Heat not Burn could gain from new FDA strategy

There’s been a lot of excitement among American vapers about Friday’s announcement from the FDA. The big news was that the deadline for submitting paperwork under the Deeming Regulations, which was set to wipe out 99% of all vapour products next November, has now been delayed for four years. But there was a lot more to the FDA’s announcement than that, and some of it is also important for Heat not Burn.

In his speech on Friday morning, FDA commissioner Scott Gottlieb outlined a new anti-smoking strategy for his agency. For the first time the FDA has publicly admitted that there’s a spectrum of risk for nicotine products, with traditional cigarettes at one end, nicotine replacement therapy at the other, and a whole range of products like e-cigs and HnB in between (in reality, very close to the NRT end). This moves the agency away from seeing reduced-risk products as another kind of cigarettes to acknowledging them as a potential solution.

As well as pushing back the deadline for Pre Market Tobacco Authorization submissions, Gottlieb says he’s also planning to make it easier to submit them. Up to now the process has been a complete nightmare. According to the FDA an application takes about 500 hours to complete and costs around $300,000 per product. Those who’ve actually done it say it takes thousands of hours and costs well over a million. Worst of all, it’s hard to tell exactly what should be in it. The FDA guidance document is 500 pages of impenetrable legal guff that nobody can understand, so for most businesses filling out the paperwork is guesswork – and, after spending all that time and money, there’s no guarantee the application will be accepted.

Expensive rules, unclear outcomes

So far we only know of one PMTA application for an HnB product; in March, PMI submitted one for their popular iQOS. That’s now under review by the FDA, although it could take more than a year for it to be approved or declined. The industry will be watching closely; if iQOS is approved it opens the door for rivals like BAT’s Glo, although iQOS will have a useful head start.

The PMTA process has been worrying a lot of people, because it hasn’t been clear how strict the FDA were planning to be. Up to now they seem to have looked at new nicotine products as a menace that should be kept off the market, and that was obviously bad news for HnB. There was a real risk that they’d want to avoid the “mistake” they’d made by letting e-cigarettes get onto the market, and take a hard line from the beginning.

Gottlieb’s new direction could change that. The FDA now seems interested in having healthier options available, and encouraging smokers to switch to them. Although the companies making HnB products are being careful so far not to call them reduced risk, there’s no doubt that they are. If the FDA has been keeping up with the science, they know that too.

Bad science strikes again

It has to be said that the FDA’s strategy has a huge problem. From what Gottlieb said, it seems that they want to cut the amount of nicotine in cigarettes as a way to force smokers towards alternatives. However, it’s not so clear why this should work. After all, we have evidence from when something similar was tried before.

Tobacco controllers still love to rant about how the industry “lied” to smokers when they released light cigarettes in the 80s and 90s. What they don’t mention is that it was tobacco control who pressured the industry to do that. The result, of course, was that people simply smoked more and took deeper puffs; they ended up inhaling exactly the same amount of nicotine, but a lot more toxic smoke.

Now the FDA seem to think they can try the same trick again but get a different result, which just begs for comments about the definition of insanity. To be fair they might get a different result this time, because now there are real alternatives to smoking, but it’s more likely they’ll just create a massive black market in smuggled high-nicotine cigarettes.

What will decide that is how effective the alternatives are at delivering nicotine. If the FDA’s brave new cigarettes aren’t very satisfying, but neither are the safer choices, most people will just either smoke more or call their dealer and ask when the next batch of proper Marlboro are due in from Mexico. On the other hand, if cigarettes don’t give enough of a nicotine hit but other products do, then people are a lot more likely to switch.

Vape or heat?

So far that’s been the big problem with e-cigs; unless you have decent kit and know how to use it, the nicotine hit isn’t as satisfying as a proper cigarette. Experienced vapers can completely turn that around, but for a beginner – especially somewhere like the EU, with its stupid 20mg/ml cap on liquid strengths – it can be a struggle to get as much nicotine as you’re used to.

Now a leading tobacco harm reduction researcher has compared a HnB product – iQOS – against both cigarettes and e-cigs. The results are interesting, especially in the context of Gottlieb’s plan.

Dr Konstantinos Farsalinos, a cardiologist at the Onassis Cardiac Surgery Centre who’s well known for his research into the safety of vaping, compared the amount of nicotine delivered by a tobacco cigarette, several e-cigs ranging from cigalikes to an advanced mod, and the iQOS. What he found was that while the iQOS still isn’t as efficient as a cigarette, but it comes very close – and it’s well ahead of the sort of e-cig people usually try when they think about switching.

If Gottlieb does push ahead with trying to cut the nicotine in cigarettes, a lot of US smokers are going to be very unhappy. Some of them – those who live near Canada or Mexico, for example – will probably just nip over the border to do their shopping. But the rest might be tempted by a product that has a familiar cigarette company brand, is distributed through the same retailers and delivers almost as much nicotine as their cigarettes did. This could be just what it takes to help Heat not Burn become huge in the USA.

Heat not Burn takes off in South Korea

When someone mentions Korea most of us think of the mad regime in the North. That’s a pity, because South Korea is much nicer – and, if you’re a fan of Heat not Burn, it’s also a lot more interesting right now. South Korea is now an expanding market for the leading HnB products, so much so that a local company is planning to join in.

Unlike its bizarre Stalinist neighbour South Korea is an advanced industrial country, with a relatively low smoking rate of 19.9% – slightly lower than Germany, but slightly higher than Japan. It also has tough anti-smoking laws that make it illegal to light up in almost any public place. The government is pretty serious about persuading its citizens not to smoke.

Unfortunately it has a couple of serious problems. The first, and probably the biggest, is the army. The country has the world’s sixth-largest standing army and second-largest reserves; in total it can mobilise 3.7 million troops, and all South Korean men have to do an obligatory 21 months of military service. This is a great way to defend against insane, highly militarised neighbours, but not so good if you’re trying to stub out smoking.

Soldiers smoke, often because it gives you something to do while you wait for the army to decide what’s happening to you next, and lots of Koreans pick up the habit while they’re in uniform. That 19.9% smoking rate? It breaks down into around 5% of South Korean women, but about 40% of men.

At the same time, vaping hasn’t really taken off in Korea the way it has in the UK or USA. It is possible to buy e-cigarettes, and there are some local manufacturers, but it hasn’t made a big dent in the smoking figures. Now, major tobacco companies are wondering if Heat not Burn can do a better job.

Here comes iQOS

HnB products are very new to the South Korean market; Philip Morris released its popular iQOS device on 27 May, and now has two stores in Seoul (if you like Korean music you’ll be pleased to hear that one of them is in Gangnam). They’re also selling the iQOS through the CU convenience store chain, which has about 3,000 branches across the country.

Philip Morris say they don’t have any firm sales figures yet but are seeing “growing popularity”. That sounds about right; an employee at a CU store says, “They have been all sold out every day.” It wouldn’t be surprising if this is the case because iQOS continues to do very well in Japan; it took a 0.8% share of the cigarette market in the first quarter of 2016, but had climbed to 4.5% by the end of the year. PMI say it’s now at around 7%.

With the iQOS apparently doing well in South Korea, British American Tobacco are aiming to introduce their rival Glo device in August. Glo is a similar format to iQOS and BAT Korea say they’ll be selling it at a slightly lower price. If they can get the device and its NeoStiks into enough shops it’s likely to catch on too.

A home-grown rival?

The global tobacco companies can’t expect to have it all their own way, though. HnB devices are consumer electronics, and when it comes to developing and manufacturing these South Korea is one of the world’s giants. The country that’s home to companies like Samsung and LG isn’t likely to let imported electronics flood its home market, is it?

No, it’s not. Clearly impressed at the popularity of the new technology, one of South Korea’s own tobacco companies is already looking at moving into the market. KT&G (it stands for “Korea Tomorrow & Global”, but used to be “Korea Tobacco  Ginseng”) is the country’s largest tobacco manufacturer. It’s a major player locally, with 62% of South Korea’s cigarette market, and its Esse superslim brand is also popular in Russia and Eastern Europe.

Now KT&G want to release a HnB product to take on Glo and iQOS – and they’re not hanging around. According to the company they’ve been watching the heated tobacco trend since 2012 and want to have their own device on the market by the end of this year.

That’s quite an ambition. If they can pull it off, they’ll be in on the ground floor with PMI and BAT. The multinationals will have a bit of a head start, but not enough to let them build up real dominance, and that’s likely to be balanced by consumers’ familiarity with KT&G brands.

The real question is what will the product be like? Unfortunately KT&G haven’t released any details yet, but if they think they can get in on the shelves by the end of the year – even as a trial product – then its design must already be fairly advanced. A HnB device isn’t something you can just throw together; PMI have invested more than $3 billion in iQOS so far, and BAT can’t have spent much less on Glo.
iQOS is the latest version of a basic concept first trialled in 1998, as Accord, then redeveloped in 2007 as Heatbar.

 

So will it happen?

If KT&G are going to have any chance at all of getting a product on the market by December, it would need to be pretty much ready to go into production by this point. That means it would need to have been tested already, and probably tried by a good number of consumers to get their feedback on it. If this has been done, it’s been done unusually discreetly – we can’t find any details or images of a KT&G device anywhere.

Of course, South Korean companies are very good at keeping innovations quiet until they’re ready to start marketing them, so it’s very possible that KT&G really do have a product ready to launch over the next few months. If they do, it will be interesting to see how it compares to
iQOS, Glo and other existing devices. Hopefully we’ll know more about it – and whether it will be marketed outside South Korea – soon.

What Effects Might Heat Not Burn Have?

As Heat not Burn products become more popular they’re steadily generating debate among the public, health activists and scientists. So far, the medical profession want to know how much safer they are than traditional tobacco products. Activists want to know if they’re part of a cunning plot to create more smokers. Smokers want to know how good they taste. This already seems like quite a lot to discuss – but it turns out some people are already thinking a lot further.

A few days ago Heat Not Burn UK had the opportunity to interview David O’Reilly, the director of science, research and development at British American Tobacco. David is a real expert on HnB and I had a fascinating discussion with him (so expect to see his name a few  times on this blog over the next month or so), and he’s been thinking way ahead of just about everyone else I’ve spoken to.

This Is The Future

One thing David was very clear on is that BAT, like Philip Morris, see non-combustible products as the future. While I was talking to him I noticed that he mentioned, more than once, moving to HnB. Eventually I asked him if he saw it as expanding their product range or repositioning it. “Our customers are moving to safer products,” he said. “We can move with them, or go out of business.” So BAT definitely seem committed to technological change.

What I hadn’t thought about was how far-reaching these changes could be. One of the products we talked about was Glo, BAT’s heated tobacco product. Glo uses “Neostiks”, similar to the Heets that feed PMI’s iQOS, and as you probably know there really isn’t a lot of tobacco in these. David explained just how inefficient a traditional cigarette is; about 90% of the tobacco in it ends up either in the filter or escaping as sidestream smoke; only about 10% of it is actually inhaled.

With a Glo this inefficiency just doesn’t exist. A Neostik has a filter but, like the one on a Heet, it’s mostly just there to give a familiar cigarette-like fee; it’s small and permeable enough that it traps very little of the vapour. Meanwhile there’s no sidestream problem either. In fact once a Glo is powered up and at working temperature it’s generating vapour constantly, but this stays in the heating chamber until you take a puff and inhale it – it doesn’t escape.

The end result is that a Neostik contains about 10% as much tobacco as a traditional cigarette, but it’s pretty much equivalent to it; if you smoke a pack of twenty every day, you’ll probably get through a pack of twenty Neostiks when you switch to Glo – but that’s as much tobacco as just two cigarettes.

Consequences?

I have to admit, I was sitting there making admiring noises about this efficiency when David said, “Of course, we have to think about what effect that will have on the tobacco farmers.”

Well, of course we do. After all, tens of thousands of people rely on tobacco farming for their livelihood. Many of them are in poor countries, too. A 90% fall in tobacco production could have a devastating effect on their economies. Tobacco controllers sometimes argue that tobacco takes up farmland that could be used for food, but the truth is the world isn’t short of food. When famines happen, which is a lot less often than they used to, it’s generally because there’s no way to get the food to the people who need it. Cutting tobacco production by 90% isn’t going to solve world hunger, but it could make a lot of people unemployed.

Then again it might not. The truth is, right now we simply don’t know. Will tobacco production fall significantly in the first place? We don’t know. A lot of it depends on what sort of reduced-risk products smokers actually move to. If they all switched to Glo then yes, a lot less tobacco would be needed. But so far the most popular alternatives are snus and e-cigarettes. Snus is made of tobacco, and e-cigs need nicotine – which is extracted from tobacco.

The most likely outcome is that there will continue to be a range of products, including snus, dissolvables and e-cigs as well as Heat not Burn devices. Total demand for tobacco will probably fall, but not dramatically at first. From the point of view of the farmers that’s likely to be good news. If demand changes gradually they can adjust and cope with it; it’s a sudden shock that would cause mass poverty.

What matters is that people are thinking about issues like this – and they are. Ironically it’s the tobacco industry, usually painted as the villain of the piece, who’s looking into the possible future effects of changing technology. Public health tend to just dismiss the fate of tobacco farmers, airily assuming that they can all start growing organic quinoa instead. Unfortunately life is rarely that simple.

Upping Their Game

The tobacco industry has a bad reputation, and leaked documents from the 1960s and 70s show that, a few decades ago at least, it was far from undeserved. They do also deserve some credit, though. BAT’s research facility in Southampton has been trying to develop a safer cigarette for decades; now they’ve abandoned that apparently hopeless quest and moved on to alternative products instead. They might have been late to the game on HnB and e-cigs, but they’re putting a lot of time and resources into it now.

In the last ten weeks I’ve spoken to researchers and senior executives from two of the world’s largest tobacco companies, and the impression I get is that they’re very serious about harm reduction. It’s unrealistic to expect them to stop selling cigarettes tomorrow, but they seem very determined to stop selling them at some point in the not too distant future. Another thing David O’Reilly, his colleagues from BAT and their opposite numbers at PMI all stressed to me is that products like Glo, iFuse and iQOS are early iterations of the technology. Some very clever people with very large research budgets are already working on improved versions that are simpler to use and give even better performance. The future for Heat not Burn, and every other category of reduced-risk tobacco product too, is looking very exciting.

iQOS Update – What’s Inside A Heet

One of the most popular pages on this site is our review of Philip Morris’s innovative iQOS device. That’s not much of a surprise, because iQOS has probably had more publicity than any other Heat not Burn product and it’s also the most widely available. It’s steadily rolling out beyond the first test markets and can now be bought in the UK, Spain, the Netherlands and several other countries; before too long it will be available globally, and I think it’s going to be a huge success.

When Heat not Burn UK first tested the iQOS the only sticks that came with it were mild menthols. Those were not as satisfying as they could have been, but did prove the concept. Happily, during our visit to PMI’s research centre at Neuchatel a couple of months ago there was no shortage of them in all flavours, and I got the chance to try an iQOS with a full-strength stick. I’m happy to report that it was very close to the experience of smoking a Marlboro, and an excellent substitute in every way.

Sticky Stuff

Obviously, what made the difference between “Meh, this is okay” on the first iQOS test and “Wow!” on the second one was the sticks it was being fed with. That means it’s probably time to look at the sticks themselves in a bit more detail.

The baby cigarettes that go in the end of an iQOS were originally called HeatSticks, but they’ve now been rebranded as “Heets from Marlboro”. Currently Heets come in three flavours – Amber, which roughly equates to full-strength Marlboro Red; Yellow, a lighter Marlboro Gold; and Turquoise, the mild menthol version. As far as I can tell these all have the same nicotine content, and the only difference is in the flavour.

Anyway, I just called them baby cigarettes. They’re not. Yes, they look like baby cigarettes, and they come in a tiny pack of twenty, but you can’t stick them in your mouth and fire them up with your trusty Zippo. That just won’t work. Even if it did work it would be pretty pointless, because the whole idea is that you don’t burn the tobacco.

In fact there really isn’t a lot of tobacco in there to burn, anyway. Looking at a Heet, you can see that the filter seems to take up about three-quarters of its length:

There are quite a few bits in here.

Not Just Tobacco

It’s not quite this simple, but we’ll come back to that. What’s in the other quarter is the stuff that gets heated, and I’ve actually had the chance to watch it being made in the factory at Neuchatel. PMI made me promise not to put all their trade secrets on the internet, but I can tell you the basics. What they do is blend selected tobaccos to get the flavour they want, then grind them to a fine powder. This is then mixed with water and some other ingredients – vegetable glycerine to keep it moist and generate the vapour; natural cellulose fibres to bind it; and guar (a natural gum) to hold the whole lot together.

This liquid mixture is sprayed onto a conveyor belt, run through a dryer then peeled off in thin sheets. The brown stuff in the end of a Heet is those sheets, rolled up like tobacco leaves in a cigar. When you load a Heet into your iQOS a steel blade in the device cuts into the roll, and when the blade heats up it creates the vapour for you to inhale. That vapour is mostly VG, loaded with aromatic flavours from the tobacco – which is why iQOS can replicate the flavour of a cigarette in a way that e-cigs can never quite manage.

So what else is in a Heet? Well, it’s not just the filter. In fact the filter itself is very short, as you can see:

From left to right: The tobacco, hollow tube, PLA and filter.

The actual filter is even smaller than the plug of tobacco at the other end, and it’s really only there to give you the familiar feel of a cigarette filter. Because iQOS doesn’t produce all the harsh combustion compounds you get from a cigarette there’s no real need for much filtration, so it can be very short. In fact if it was much longer it would probably soak up a lot of the VG vapour that you want to inhale.

After the filter is a loose roll of PLA, a very stable, food-safe plastic material. This is what does the real work; it slows the vapour down without absorbing it, giving it time to cool to a more pleasant temperature before you inhale it. This takes up almost half the length of the entire Heet.

Between the PLA and the tobacco is a short length of hollow tube, made of a similar material to the filter. As far as I understand it this is mainly to keep the blade away from the PLA and give the vapour a clear path to start its journey through the Heet. Then finally, at the end, you’ll find that little plug of tobacco.

Small But Complicated

So a Heet might look like a cigarette, but inside it’s a bit more complicated. This, and the fact they’re so small, means they’re also trickier to make; PMI had to do some creative rebuilding of some old but reliable cigarette-making machines to come up with something that would make Heets.

All this effort has paid off, though. It might be tiny, but a Heet will give as many puffs as a full-size cigarette. If you get the strength that suits you those puffs are just as satisfying, too. I had a few lingering doubts about iQOS after my first experiment with it in Poland last year, but using an identical device with Amber Heets was a totally different experience.

What’s most exciting is that, while iQOS isn’t the first generation of this technology, it’s still at a relatively early stage; there’s a lot of potential for development in there. I’m increasingly sure that HnB products like this have a very bright future in front of them.

If you are looking for HEETS at a fantastic price

E-cigs don’t work everywhere – Heat not Burn does

I’m a freelance writer, and I love e-cigarettes. Since I switched to vaping my desk isn’t cluttered with smelly ashtrays anymore, and I don’t have to brush ash off my keyboard twice a day. I spend most of the day at my PC, so I can keep a charger on the desk for my batteries and there’s a nice long USB cable for pass-through mods. The top shelf in one side of the desk holds an assortment of e-liquids; in my job, vaping works perfectly.

On the other hand, before I became a writer I spent years in the British Army. Like many soldiers I smoked, and I remember a lot of early mornings happily puffing away in some cold, wet forest. No matter how soaked, frozen and miserable you get, a cigarette is a reliable way to inject some very welcome morale into your life.

The thing about cigarettes, of course, is that they couldn’t be simpler. You take one out the pack, stick the brown bit in your mouth and set fire to the other end. Unless you’ve let them get soaked, or you’ve sat on the packet and squashed them (a waterproof tobacco tin will avoid both these issues) they’re guaranteed to work.

War is hell – for e-cigs

But how is an e-cig going to cope with the hardships of a soldier’s life? All the liquid is probably going to leak out, turning the contents of your pocket into a slippery mess. The tank’s probably going to get broken the first time you trip over a stump in the darkness and fall flat on your face. The ability of most box mods to survive being soaked with rainwater is pretty dubious. Worst of all, your batteries aren’t going to last forever and there won’t be any USB ports in the tree you’re living under. E-cigarettes are great as long as you’re surrounded by civilisation, but they’re not going to work out in the field.

It isn’t just soldiers, either. What if your workplace is the deck of a trawler? The first wave that knocks you down, and leaves you flailing around in a pool of seawater and fish guts, is going to destroy every electronic device in your pockets. Let’s not even start thinking about rebuilding a coil in a cramped cabin that’s rolling through sixty degrees.

So it’s pretty obvious that there are some people who e-cigarettes just aren’t going to work for. But does that mean they’re doomed to a lifetime of smoking? Not so fast. There’s probably a heat not burn product that’s going to work just fine.

What’s the solution?

Last month I visited Philip Morris International’s research facility at Neuchatel in Switzerland, where they’re making the Heets that feed their iQOS device as well as working on the next generation of HnB technology. It was a very interesting visit – I’ve already discussed their latest research on safety – and left me feeling very optimistic about the future of heated tobacco products. There were some lively discussions, too, and during one of these I explained that I’d been a soldier for a long time and, based on my experiences, I didn’t think iQOS was going to be much use in the field. The PMI rep didn’t even blink. “We know,” she said. “That’s why we’re working on three other products.”

One of those products is the Mesh e-cigarette, which is already on the market. I have one, and it’s pretty good; the Mesh is an extremely simple and fairly sturdy gadget, and its disposable cartridges are more compact and probably a lot tougher than cigarettes, but if you’re doing hard work outdoors in bad weather it has the same drawbacks as any other e-cig; it isn’t very waterproof, and it needs charged a couple of times a day. Then there’s a completely different product in the development pipeline that isn’t HnB, but isn’t an e-cig either; it uses a chemical reaction to create a nicotine-containing vapour. The interesting thing about this is that it doesn’t need any batteries, so it might be a good solution for people who don’t have regular access to a charger; that depends on how robust it is, and I can’t comment on that because I haven’t seen one yet.

That’s three of PMI’s Smokefree nicotine products. The fourth one is a heat not burn product that uses the same concept as RJ Reynolds’s Revo. It’s a disposable item that contains a stick of processed tobacco and a charcoal pellet that provides the heat. All you have to do is light the pellet and puff away.

Revo isn’t really a new product; it’s basically a rebranded version of the 1990s Eclipse, which was a complete flop. Reynolds relaunched it under the new name because they decided the market had moved enough to make it viable this time around, but it’s still basically the same thing. I’m not very familiar with it but I do have some doubts about how effective it is.

So far, at least, those doubts don’t apply to the PMI product, which the company are currently calling Platform 2. It works on the same principle as the Revo, but it’s a completely new design. That gives PMI a chance to iron out any bugs, and hopefully come up with something that delivers a consistent vape with no risk of accidentally burning the tobacco.

Keeping it simple

The benefits of this sort of design are obvious. If you can manage to smoke, you can use a HnB product like Revo or Platform 2. It works exactly like a cigarette; you just have to take it out the pack, put it in your mouth and light it. There’s nothing fiddly to play with, it doesn’t need electricity and it’s no more vulnerable to the weather than a cigarette. In fact it’s probably less likely to get damaged by water; Revo has a metal foil tube to hold the tobacco, which is a lot more waterproof than cigarette paper.

A lot of smokers have switched to vaping – probably over ten million by now – but it’s not going to work for everyone. Improved technology will eventually increase battery life and make the hardware easier to use and more robust, but it’s not likely e-cigs will ever be as simple as a traditional cigarette. Heat not burn has the potential to solve that problem, because the basic principle – get some tobacco and heat it – is a lot more flexible. Inside a few years there will be HnB products that anyone can use, no matter how tough their job is.

 

Heat Not Burn Safety Update

Over the last year we’ve seen a lot of progress for heat not burn products, with the iQOS now available in several countries and a few new devices set to be released soon. The market looks like it could be on the brink of some serious growth, and within a few years HnB could have made as big a dent in smoking rates as e-cigarettes already have.

There’s one thing still missing, though. If heated tobacco products are really going to grab a sizable percentage of the cigarette market it’s important that their makers can show they’re safer than smoking. As we’ve mentioned before, common sense tells us they pretty much have to be a lot safer, because the tobacco isn’t being burned, but there’s a distinct lack of actual data. Isn’t anyone doing the research on this? It turns out the answer is yes.

Of course, you won’t see this research appearing in the medical journals just yet, because it’s actually being carried out on behalf of the tobacco industry. Philip Morris International have invested more time and money in HnB than anyone else, and a lot of that has gone towards looking into how much risk can be removed by switching from lit to heated tobacco. Some world-class laboratories have been asked to investigate how HnB is working and what that means in terms of health effects. Last week Heat not Burn UK got a chance to visit the Cube, PMI’s European research HQ at Neuchatel in Switzerland, to find out what’s going on.

How hot is too hot?

By now everybody knows that smoking-related diseases aren’t caused by tobacco; it’s the combustion process that creates the worst toxins and cancer-causing substances. Tobacco-free herbal cigarettes aren’t any better for you than Benson & Hedges, because you’re still inhaling burning plants. However, PMI have found out that making a safe HnB product isn’t as simple as not setting fire to the tobacco.

The tip of a lit cigarette, between puffs, is at between 600°C and 800°C; when you take a drag on it this rises to over 900°C. That’s the sort of temperature tobacco burns at. However, at much lower temperatures it goes through a process called pyrolysis, where it’s being broken down by heat but not actually burning. Pyrolysis starts at around 350°C, much lower than combustion temperatures – and pyrolyzing tobacco still gives off a lot of nasty chemicals. Not as much as burning it, of course, but probably still more than you really want to be inhaling.

So the trick to safe HnB is to heat the tobacco to just below the point where pyrolysis begins. If you were wondering why iQOS heats its sticks to 350°C when tobacco doesn’t start burning until hundreds of degrees above this temperature, now you know. PMI have opted for the highest safe temperature, where there’s little or no pyrolysis going on but the tobacco is still hot enough to generate a decent vapour. Because HnB products like iQOS, Glo and PAX 2 are electronically controlled it’s easy to get them to produce a constant temperature and avoid pyrolyzing or burning the tobacco.

Tracking the toxins

Obviously the big question is, what effect does HnB have on the levels of chemicals you’re inhaling? It’s unrealistic to insist on zero chemicals, because many of the toxins in cigarette smoke are very common substances. For example, smoke contains high levels of formaldehyde – but human bodies contain formaldehyde, too. Our metabolism produces it, and there are detectable levels of it in exhaled breath. What we’re looking for are levels that might not be zero, but are much lower than you’d get from a cigarette.

To test this, PMI analysed the smoke from a reference cigarette – this is a standardised cigarette used for lab testing – then compared it with the vapour from their two HnB products. One of these is iQOS; the other, known as Platform 2, hasn’t been released yet but works in a different way. What they found was that for every chemical they tested, levels were dramatically reduced in both HnB products. The highest levels were for ammonia, with iQOS having about half the level of a cigarette and Platform 2 around 40%. Is that enough to worry about? No; even cigarette smoke doesn’t have anywhere near enough ammonia to be an issue. For the other chemicals they tested levels were reduced by at least 80%, and in most cases 90 to 95%. Overall it looks like HnB eliminates more than 90% of the harmful chemicals found in cigarette smoke.

One impressive point about PMI’s research is that they’ve been extremely thorough. Different agencies have different lists of chemicals in smoke that concern them. For example the FDA have a list of 28 different substances; the International Agency for Research on Cancer’s list has fifteen. To be on the safe side, Philip Morris have simply combined everyone else’s lists; they test for fifty-eight different chemicals – far more than anyone else does.

Attention to detail

PMI aren’t just measuring what’s in the vapour; they’re also testing smokers who’ve switched to their HnB products to see how they compare with people who’ve either quit entirely or continued to smoke. What they’re doing here is looking to see if switchers’ blood chemistry is more like a smoker or a quitter. For every chemical they’ve tested – including carbon monoxide, benzene and acrolein – HnB users either have identical levels to smokers who’ve quit entirely or (for acrolein) the level is slightly higher than a quitter but much lower than a smoker.

At Heat not Burn UK we might not be scientists, but we do know how science is supposed to be done. The research that’s being carried out on the health effects of HnB is very good science. It’s extremely thorough and detailed. The actual analysis is being carried out by independent labs, which should deal with any accusations of bias. PMI are being completely open about the experimental methods, so anybody who has doubts can replicate the research themselves.

Why so modest?

That leaves one question: With all this research to back them up, why aren’t PMI shouting from the rooftops about how safe HnB really is? Most likely that’s down to an understandable wariness of being sued. If they say that iQOS is 90% safer than smoking, and then at some point in the future evidence shows it’s only 89.9% safer, how long is it going to be until swarms of Californian lawyers descend on them with a fistful of class action suits? Not long, probably.

So, for now, they’re playing a cautious game. The data is there, and steadily growing. Sooner or later it will be presented to some government agency, probably the FDA, and they’ll confirm that these products are much safer than smoking. That’s when the manufacturers will start publicising it. Until then we’re just going to have to rely on common sense.

BAT’s glo – sneak preview

A couple of months ago we looked at BAT’s glo, their stick-fed iQOS rival that’s currently being trialled in Japan. It still hasn’t been released in other markets, and BAT haven’t revealed their plans for it yet, so it could be a while before smokers in the UK have a chance to try it. Just so you know what you’re waiting for, however, Heat Not Burn UK set out to track one down. It was a struggle, but last week one of our agents finally managed to get his hands on the elusive device.

Because of how our glo was obtained (no, we didn’t steal it) it didn’t come in its usual retail packaging, so that won’t be included in this review. It did come with a full pack of Bright Tobacco sticks to feed it with, so it was thoroughly tested as well as being poked, prodded and generally fiddled with. So what’s it like?

The device

The Glo is a neat, simple device. The silver oval on top slides to reveal the NeoStik socket.

The glo device looks like a small, simple box mod e-cigarette. It’s about the height and thickness of a pack of cigarettes, and maybe two-thirds of the width. The aluminium body is rounded on both sides, making it comfortable to hold, and it’s not too heavy. It does feel solid and well made, and the build quality looks excellent. The end caps are textured plastic, the metal body has a nice satin finish and there’s a laser-etched glo logo on the front.

Looking at the top, there’s an oval silver cover. On the bottom is a micro-USB charging port and a small cover that looks like it should open, but was left well alone in case it broke. After some discussion we think that’s the airflow vent; there has to be some place for air to flow into the heating chamber so you can inhale the vapour, and we couldn’t see anything else that might do that job.

The only actual control on the glo is a single button on the front. Its placement looks odd if you’re used to e-cigs; most box mods now have the fire button on one side, because that way it falls naturally under your thumb. However the glo’s button is just the on/off switch, and you won’t need to touch it when you’re actually using the device. The button itself is metal and surrounded by a ring of translucent plastic, which turns out to be LED-illuminated – but we’ll get to that.

The Tobacco

Like the iQOS, glo uses cigarette-like sticks which BAT call NeoStiks. Compared to PMI’s HeatSticks these are longer and slimmer – almost exactly the same size as a traditional cigarette. Instead of a filter there’s a hollow plastic tube, which makes sense – why fit a filter when there’s no smoke? The centre of the stick is filled with finely shredded tobacco. Actually it looks like the bottom is, too, but BAT say that’s not tobacco. It could be shredded cork or something similar.

In Japan the NeoStiks are priced about the same as normal cigarettes, as are iQOS HeatSticks. Industry gossip suggests the reason for this is that nobody’s quite sure how they’ll be taxed yet, so BAT and PMI are both playing it safe. If they end up being taxed at a lower rate the price may fall in the future.

Some of the stuff inside is tobacco. Some, according to BAT, isn’t.

How does it work?

Using the glo is very simple. The cover on top slides to one side, revealing a hole about the size of a cigarette. All you have to do is insert a NeoStik into this hole until it won’t go any further. This is quite simple, like the iQOS, as long as you don’t rush it.

Once the stick is fully inserted all you have to do is press the button to turn the glo on, then wait for it to warm up. Progress can be tracked by watching the surround on the button; this progressively lights up as the coil temperature rises, the glow of the LEDs advancing clockwise wound the circle, and when the whole thing is illuminated it’s ready to go. Just in case you miss that the glo will also vibrate with a faint buzz when it reaches operating temperature. Then all you have to do is take a puff.

So the big question is, what’s it like? The answer is that it’s very good. Our agent was lucky enough to try the iQOS and glo together, and thinks the glo is just as good at producing vapour and has a slightly better taste. This was a bit surprising, as it runs at a much lower temperature – 240°C, rather than 350°C for its PMI competitor.

Each stick gives about as many puffs as a traditional cigarette, and when the glo decides you’ve fully vaped it, the device will vibrate again and turn itself off. This seems to be aimed at making sure you don’t overheat the tobacco to the point where it starts producing nasties.

Looking at the used stick was interesting. The heat seems to be applied in a narrow ring, just below the end of the plastic tube. It’s hard to say how much of the tobacco is being affected by it. On the other hand it doesn’t matter much, because whatever the glo is doing, it works.

Conclusions

The overall concept of glo is very similar to the iQOS, but BAT have taken a different approach to the hardware. Our first impression is that this has paid off. Battery life is much better than the PMI device – although it’s hard to say yet if it lives up to BAT’s claims of a 30-stick life between charges, because we didn’t get that many sticks. The downside is that the device itself is much bulkier, and unlike iQOS you certainly can’t hold it like a traditional cigarette.

It does seem to do the job, though. There’s a satisfying amount of vapour and the taste is very good. The device itself is simple and well made, and disposing of used sticks is a lot less messy than emptying an ashtray. This is a very interesting product, and if it’s released in the UK we think it has a lot of potential.

When will heat not popular become popular?




iFUSE – the Heat not Burn hybrid

There’s more interest than ever before in safer alternatives to smoking, with millions of smokers either thinking about moving to new technology or already having taken the plunge – mostly with electronic cigarettes. E-cigs aren’t for everyone, though. Many smokers have tried them and found that they didn’t really work for them; some have been put off by misleading newspaper articles claiming that vaping is just as unhealthy as smoking; still more simply don’t want to give up their real tobacco.

Heat not Burn technology is the new hope for smokers who want that authentic tobacco taste, and although the devices aren’t all that widely available yet they’re steadily being rolled out. iQOS is now on sale in the UK, for example. By the end of the year HnB products should be on sale in a lot more places, giving a new option for smokers.

HnB or e-cigs – What’s better?

It’s likely that the next few years will see a lot of arguments about which technology is better – e-cigs or HnB. They both aim to do the same thing, but take different approaches to it, and we can safely assume that each side will have plenty of enthusiastic supporters. Which will win in the long run? Who knows? However, British American Tobacco have already tried to combine the best of both worlds with their iFUSE device.

So what’s iFUSE? Basically it’s a hybrid device that starts with a fairly standard e-cigarette, then adds some elements of HnB technology aimed at creating a more authentic tobacco taste. It’s an interesting concept, so have BAT managed to get it to work?

If you’re familiar with latest-generation tobacco industry e-cigs like PMI’s Mesh, the iFUSE will have a familiar feel to it. The designers have obviously put a high priority on making it easy to use, and they’ve done a very good job of that. It isn’t quite as simple as the Mesh, but then nothing is as simple as the Mesh – and the iFUSE has a lot more going on inside.

Externally, there are two visible components. The battery is a fairly standard looking unit about the size of an eGo battery, but with a more flattened cross-section. It feels well-made and has a nice rubberised coating which, along with its light weight, makes it very comfortable to hold. There’s a USB charging port and a single large button, which appears to be metal and has a reasonably nice clicky feel. It’s not up to the standard you’d expect on a high-end e-cig, but then the iFUSE device costs just £14.99. At the top end of the battery is a proprietary connector for the cartridges it uses, which we’ll come back to.

The cartridge isn’t visible when the iFUSE is assembled; a large cover, which BAT call the mouthpiece, slips on over it. This is in two parts – the actual mouthpiece is black plastic, and is inserted into the end of a metal cone that covers the cartridge. The cones are available in a couple of different colours – silver and gold ones are for sale through the iFUSE site, but the same site has illustrations of some more options. Presumably they’ll be available soon.

When it’s all put together the overall effect is a simple, clean-looking little device. It’s not much larger than a standard eGo-type electronic cigarette, and no heavier. It is bulkier than an iQOS, but not by much – and it feels lighter, too.



Meet the Neopod

It’s inside that the iFUSE does things differently. It’s fed with disposable cartridges which BAT are calling Neopods; these carry the Kent cigarette brand, and they come in three flavours so far: Tobacco, Crisp Blue and Winter Green. Each Neopod is plastic, slightly tapered and a couple of inches long; inside it are three components, one of them unique to the iFUSE.

At the bottom of the cartridge, where it plugs into the battery, is a standard heating coil. This is fed from a reservoir of nicotine-containing liquid, which seems to be similar to regular e-liquid for an electronic cigarette. That’s what produces the actual vapour you inhale, so no surprises there. Where the Neopod is different from a Mesh or Vype Pen cartridge is that above the liquid tank, and directly below the mouthpiece, is a cylinder of finely chopped tobacco.

To use the iFUSE you just turn it on by pressing the button three times, and take a puff. It has an auto switch, so there’s no need to press the button every time you inhale, and because it’s creating the vapour from e-liquid there’s no need to let it warm up. This is an irritation with the iQOS; having to wait for the coil to reach running temperature isn’t exactly spontaneous. The iFUSE, on the other hand, is ready to go right away.

When you inhale the coil activates, vaporising some of the liquid. This is then drawn through the tobacco capsule, heating it and releasing the complex aromatics that give cigarette smoke its taste. Instead of being artificially flavoured, like e-cig vapour, you’re inhaling real tobacco flavour.

So does it work?

The iFUSE is a very interesting concept, backed up with simple and nicely made hardware. The only problem is, it doesn’t work very well. There’s a hint of tobacco flavour, but not really very much of it. The vapour itself is also quite thin, and the throat hit isn’t a patch on the Mesh or a conventional e-cigarette. It’s no match for an iQOS either.

Most likely, the problem is that the system just doesn’t apply enough heat to the tobacco. It’s not a full-on HnB product anyway, but the reason things like the iQOS work the way they do is that it takes quite a lot of heat to get a decent flavour from tobacco – and the iFUSE isn’t delivering it. There could be potential for it with a bit more development, but right now it suffers from being neither one thing nor the other. It’s a mediocre e-cigarette, and physics is against it really working like HnB.

It’s disappointing that the iFUSE doesn’t live up to its potential, because it is a nice and affordable little gadget. The vapour delivery is what really matters, though, and it just isn’t there yet. Buy a proper HnB device instead.

 

glo from BAT – iQOS’s latest rival

Philip Morris have been watching the Japanese tobacco market with interest, and probably quite a lot of satisfaction, this year. Japan was the first major test market for their iQOS heat not burn product, and it’s performed remarkably well. In September 2015 the HeatSticks it uses to create vapour accounted for 0.7% of the country’s cigarette sales; twelve months later that had risen to 5.2%. PMI say that around a million Japanese smokers have switched from traditional cigarettes to iQOS, and that 70% of people who’ve tried the device have fully switched.

Now the iQOS could have a fight on its hands, as British American Tobacco prepare to launch a rival product in mid-December. BAT are already testing a hybrid e-cigarette/HnB product, the iFuse, in Romania (I’ve tried it, and will write about it soon) but this new one is going to be exclusive to Japan for a while.

Japan is an interesting market for HnB products. Strict rules on nicotine-containing liquids mean that e-cigarettes, which the tech-happy Japanese would be expected to enjoy, are still rare. That means the only real competition for HnB is traditional cigarettes, so it’s the perfect place to see how many smokers are willing to switch. For BAT there’s a bonus; they also get to see how their new device performs against the already-established iQOS.

glo-ing with satisfaction?

So anyway, let’s look at BAT’s latest product. It’s called glo, and the concept is very similar to iQOS. The device itself is a bit different, and as expected there are positive and negative aspects to those differences. Overall, however, it looks pretty interesting.

Like iQOS, glo is fed with cigarette-like tubes which are inserted into the unit and heated. These have a filter on top of a stick of reconstituted tobacco, which probably also has some propylene glycol and other additives to help generate vapour. BAT are calling them Neostiks, and say each one should last about as long as a regular cigarette – a dozen puffs or so. As far as pricing goes they also cost about the same as cigarettes; in Japan a pack of 20 Neostiks will sell for 420 Yen, which is roughly the same as a pack of BAT’s Kent king size.

When glo launches there will be three Neostik flavours available: Bright Tobacco, Intensely Fresh (a menthol blend) and Fresh Mix, which has a less dominant menthol flavour. They’ll all carry the Kent brand initially – it’s one of the leading brands among Japanese smokers – but if it rolls out globally expect to see differently branded sticks and possibly a wider range of flavours.

Like iQOS, but more so

As for the actual device, it follows the basic iQOS system – insert a Neostik into the top, turn it on, wait for it to heat up then puff away as normal. Visually it’s very different, though. Where iQOS is a pen-style device, glo looks more like a small box mod. The case has an oval profile and is very uncluttered; there’s a laser-etched logo and a ring-shaped LED indicator on the front, and on top a large button and the socket for the Neostik. BAT say they aimed for the simplest interface they could manage, and the single button controls everything on the glo. That’s actually not too hard, because like iQOS – and unlike a box mod – there aren’t a lot of settings to manage. Basically all you have to do is turn it on and off.

So why have BAT gone for this larger format? PMI deliberately made iQOS as small and slim as possible, to keep it as close as they could to the size and weight of a traditional cigarette. There’s a down side to that, though – battery life. The iQOS handset simply doesn’t have enough space for a lot of power storage, and a full charge will be mostly used up in vaping a single HeatStick. It does come in a portable charging case that can recharge the handset on the go, but there’s an enforced break of about ten minutes between HeatSticks while it tops up.

By going with the box mod style, BAT have given themselves a lot more space for batteries – and it shows. They claim that a fully charged glo holds enough power to vape over 30 Neostiks. If that holds up in real-world use it means a single charge should last most smokers a full day, which makes it a lot more practical.

Gambling on power

So there are real advantages in the glo’s bulkier dimensions, but it’s definitely a gamble on BAT’s part. It’s likely they’re hoping that smokers will value the extended battery life enough to use a device that’s less familiar in shape (and a good bit heavier) than iQOS. One advantage of them both being tested in Japan is that they can compete head to head; apart from the size they’re similar enough in concept to make for a fair comparison.

There is one other difference between the two, which is that glo heats its tobacco sticks to a significantly lower temperature. iQOS runs at around 350°C, while glo reaches 240°C. The lower temperature is likely to mean fewer toxicants in the vapour, but the big question is what impact it has on the user experience. If the vape itself is less satisfying that’s going to count against it.

BAT say that lab tests show that glo vapour eliminates around 90% of the toxicants found in cigarette smoke, although they’re being careful not to make any health claims right now. They are emphasising that it’s less messy than smoking and doesn’t leave a strong smell on clothes. As far as price goes, the glo handset will sell for around 8,000 yen, which is about $77. That makes it roughly 20% cheaper than iQOS in Japan. If glo rolls out in the UK it will be interesting to see how it’s priced, because iQOS is currently selling for £45. If the same price difference carries across that will put it at about £36. Of course the real cost of these systems is in the tobacco sticks, which aren’t much cheaper than traditional cigarettes.

Overall glo looks like an interesting device. Anyone who’s used a box mod is unlikely to be bothered by its size and shape, so the real question is how smokers will take to it – and, of course, what the actual vapour is like. BAT have invested heavily in it, though, so it’s probably safe to assume their consumer trials have been positive. Hopefully UK smokers will soon get a chance to try it, too.

WHO notices Heat not Burn

Heat not Burn products are coming to the attention of a new audience – and that might not be good news. The World Health Organisation is gearing up for its latest tobacco control junket and, for the first time, heated tobacco products are on their radar. They haven’t attracted as much of the WHO’s dislike as electronic cigarettes yet, but this could be just a matter of time.

The WHO event is the Seventh Conference of Parties to the Framework Convention on Tobacco Control, which is a bit of a mouthful. Unsurprisingly it usually goes by the less awkward title of COP 7. The previous one, COP 6, was held in Moscow two years ago and attracted quite a lot of bad press. The organisers, who include the UK’s Action on Smoking and Health, seem to be somewhat paranoid, and they claim to be terrified that the tobacco industry will somehow manage to sneak observers in to find out what’s happening. Last year they avoided this risk by first banning all members of the public, in case any were Big Tobacco spies, then banning all members of the press.

As COP is funded from taxpayers’ money not everyone was happy about the oppressive secrecy, especially as some hints of what was going on did slip out. Although it was supposed to be a conference to set tobacco control policy, the reality is that no dissent from the organisers’ position was allowed. It’s been alleged that the health minister of a fairly large country was physically forced back into his seat when he disagreed with one of the proposals. Obviously it’s hard to say if this really happened or not, because any potential witnesses had been locked out.

They’re paranoid, and they are out to get us

This year’s event will be held in India, and it seems the paranoia has got even worse since 2014. The organisers are talking seriously about banning representatives of any government that’s involved with tobacco sales in any way, which is most of them. The Indian government itself might be shut out, despite paying to host the event.

So what does this have to do with heat not burn? The agenda for COP 7 was released last week, but for a couple of weeks before that there has been a sudden increase in interest among tobacco control activists. Anti-smokers have been asking questions about heat not burn on Twitter, mainly trying to find out what e-cigarette users think of it.

Some people were puzzled about this. Why ask vapers for their opinions about heat not burn? Obviously there are connections – both are alternatives to smoking – but they’re very different products. Surely it would have made more sense to ask smokers what they thought, but there was no sign of anyone doing that. Of course that could just have been the usual dismissive public health attitude towards smokers, but was there something more significant behind it?

As it turned out, yes there was. One of the documents the WHO released last week was their new position paper on electronic cigarettes, and as well as e-cigs it mentions heat not burn products. It’s not a big mention, but it’s there – just a single sentence about how the tobacco industry “has launched alternative nicotine delivery systems that heat but do not burn tobacco”.

Bad attitudes

Unfortunately the WHO has been extremely negative about e-cigarettes right from the start, and the tone of this new paper suggests they’re going to be exactly the same about HnB. This probably shouldn’t be a big surprise – the organisers of FCTC lost interest in keeping people healthy long ago. Their priority now is attacking the tobacco industry every chance they get, and heat not burn is an obvious target. After all the leading products are all actually made by tobacco companies, unlike most e-cigs. They contain tobacco, and some of them have well-known cigarette brands. It’s pretty much inevitable that HnB is going to be painted as another evil tobacco industry plot.

So does this attention from WHO mean heat not burn is doomed before it even has a chance to get off the ground? No, not really. Look at what’s happening with e-cigarettes. Yes, the USA and EU have introduced tough new laws – but they haven’t actually banned them, and that’s what the WHO was demanding as recently as last year. There’s now so much evidence they’re safer than cigarettes that even the WHO can’t justify a ban.

It’s almost certain that the same will happen with HnB. Not much research has been done yet, but when the evidence starts coming in it’s likely to show that these products are much safer than conventional smoking. The FCTC crew will huff and puff, but governments aren’t likely to ban the products. They’ll get health warnings, and possibly plain packs, but they aren’t going to be banned except in a few totalitarian states.

Hints of positivity

Actually it could be good news that WHO seem to have been talking to tobacco control people about HnB. While a lot of them are driven by hatred of the industry, some of the more open-minded ones will be interested in anything that gives a safer alternative to smoking. One or two of those were among the ones asking questions, including the chief of an NHS stop smoking service. The same service was the first in Britain to start recommending e-cigs to smokers who wanted to quit; if HnB looks like being a real alternative – and with the current technology it certainly does – it could find supporters in unlikely places.

Sadly it’s a fact of life in today’s world that, whenever something new and enjoyable appears, a lot of people will instinctively want to ban it. Sometimes they succeed, worse luck. More often they manage to cause some problems, but the new technology goes on to eventually become widely accepted. Remember how mobile phones would cause sterility and brain cancer? Now everybody has one. Heat not burn will be opposed by people like the WHO, but the chances are it’s not going to go away. Technology has caught up to the point where it really works, and it’s just going to keep getting better.

How safe are tobacco vaporisers?

Rumours are circulating that tobacco vaporisers and other heat not burn products might not deliver on the reduced harm that justifies the products’ existence. Not all these health claims are new, of course – they’re as old as the products themselves. Heat not burn probably has more potential now than ever before, though. Earlier attempts to sell the technology failed, probably because it was just too different from what smokers were used to.

That’s all changed over the last few years. The popularity of electronic cigarettes has grown at a stunning rate, and despite the fake concerns of many public health charities almost all the people who use them are, or were until recently, smokers. The key point about that is that by any sensible definition e-cigarettes are far more different from traditional cigarettes than any heat not burn product is. E-cigs don’t even contain any tobacco, while heat not burn products do. In fact most of the ones in the pipeline just now include something that’s recognisably like a cigarette. The only exceptions are loose tobacco vaporisers like the excellent PAX 2. Phillip Morris’s iQOS uses cigarette-like tobacco sticks, while RJ Reynolds’ Revo looks just like a cigarette and even works like one; you simply put it in your mouth and light the end.

So the companies interested in heat not burn technology are gambling that if smokers are willing to switch to something as unfamiliar as a tank full of liquid with a battery to heat it, they’ll be even more enthusiastic about something that retains the familiar tobacco. They could be right; although vaping has become widely accepted among smokers there’s still a significant number who aren’t tempted.

The fear industry

The problem is that heat not burn is still at the stage where it’s very vulnerable to health scares. E-cigarettes have suffered badly from this; media coverage has been so bad, and misinformation from anti-vaping groups so vicious, that a majority of American smokers believe vaping is at least as harmful as smoking; the truth is it’s at least 95% safer. If so many terrifying rumours can be spread about vaping, though – where users are inhaling vaporised liquid – what can the fearmongers do with a product that contains actual tobacco?

It’s complicated by the fact that heat not burn is a much broader category of device than e-cigarettes. There’s an incredible variety of vapour products, but no matter how different they look, they all function in basically the same way. The battery heats a coil, which draws up liquid through the wick and vaporises it. Once you’ve shown that one e-cig is relatively safe to use, you can be pretty sure that your conclusions apply to all e-cigs.

Heat not burn is different. Some devices heat loose tobacco in a chamber, using an electric heating element. Others wrap the element around a paper tube of tobacco. Revo doesn’t have any electronics at all; it uses a charcoal pellet to generate heat. These devices share the same basic principle – heating tobacco to liberate flavoured vapour and nicotine – but they work in very different ways. That means conclusions drawn from studying one product don’t mean much for others.

The product that’s causing the most concern is Revo. How much of that is down to the fact that it looks just like a cigarette, it comes in packs just like a cigarette and it’s used just like a cigarette? Who knows? There are some legitimate reasons to worry, though. For a start, heat not burn isn’t an entirely accurate description of the Revo. The tobacco isn’t burning – in theory, at least – but the charcoal pellet that heats the whole thing certainly is.

How much burning is too much?

Burning charcoal is a notorious producer of carbon monoxide; lighting half a dozen disposable BBQ grills in a closed room is an increasingly popular way of committing suicide. The level of carbon monoxide emitted by a Revo is obviously much lower – but regularly inhaling small doses of CO is one of the most dangerous things about smoking cigarettes. The constant respiratory stress caused by the gas eventually damages arteries and leads to heart disease. The fact that Revo relies on charcoal has to be a point against it.

There are also questions about what exactly the Revo is vaporising, and even if vaporising is all it’s doing to the tobacco inside. Electronic devices, like iQOS, can maintain precise control over the temperature of the heating element. There’s almost no way an iQOS or PAX 2 is going to burn the tobacco you load in, unless you abuse it. Is the same true of the Revo? RJ Reynolds say so, but it’s hard to be sure. Because it does involve combustion, adding more oxygen to the process can raise temperatures. Take an unusually hard puff, or use it outside on a windy day, and the temperature could easily spike above the point where the tobacco is actually burned.

There’s no evidence that this is happening with Revo, but it’s certainly a theoretical possibility. Even in normal use the tip gets hot enough that many of the chemicals found in tobacco smoke can be vaporised. These include acetone and ammonia, as well as the monoamine oxidase inhibitors (MAOIs) that make tobacco smoke many times more addictive than pure nicotine.

It’s still pretty safe

On the other hand, while these worries are real, they probably aren’t very significant. It still seems to be a no-brainer that, because the tobacco inside isn’t being burned to ash like it is in a cigarette, Revo is going to be much less dangerous than a traditional smoke. There is also a spectrum of risk with heat not burn products. Electronic devices are likely to produce a far cleaner vapour than anything that involves combustion. Are they as safe as e-cigarettes? Because they contain tobacco, probably not. Are they safer than burning anything and inhaling the result? Yes, they almost certainly are.

So far there’s no evidence that even begins to suggest smokers shouldn’t try heat not burn. Even a Revo is going to be a lot safer than a normal cigarette; iQOS should approach the safety of a typical e-cig. If you’re already a smoker, and thinking about giving heat not burn a go, safety is not something that should affect your decision. Compared to smoking they’re safe enough; that’s what matters.