safe
Cocoa	Safe
Lemon Oil & Lime Oil	Safe

Material:*

Material	Safety
Filters
Polylactic Resin/ Polylactic Acid (PLA)	Polylactic resin/ PLA is one of the main components of a polymer filter. It is safe enough to be used in medical implants, however it can be dangerous if heated to the point of melting, as it is toxic when inhaled
Cellulose Acetate	Cellulose acetate is a synthetic substance that comes from plant cells. Much like polylactic resin/PLA, cellulose acetate is generally not dangerous but can be if inhaled or ingested
Triacetin/ Glyceryl Triacetate	Triacetin/ Glyceryl Triacetate is created when glycerin is mixed with other substances. It is generally recognized as safe by the FDA
Tipping Paper and Wrapper
Cellulose	Cellulose is an organic compound derived from plant cells. In general, it is considered safe
Calcium Carbonate	Calcium carbonate is a natural ingredient. It is safe but experts warn against ingesting it in excess
Aluminium Foil	In general aluminum foil is safe. There is a risk of aluminum leaking into the contents at high temperatures, however the exposure would be very minimal
Carboxymethylcellulose/ sodium salt	It is generally considered a non-hazardous material, however it can cause bowel inflammation if ingested in excess
Adhesives
Ethylene-Vinyl Acetate (EVA) Copolymer	Ethylene-vinyl acetate (EVA) copolymer, sometimes called Polyethylene-vinyl acetate, is considered not hazardous. It is actually a safer alternative to the previously used polyvinyl chloride, because ethylene-vinyl acetate does not contain chlorine

NOTE*: Unfortunately we can’t fit every ingredient and material, from every HeatStick brand on these charts so we’ve included only the most notable – generally anything that comprises 0.5% of HeatStick composition or higher.

For a full listing of ingredients and materials in HEETS, click here. For a full list listing of all other HeatStick brands, check the ingredients listed on your HeatStick package and/or contact the manufacturer.

Are nicotine-free HeatSticks safer than HeatSticks with nicotine?

There’s no evidence to show that they are. In fact, they may be less safe because there is less regulation over them than there is over HeatSticks that contain nicotine.

How safe are Heat-not-Burn devices?

Once again, each brand is different. Here is a chart of the types of materials commonly found in Heat-not-Burn devices and their level of safety;*

Material	Safety
Body of Device
Aluminum	Under high temperatures aluminum can begin to seep into surrounding objects, however most aluminums are treated by the process of anodization. This helps prevent pyrolysis and makes the metal safe to use under high temperatures. The risk of pyrolysis with a Heat-not-Burn device is very minimal
Aluminum Alloy	Just like aluminum, aluminum alloy is almost always treated and so is safe. The risk of pyrolysis with a Heat-not-Burn device is very minimal
Stainless steel	Much like aluminum and aluminium alloys, stainless steel can leach nickel into surrounding objects under high temperatures, however most stainless steels are treated to prevent this. The risk of pyrolysis with a Heat-not-Burn device is very minimal
Polycarbonate (PC)	Polycarbonate is a type of organic heat resistant plastic. It is generally quite safe
Polyphenylsulfone (PPSU) (PPSF)	Polyphenylsulfone (PPSU) (PPSF) is a type of heat resistant plastic, frequently used in baby bottles. It is generally quite safe
Polyether Ether Ketone (PEEK)	Polyether ether ketone is a type of organic, high-performance thermoplastic. It is generally quite safe
Battery
Lithium-ion	Lithium-ion batteries are on the most common batteries available. They can be found in everyday devices such as cell phones, cameras, and HnB devices. Lithium-ion batteries get a bit of a bad name seeing as they are classified as ‘dangerous and prohibited items’ by mail carriers and airlines. However, they are one of the safest batteries on the market, providing that they are handled properly. There is some concern over the fact that they can explode without warning, however these instances are rare. Lithium-ion battery technology is constantly improving and becoming safer

NOTE*: We’ve included only the most notable materials – generally anything that comprises 0.5% of device composition or higher.

I heard that polymer filters in HeatSticks can be toxic, is that true?

A 2018 study funded by the Tobacco-Related Disease Research Program (TRDRP) of California found that, when heated to 90°C, the polymer filters in IQOS HeatSticks (HEETS) melted. This released “formaldehyde cyanohydrin (glycolonitrile), an acute toxicant often used in the production of synthetic resins and used as a solvent.” The study found that with each use the polymer filter incurred more damage, however it is recommended by the manufacturer that an IQOS HeatStick only be used once, then discarded. It is important to note that the study called IQOS “well manufactured” and did not call for the removal of IQOS from the market. Rather, it recommended “further safety testing.”

SOURCE: https://www.researchgate.net/publication/323781469_IQOS_Evidence_of_pyrolysis_and_release_of_a_toxicant_from_plastic

Is Heat-not-Burn safer than vaping?

In general vaping is considered safer, however both vaping and Heat-not-Burn are classified as ‘reduced risk’ and ‘harm reduction’ products.

Do you feel better using Heat-not-Burn?

Everyone is different, but alot of users say they feel better. Some of the common user testimonials are;

Increased energy
Clearer lungs and airways/no longer breathless
More restful sleeping
Improved taste for food
Regulated heartbeat
Less mucus

Moreover, alot of people say that they no longer smell like smoke and the yellow stains on their skin and/or teeth have faded.

Can IQOS cause liver damage (hepatotoxicity)?

There is currently not enough data to know for certain. This issue was raised by the University of California, San Francisco, which published a study claiming that IQOS does cause hepatotoxicity. Philip Morris, the maker of IQOS, responded by calling into question the University of California’s research methods which focused only on a small test population. More studies are needed.

Did the FDA approve IQOS?

No, the FDA did not approve IQOS; they gave it Pre-Market Approval in April of 2019, and then in July of 2020 ruled that it could be classified as a modified-risk tobacco product. So what does this mean?

Pre-Market Approval: Receiving FDA approval means that the United States Food and Drug Administration (FDA) believes the benefit of a product outweighs the potential harms. Receiving Pre-Market Approval means that the product had been granted entry into the American retail market but was not yet deemed “safe” by the FDA. This means, essentially, that IQOS had been allowed into the American market because the FDA strongly believed that it could be beneficial enough to outweigh potential harms, but didn’t know at the time. To learn more, click here.

Modified-Risk Classification: Being classified as a modified-risk tobacco product means that the FDA has conducted their own testing and scientific evaluations of IQOS and has deemed it to pose “significantly lower risks to individual users and benefits the population as a whole.” So what the ruling means is that, within the United States, IQOS can now be marketed as less harmful than traditional tobacco products, not just for the user, but for all people who come into contact with that product. To learn more, click here.

SOURCE: https://www.fda.gov/tobacco-products/advertising-and-promotion/fda-authorizes-modified-risk-tobacco-products

Can we trust the studies?

Well that depends, can we trust the source? Studies funded by Big Tobacco: Any study conducted by a Big Tobacco company (PMI/Altria, BAT, KT&G, etc.) should be taken with a grain of salt. These are companies that profit from the sale of Heat-not-Burn products. They don’t want studies going around that say Heat-not-Burn isn’t safe. Can we really trust their results? Studies funded by anti-tobacco groups: Do you even need to ask? Studies conducted by governments: It depends which country but, in general, where there is government, there is lobbying. Just look at the anti-vaping movement in the United States. Studies conducted by educational institutions (universities, colleges, etc.): These studies tend to be pretty unbiased but make sure that you read the fine print. By that we mean, check the document for a Conflict of Interest Statement or for an acknowledgement of funding. Sometimes companies, lobbyists, etc. will fund research studies at educational institutions. Once an institution accepts money from a biased source, the study is no longer impartial. Independent studies: These are studies that are funded by/conducted by private individuals or companies. They tend to be pretty fair but, once again, do a big of extra research if you’re not sure.

What is pyrolysis and how does it effect my health?

Pyrolysis is a decomposition of material as a result of high-heat. Sometimes when pyrolysis occurs toxins can be released from the material. There is some concern that HeatStick components can fall victim to pyrolysis, specifically polymer filters. A 2018 study showed evidence that IQOS HEETS filters did undergo slight pyrolysis, which altered the chemical compound of the filter. However the study concluded that more research needed to be done before it could be confirmed whether the pyrolysis posed a hazard to human health. For now, just make sure you change your HeatStick with every use.