Cigarette sales in Japan have decreased by 43% over the past five years, the greatest decrease in recorded history. This drastic reduction in cigarette use is a direct result of heat-not-burn products, a recent innovation that is already saving lives.
Switching to a heat-not-burn (HNB) product reduces a cigarette smokers' exposure to harmful chemicals. HNBs produce a vapor by heating the tobacco rather than burning it, like in cigarettes, to create smoke. As there is no combustion, and therefore no smoke, thousands of toxic chemicals found in traditional cigarettes are eliminated, and HNBs are proven to contain significantly less chemicals than combustible tobacco, a claim supported by the U.S. Food and Drug Administration.
In July 2020, the FDA authorized the marketing of the IQOS Tobacco Heating System with “reduced exposure” information, meaning the product contains a reduced level of a substance. In their authorization, they noted that the heating process “significantly reduces the production of harmful and potentially harmful chemicals compared to cigarette smoke”. Further, the FDA stated that the product “significantly reduces the body’s exposure to 15 specific harmful and potentially harmful chemicals” as well as “potential carcinogens and toxic chemicals”.
A study from January 2021 tested the chemical composition of cigarettes, e-cigarettes, and heat-not-burn products, referred to in the study as heated tobacco products, in addition to their toxicological impacts on respiratory cells. Published in the Journal of Hazardous Materials, the researchers made sure to test each product at the levels a consumer would. As they noted in their article, studies that have claimed to show high levels of chemicals in e-cigarettes and other reduced harm products are often the result of “unrealistic or extreme conditions”, such as extreme levels of consumption, unnaturally high e-cigarette power and temperature, and even the use of broken vapes.
The key findings from the study can be read below. The full study can be accessed here.
Heated Tobacco Products (HTP) emitted 87.4% less carbonyl compounds than a conventional cigarette. Carbonyl compounds include formaldehyde, acetaldehyde and acrolein which are incredibly harmful.
Amazingly, the levels of carbonyl compounds found in e-cigarette vapor were “at least 98.5% weaker than in HTP aerosols”.
PAH (Polycyclic aromatic hydrocarbons) levels were also significantly lower in HTPs and e-cigarettes. A puff of a HTP produced 96.2% less PAHs than a conventional cigarette puff.
E-cigarettes emitted between 64.9-78.2% less PAHs than HTPs depending on the e-cigarette.
While PAHs “generally have a low degree of toxicity”, continued exposure to them, like long-term cigarette smoking, can cause lung, skin, and bladder cancer.
This study is clear evidence that HNB products are significantly less harmful than traditional cigarettes. Further, it adds to the ever-growing body of evidence in support of electronic nicotine delivery systems as a reduced harm alternative to tobacco.
While e-cigarettes are growing in popularity in the United States, the UK, and other countries, they are still prohibited in Japan. Therefore, HNBs provide Japanese smokers with an opportunity to continue to use nicotine, which does not cause cancer and is simply addictive, while decreasing the harm they are subject to. Incredibly, the 43% decrease in cigarette sales in Japan has come without any sort of educational campaign from the government. Rather, Japan’s government has largely avoided interfering in the HNB market, allowing the industry to flourish, improving public health.
South Korea is following Japan’s lead and is seeing similar results. Increases in HNB sales in South Korea has coincided with decreases in cigarette smoking, demonstrating that Japan's success can be replicated in other nations.
This should serve as an example for the United States, where lawmakers and government agencies are constantly waging war on e-cigarettes. This has resulted in an increase in cigarette sales after decades of steady decrease. If Japan and South Korea are any indication, serious improvements in public health are possible when government stays out of the way and allows reduced harm alternatives to be marketed as safer than cigarettes.