A comprehensive review of more than 200 scientific studies found that transitioning from smoking to using heated tobacco dramatically reduces the health risks of individuals indoors.
This is because the switch to smoke-free heated tobacco products (HTPs) cuts the exposure of smokers and those around them to harmful chemicals inside homes and other indoor settings.
“Considering both the aerosol content and the indoor air quality are much reduced when using HTP as compared to cigarettes, there appears to be a case to state that there is a lower risk of harm,” the study said, when comparing HTP use and cigarette smoking.
The paper titled “Heated Tobacco Products: Potentials of Harm Reduction, Improvement of Indoor Air Quality and the Need for Further Studies” found that aerosol from tobacco harm reduction (THR) products like HTPs does not produce the same harms as smoke.
“The conclusions are clear: it is not smoke, and while not risk-free, it contains only a fraction of the harmful and potentially harmful compounds (HPHCs) found in cigarette smoke,” it said.
Published in SciEnggJ, the official journal of the Philippine-American Academy of Science & Engineering (PAASE), the study was authored by Aldwin A. Camance, a chemical engineer and climate change mitigation advocate.
The paper said, “All calculations estimate a reduction in possible deaths and incidence of cancer because of switching to HTP.”
HTPs are a relatively new nicotine delivery method that does not burn tobacco unlike traditional cigarettes. The study aimed to summarize existing international research on HTPs’ toxicological impacts and their effects on indoor air quality.
A well-known brand of HTP in the Philippines is IQOS, which has been available in the country since 2020. It heats, without burning, specially designed tobacco sticks called TEREA to deliver nicotine without smoke and ash.
The Nicotine Consumers Union of the Philippines (NCUP) said the findings prove that nicotine is not the problem but the way it is consumed through combustion. “By using smoke-free methods such as HTP to deliver nicotine, people can continue to enjoy nicotine while potentially reducing pollution or harm indoors or outdoors,” said NCUP president Anton Israel.
Camance’s research found that air pollution and tobacco smoke are among the top five causes of death in the Philippines. As Filipinos spend a lot of time indoors, switching to HTPs could potentially reduce the risk of these diseases, according to the paper.
The paper analyzed 282 studies, research, books, and narratives related to HTP use. Most of these studies were sourced from PubMed and ScienceDirect databases, with data collection continuing until July 2021.
“These studies show reduced release of harmful and potentially harmful compounds (HPHC) in the aerosol and lower concentrations of HPHCs in the indoor environment when using HTPs as compared to tobacco smoke,” the paper said. This suggests a reduced risk of harm associated with HTP use.
A 90-day study found that biomarkers of exposure to HPHCs were significantly lower in HTP users compared to cigarette smokers. However, the study emphasized the need for longer-term trials to confirm these findings.
Given the significant health risks associated with smoking, Camance argued that waiting for definitive long-term studies is not feasible. “But the considerable risk of deaths due to tobacco products as provided in the foregoing discussions means that we do not have the luxury of time to wait for further and longer epidemiological studies to confirm the current observation that these HTPs do reduce the harm of use of tobacco products,” Camance said.
The paper said that if the international findings on HTPs’ harm reduction potential hold true, shifting from cigarettes to HTPs could be a valuable component of a broader program to reduce respiratory diseases in the Philippines.
