Heated tobacco products have gained significant traction worldwide, but the debate over their health implications continues to grow. Ben Taylor, an IT consultant and long-time smoker, was curious about these devices after struggling to quit smoking with e-cigarettes. He decided to try IQOS, a product from Philip Morris International (PMI), which heats tobacco sticks without burning them. Taylor noted that the product provided a sensation closer to smoking than vaping, and it even helped alleviate his chronic cough. However, experts remain divided over the long-term effects of these devices.

Industry’s Claims and Growing Concerns

Tobacco companies market heated tobacco products as a safer alternative to traditional cigarettes, citing studies that show reduced levels of harmful substances. However, healthcare professionals are skeptical, as these studies are often funded by the industry itself. While the devices may produce fewer toxic chemicals than conventional cigarettes, many experts warn that the health risks to both users and bystanders are still unverified.

Despite these concerns, heated tobacco devices are now available in over 60 countries, with significant uptake in places like Japan and Italy. PMI estimates that 22 million adults worldwide have switched to these products, and it aims to generate two-thirds of its revenue from smoke-free alternatives by 2030. However, experts caution that heated tobacco could still pose a significant public health risk.

A Repackaged Industry Experiment

Heated tobacco is not a new concept. In 1988, RJ Reynolds introduced “Premier,” a similar device that failed within six months due to its unpleasant taste and odor. Today, products like IQOS, Ploom by Japan Tobacco International (JTI), and glo by British American Tobacco (BAT) have risen to prominence. These products rely on advanced technology to heat tobacco, rather than burning it, and are marketed with heavy influence from pop culture, including celebrity endorsements and glamorous events. Steve Aoki’s performances and high-profile parties sponsored by BAT showcase the growing presence of these products in the public eye.

Targeting Younger Audiences Through Innovative Marketing

In the United States, awareness of heated tobacco is still relatively low. A recent study found that only 8% of adults knew about these products, with just 0.5% having tried them. However, with partial approval from U.S. regulators in 2019 and 2020, PMI’s IQOS returned to the market in Austin, Texas, in March 2025. Critics argue that the marketing tactics, which target young and trendy audiences, could lead to an increase in use among teens and non-smokers. Despite PMI’s insistence that they market exclusively to adults, experts like Silvano Gallus suggest that the products are increasingly popular among younger users, raising concerns about the long-term health impact on this group.

Industry Defends Its Guidelines Amidst Growing Scrutiny

Tobacco companies have strict guidelines in place to prevent targeting minors. For example, they ban youth-oriented celebrities and verify influencer audiences. However, these efforts have been challenged. In 2019, PMI halted a social media campaign after it was revealed that an influencer, who was only 21 years old, had violated the company’s youth-targeting policy. While PMI asserts that youth use remains low globally, some surveys indicate that teen usage of heated tobacco is on the rise, particularly in Italy. This trend has sparked fears about the future impact of these products on public health.

Health Risks and Chemical Exposure

Researchers like Gallus warn that the chemicals in heated tobacco products, though fewer than in traditional cigarettes, still present significant health risks. Studies show that these devices release harmful compounds into the air, and in some cases, the exposure is even greater than that from smoking regular cigarettes. Swiss researchers argue that IQOS emissions should still be classified as smoke, as the heating process produces toxic byproducts that can harm users and those around them.

Chemical engineer Efthimios Zervas has conducted extensive studies on the fumes emitted by heated tobacco devices and found that they contain fine particles that can penetrate deep into the lungs. Some of these compounds are more harmful than those found in traditional cigarette smoke, raising concerns about their safety.

Contradictory Findings and Lack of Long-Term Data

Tobacco companies continue to claim that their products are less harmful than traditional cigarettes. However, independent studies show mixed results, with some researchers identifying over 120 compounds in the aerosol produced by heated tobacco devices. Many of these chemicals require further study to fully understand their potential health impacts. Despite claims of reduced harm, the World Health Organization (WHO) calls for further investigation into the long-term effects of exposure to these substances.

The lack of conclusive data on the safety of heated tobacco has raised alarms among public health experts. In the absence of independent research, most of the studies supporting the safety of these products have been funded by tobacco companies themselves, casting doubt on their reliability. Researchers argue that, like food and medicine, safety should be proven first before products like heated tobacco are released to the public.

The Growing Issue of Dual Usage

One of the major concerns surrounding heated tobacco products is the rise of dual usage. Many people who try these devices continue to smoke regular cigarettes, leading to an increased risk of health problems. A 2023 WHO report confirms that dual users face even greater health risks than those who only use traditional cigarettes or heated tobacco. Critics worry that the return of products like IQOS to the U.S. market could encourage dual usage, further complicating efforts to reduce smoking-related diseases.

The Uncertain Future of Heated Tobacco

While heated tobacco products promise a smoke-free future, the science surrounding their long-term health effects remains unclear. PMI claims that 72% of IQOS users have completely quit smoking cigarettes, but experts remain cautious about the potential risks of dual usage and the growing popularity of these devices among youth. As new nicotine products like e-cigarettes and chewables continue to emerge, public health advocates are calling for stronger regulation and greater transparency from the tobacco industry.

As the debate continues, one thing remains clear: the future of heated tobacco is uncertain, and the risks associated with its widespread adoption could still be far greater than we realize.