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California study claims iQOS risks – but is this good science?

iQOS risks

Im my last post I mentioned that there would be some good news about Glo being released today. What I didn’t know at the time was that some bad news about iQOS was also scheduled for release. Luckily the ever-resourceful Dick Puddlecote tipped me off that it was coming. He wasn’t the only one who knew about the paper, either; Philip Morris International have obviously got hold of an advance copy in plenty of time to have a look at it and compare its conclusions to their own science.

Actually, as a long-time advocate for vaping, this all looks very familiar to me. I mentioned in my last post that tobacco control is increasingly rejecting science, and this new paper is an excellent example of that. I was going to say it’s terrible science, but that’s too kind – it isn’t science at all. In fact PMI’s response completely demolishes it. Unfortunately the media won’t pay any attention to that. They’ll report the bad news, and ignore the response because it comes from an Evil Big Tobacco Company. So I’m going to do what I can to get the message out – and hopefully, in the process, show just how low tobacco control “science” has fallen.

The usual suspects?

The new study has been published by the University of California, Riverside – and that’s something else I’m familiar with as a vaping advocate. The UC system is excellent in many ways, and includes several world-class universities, but it also harbours a nest of virulently prejudiced anti-nicotine loons. The most notorious, of course, is Stanton Glantz, but there are others. So when I looked at the authors of the new paper and saw the name Prue Talbot, I wasn’t at all surprised. Talbot is a professor of cell biology at Riverside – so, unlike Glantz, she does at least have some actual qualifications – and she’s also a fanatical opponent of any form of tobacco harm reduction. Her obsession with the subject started with e-cigs, but now she seems to have transferred it to heated tobacco. And the quality of her science is as bad as ever.

Talbot and her team have come up with the argument that iQOS isn’t really a Heat not Burn device. They’re claiming that it burns tobacco and other parts of the Heet, creating toxic substances in the process, and that the way people use it actually increases their exposure to nicotine and harmful chemicals. The thing is, they aren’t the first people to investigate this, and their results are wildly different to what previous researchers found.

There were four main claims in Talbot’s paper, adding up to the conclusion that iQOS exposes users to serious toxins. They are:

  • Despite PMI’s claims, iQOS does burn tobacco
  • The device runs hot enough to melt part of the filter, releasing toxic fumes
  • The time limit on an iQOS session makes users puff more often, increasing their exposure to toxins
  • Not cleaning the iQOS increases the temperature when it’s heated

These are obviously worrying claims, if they’re true – but are they? The hazards identified by Talbot and her team haven’t been spotted by anyone else, and it’s not like Talbot was the first person to look. PMI did a lot of research into safety before iQOS went on the market, and while it’s easy to dismiss that as industry research, PMI have a big incentive to do rigorous research. They’ve invested a lot of money in moving to less harmful products, after all. If it turned out that those products hadn’t been properly researched, and there were risks people weren’t being told about, their whole strategy would collapse. On top of that, PMI know that if they do the research themselves a lot of people will attack it, so they’ve been using independent labs for most of the work.

For obvious reasons, that research has already looked at all the issues Talbot claims to have found. PMI have looked at each of them, and compared them with their own research. The results don’t look good for Talbot.

Does iQOS burn tobacco?

According to Talbot, the tobacco in a Heet is charred when the iQOS heats up. That, she says, leads to a process called pyrolysis, which creates toxins. Her team decided this after looking at a used Heet under a stereomicroscope – but a stereomicroscope isn’t powerful enough to detect pyrolysis. I have one at home; they’re designed for looking at insects, coins and electronic components. If the tobacco really was charred, like she claims, a stereomicroscope could detect that, but is charring possible in an iQOS?

No, it isn’t. The heating blade in an iQOS never gets hotter than 350°C, and that temperature was chosen for a reason. In a cigarette the tobacco burns at a temperature of at least 800°C, and there’s no way an iQOS will ever get anywhere close to that. PMI deliberately selected a temperature that was hot enough to create a vapour from the tobacco, but not hot enough to burn or char it.

I’ve dissected used Heets myself, and looked at them under both a stereomicroscope and a high-powered biological microscope. I didn’t see any signs of burning or charring; what I did see was some discolouration around where the blade had been. PMI say this is torrefaction, a kind of mild thermal decomposition that takes place around 300-350°C.

PMI also cited Public Health England, the UK Committee on Toxicity and the Netherlands National Institute for Health and Environment, all of which confirm from their own research that iQOS does not burn tobacco – and Talbot is wrong.

Are the filters melting?

Talbot claims that the PLA roll inside a Heet, which is there to let the vapour cool before being inhaled, gets hot enough to melt and release a highly toxic chemical called formaldehyde cyanohydrin.

PMI say that they’ve tested the aerosol from iQOS with advanced techniques, including gas and liquid chromatography, and found no trace of formaldehyde cyanohydrin. They also said that the chemical is found in conventional cigarettes.

Finally, PMI pointed out that PLA is made from corn starch, and is a very safe product. When the PLA filter in a Heet is exposed to the heated vapour it doesn’t melt; it hardens, and it doesn’t release any toxic chemicals. In fact that’s exactly why the material was chosen.

Do users puff more rapidly?

Talbot thinks – and it’s just speculation; she has no evidence for it – that because iQOS switches off after six minutes, users will puff faster and expose themselves to more toxins. What this suggests is that Talbot doesn’t understand how iQOS – or cigarettes, for that matter – works.

Firstly, a smoker who’s used to smoking a cigarette in five or six minutes isn’t going to feel rushed with an iQOS. They can puff at their usual speed, with no worries about running out of time. Secondly, iQOS shuts down after six minutes or 14 puffs. It doesn’t matter how fast you chuff away at it; you’re not going to get any more than 14 inhales. On this point Talbot isn’t even wrong; she’s just making things up.

Does not cleaning the iQOS make it run hotter?

Talbot’s final claim was that iQOS, if not properly cleaned after every session – and she said that PMI’s recommended cleaning routine doesn’t work – collects residue that makes it run hotter and generate more toxic chemicals. Again, PMI point out that she obviously doesn’t know how it works. The temperature of iQOS is electronically controlled and cannot go above 350°C. Again, Talbot seems to be making things up.

 

Nobody at PMI is pretending that there are no toxic substances in iQOS aerosol. That would be ridiculous; there are toxic substances in fresh air. However, all the research except Talbot’s has found that the levels of toxic substances are close to two orders of magnitude lower than what’s found in cigarette smoke. As the product is aimed at smokers, that’s the comparison that should be made.

Overall this looks like the same kind of sloppy, biased research vapers have been used to for a long time. It’s even by one of the same researchers who produced a lot of that sloppy, biased research. The aim of Talbot’s paper isn’t to increase the sum of scientific knowledge; it’s to give tobacco controllers ammunition to bash iQOS and the people who make it. There’s likely to be a lot more of this in the future, so all Heat not Burn enthusiasts need to start activating their bullshit detectors now.

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HnB and vaping – We’re on the same side!

Vaping

Most readers of this blog will know that, while I’m a user and huge fan of Heat not Burn products, I’m mainly a vaper. When I quit smoking I used an early e-cig starter kit, and I’ve now been vaping for more than five years. In that time I’ve used a lot of different e-cigs, learned to make my own coils and e-liquids, and written thousands of words to advocate for vaping. I go to pro-vaping conferences and know most of the UK’s prominent vaping advocates. Vaping is a thing that I do.

It’s not the only thing I do, though. I don’t see vaping as the only acceptable alternative to smoking, the way public health nuts think nicotine patches are the only acceptable alternative. I use Swedish snus, when I can get it. I have a couple of tins of snuff around. I like HnB products. I even have a cigar a couple of times a year.

So I like vaping, but I’m open to anything else that gives the pleasure of smoking but eliminates most of the risks – and if someone is willing to accept the risks and continue smoking, I’m squarely behind their right to do that too. I am definitely not one of those born-again vapers who thinks all smokers need to switch right now, and if any smokers do want to move to something safer I’m not going to tell them they need to move to an e-cig. If they’d prefer to buy snus online, or find an old-style tobacconist and stock up on snuff, or get themselves an iQOS, I have no problem with that at all.

iQOS and 100 HEETS £49

The circular firing squad

That’s my philosophy, then – a tolerant one that’s mostly interested in making sure people have access to the products they want. So I wasn’t too please the other day when Dick Puddlecote sent me a link to a YouTube video from a popular UK vaping channel.

The first half of this video seems to have been provoked by an article in Vapouround, a British vaping magazine. Early this year the magazine carried a two-page feature on iQOS and how it features in PMI’s plans to phase out cigarettes from the UK market. Personally I don’t see any thing controversial about that. Yes, it’s a vaping magazine. That’s fine; iQOS is also a vapour product. It creates its vapour from heated tobacco instead of aerosolised liquid, but that’s a technical difference; the basic principle is the same.

Obviously that’s not what the star of the video thought, though. In fact he launched into a stunningly ignorant half-hour rant against iQOS, PMI, and HnB in general. And when I say stunningly ignorant, I’m not kidding. According to him, a Heet is just a cigarette that’s been coated with propylene glycol. In his opinion, using an iQOS “still qualifies as smoking” just because Heets contain tobacco. This is obviously total bollocks; by that logic using snus also counts as smoking, and do I really need to explain how ridiculous that is?

Ignorance is bad, but what really staggered me was the level of venom aimed at Philip Morris – who the culprit seems to think is an actual person involved in the sale of iQOS, by the way, rather than the long-dead proprietor of a small tobacconist in Victorian London. The video is peppered with delusional ramblings like “Phil, come to the office and have a coffee”. Frankly, it sounds unhinged.

Fake moral high ground

I’ll be blunt here: I’m fucking sick of certain vapers getting on their high horse about the tobacco industry. None of us whinged and moralised about the tobacco industry when we smoked, did we? Oh no; we all loved the tobacco industry back then, because they sold us things we liked. They’re still doing that, because millions of people like iQOS and Glo.

I don’t want to hear any crap about how the tobacco industry lied about the dangers of smoking either. That was decades ago, and the people who did it are all retired and mostly dead. Philip Morris is a company – a sign on an office and a name on a bank account. It isn’t an actual guy named Phil who wants to sell iQOS so he can buy another Bentley. The company is just a legal entity that lets people work together. It doesn’t bear any guilt for what people who worked for it in the 1970s did, so trying to smear iQOS because some guy lied about Marlboro causing cancer 50 years ago is just stupid.

The tobacco companies aren’t going to shut down tomorrow and only a moron would want them to. Apart from anything else, if Philip Morris and BAT go down, millions of ordinary people’s pension funds will go down with them. Do you seriously think it’s worth causing massive poverty just because you don’t like iQOS? No, you don’t – so why the vitriolic hatred of a business that’s just trying to give its customers what they want?

Let’s be realistic here: If reduced-risk products are going to be made widely available, the tobacco industry is going to play a role in making that happen. A lot of people simply don’t want to go into a vape shop staffed by tattooed people with hipster beards and ear gauges, and spend their money on Chinese brands they’ve never heard of. They’d much rather buy something that says Marlboro on the box, because that’s the taste they’re looking for. Yes, I get it; you hate the taste of tobacco now and think everyone should vape 3mg/ml mango sorbet. The problem is most smokers don’t agree with you. They want Marlboro, and unless you can give them an e-liquid that tastes like a burning Marlboro – which you can’t; it’s been tried often enough – they’re not interested. E-cigs work for many smokers, but not for all, and why should smokers be denied a safer alternative that does work for them just because you’re puffed up with moral indignation about the people who made it?

 

I don’t care if you don’t like Heat not Burn products. I don’t even care if you think they’re morally wrong. What I do care about is that you’re making angry, incoherent videos attacking reduced-harm products, and in the process doing public health’s work for them. If you’re ranting about how HnB is a cunning plot by the evil tobacco companies, you’re basically Stan Glantz. iQOS, and other products like it, are designed to do exactly the same thing as e-cigs are – give smokers a safer alternative. That’s something we should all be able to support. If you don’t like Heat not Burn products then just don’t buy them; there’s no need for all these tantrums.

iQOS and 100 HEETS £49

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Buy an iQOS with 100 HEETS for just £49.

Here at Heat Not Burn UK we are very passionate about harm reduction and that is one of the reasons that we have embraced the iQOS more than any other heated tobacco device, it is in our own humble opinion the best heated tobacco device currently on the market bar none.

Well we have now teamed up with a very good UK dealer and are able to offer up a fantastic deal on the PMI iQOS.

The deal we are able to offer is a complete iQOS starter kit in either navy or white complete with 5 packs of HEETS (100 sticks) for the fantastic price of only £49. The R.R.P of the iQOS is £89 and the cheapest you can get HEETS for is around £7 so this deal would normally be retailing at around £124 but right here on this website you can get that all for just £49 for a limited period.

If you are fed up of smoking traditional cigarettes then this is the perfect opportunity to take advantage of a great offer. PMI (Philip Morris International) already know that the traditional cigarettes days are numbered, why not come and join the revolution?

All iQOS starter kits are genuine, come with a one year “no quibble” guarantee, our shipping is fast and our customer service is second to none, what’s not to like?

As for the HEETS they are available in 3 different flavours: Amber is for the smoker who prefers the full strength taste, yellow is more of a smoother flavour and for any fans of menthol then our Turquoise HEETS are perfect!

Also if you are just looking for genuine HEETS on their own we sell them too and you can buy a carton of ten packs for just £70, which works out at £7 a pack.

Click here to be taken to our online store!

 

This post has been updated to reflect a price change in the offer, it was originally £89 for the deal, now the same deal is just £49. Jurassic Park!!

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Glo safety update – good news on DNA trials

DNA trials

Anti-nicotine zealots chose safety as their main battleground on e-cigarettes, and it didn’t work out too well for them. Now they seem to be doing the same again with Heat not Burn. Will it be more effective this time? Probably not.

We’ve already seen a lot of research from PMI on the safety of their iQOS device. Now British American Tobacco have released their own work on Glo, which is currently on sale in Japan and South Korea. Glo works on the same concept as iQOS, delivering vapour from heated tobacco that’s held in a cigarette-like stick, and the only real difference in the technology is that Glo heats its sticks to a lower temperature. That means we wouldn’t expect to see a huge difference in its vapour compared to iQOS – and, sure enough, we don’t.

Science and smoking

What BAT were interested in was the potential of Glo vapour to cause DNA changes in human cells. Damage to DNA can kill a cell – but, even worse, it can also cause cancer by making the cell grow and divide abnormally. Smoking is known to cause damage to thousands of genes; the question is, how does Glo compare?

Recently there’s been a lot of criticism of studies that use human cell cultures to measure the effects of e-cigarette vapour. This criticism is well aimed, because while the cells might be the same as the ones in a real human body, they don’t benefit from all the body’s layers of defence systems and repair capabilities. In a living body, damaged cells are quickly repaired or ejected; this doesn’t happen in a petri dish.

For their own trials BAT decided they could do better than that. Instead of a simple culture they used an actual simulation of a human airway. Known as MucilAir, it’s grown in a laboratory from cloned human cells and it replicates the body’s own defence mechanisms. The culture can produce mucus, to clear away contamination, and is covered in hair-like cilia like the ones human airways use to expel dust and particulates.

With the experimental tissues set up, BAT’s scientists then programmed a smoking machine to mimic the way people actually use Glo. This is another frequent problem with research into reduced-risk tobacco products – researchers set up their equipment to work in unrealistic ways. Several studies on e-cigs have turned out worthless because the machinery took puffs that were too long and too close together, producing dry hits and high levels of toxic substances that no real vaper would ever experience.

To carry out the actual experiment the machine produced vapour from the Glo and exposed the cells to it continuously for one hour; as a control, a second sample was exposed to smoke from a standard cigarette. Then, 24 hours after the experiment, cells were harvested and broken down to extract their DNA; which was then examined for changes. The process was repeated after another 24 hours to check for damage that took longer to show up. Then the results for Glo were compared with those for the cigarette.

Does Glo cause cancer?

The difference was dramatic. After 24 hours cigarette smoke had caused observable changes in 2,206 genes; Glo vapour had affected one. By 48 hours 2,727 genes were showing a reaction to the smoke, while all genes from the Glo sample were normal. After the researchers adjusted the figures to get a worst-case scenario Glo was still only affecting two genes, while smoke affected 2.809.

It’s obvious from this that Glo’s heated tobacco vapour has much less effect on DNA than cigarette smoke does – in fact, it would be interesting to see a comparison between Glo vapour and city air. So why are BAT insisting that “these results do not necessarily mean this product is less harmful than other tobacco products”? The reality is that’s exactly what these results mean, but heat not burn is in a complicated legal position just now. Philip Morris are still hoping their iQOS will be classed as a reduced risk product by the US FDA, which would allow them to advertise it as less harmful; Glo hasn’t reached that stage yet. Until it does we can expect BAT to be very cautious about what they say, to avoid any damaging legal challenges.

The reality, however, is that this is great news for heat not burn. The gene changes caused by cigarette smoke are known to be linked to lung cancer, as well as fibrosis and inflammation of lung tissue. The new research – which has been peer reviewed, and will be published in the medical journal Scientific Reports – shows that Glo is not causing these changes.

While the health effects of cigarettes are complicated, some things are quite simple. If Glo isn’t causing the gene changes that lead to cancer, it’s not going to give you that type of cancer. That doesn’t mean there are no health risks at all – we can’t say that about anything – but what we can say is that many of the ways cigarettes cause cancer just aren’t possible with Glo.

Earlier research into Glo shows that levels of toxic substances in the vapour are between 90% and 95% lower than in cigarette smoke. That fits together well with the new study. There isn’t a simple relationship between levels of a chemical and the effects it has. Some people make wild claims, such as “There’s no safe level of cigarette smoke!”, but the truth is there’s a safe level of anything. There’s a safe level for things like cyanide and arsenic. It might be a very low safe level, but it exists.

We’re probably fine

My guess – and it is a guess, but a reasonably informed one – is that the level of toxic chemicals in Glo vapour is low enough that it’s below the threshold where it’s going to do any harm. It seems reasonable to believe, based on the evidence we have so far, that using Glo or a similar product is going to eliminate most of the risks of smoking. Common sense backs this up; it isn’t nicotine or even tobacco that kills smokers – it’s smoke. Glo isn’t producing any smoke, so it’s sensible to assume we’re not going to see the same problems.

The last thing to say about this research is that it’s going to be attacked because of who carried it out. We’ve seen that already with research on iQOS, just because PMI paid for it – they didn’t even do the work themselves. BAT have tested Glo in their own labs, but they’ve handed over the data for peer review and it’s been approved of by experts. That won’t stop people attacking it, but they’ll attack the source because they can’t attack the data itself. So far the science is looking good for heated tobacco products, and that’s what counts.

Selling iQOS and HEETS

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FDA vote is a setback – but not a disaster – for iQOS

Yesterday was an important day for PMI’s iQOS device, and for the whole future of Heat not Burn in the USA. Following a long bureaucratic process an FDA advisory panel discussed, then voted on, PMI’s claim that iQOS is a Modified Risk Tobacco Product (MRTP), a decision that could decide whether or not it goes on sale in the United States. It went better than it might have done, but unfortunately the results were still disappointing.

PMI submitted their MRTP application in December 2016; the reason it’s taken so long to come to a vote is that the application came to over a million pages of data. Achieving MRTP status would be a significant advantage for iQOS; it would allow PMI to market the product as less harmful than cigarettes, and to alter the warning labels on packaging to make clear that it’s a safer alternative. The final decision on granting MRTP status will be made by senior FDA management, probably some time in the next few months – and, while they’re free to ignore the recommendations of the advisory panel, they rarely do.

What was decided?

Yesterday’s panel voted on three issues. Firstly, have PMI proven that switching to iQOS will cut the risk of developing a smoking related disease? Secondly, is using iQOS healthier than continuing to smoke? Finally, does switching to iQOS reduce exposure to harmful and potentially harmful chemicals? In a slightly confusing mixed decision the panel rejected the first two claims, but voted strongly in favour of the third.

On the first question, reducing the risk of smoking-related disease, eight of the panel’s nine members voted that PMI hadn’t provided evidence for this; the last member abstained. The main issue seems to be that most of PMI’s clinical testing was carried out on rats, and the panel want to see results from human tests. To be blunt about it, this is not very reasonable. iQOS is a relatively new product, so there hasn’t been time for long-term trials on humans.

However, when it comes to the chemicals involved in iQOS vapour, this isn’t exactly a leap into the scientific unknown. All the potentially harmful substances found in iQOS vapour are also found, at much higher levels, in cigarette smoke – and of course the most harmful ingredients of smoke, carbon monoxide and tar, aren’t found at all.

On its own the panel’s rejection of this claim isn’t too surprising, although it’s certainly not justifiable. The FDA has a huge institutional hostility to tobacco products; even Swedish snus, which appears to pose no health risks at all, hasn’t been able to make its way through the MRTP process yet. However, put the decision into context with the FDA’s finding that PMI are right about iQOS users being exposed to fewer, and less abundant, toxins and it makes no sense at all. After all, it’s exposure to these chemicals that causes smoking-related disease, so if the chemicals are reduced or eliminated the risk of disease will fall. That’s basic toxicology – “The dose makes the poison”. This isn’t exactly a radical idea either; it’s been universally accepted since Paracelsus wrote it in 1538.

Exactly the same applies to the panel’s decision that using iQOS hasn’t been proven healthier than continuing to smoke. If they accept that the vapour is far less toxic than cigarette smoke – and they did, by eight votes to one – then why not also accept that inhaling vapour is much less risky than inhaling smoke?

So what’s going on?

On the face of it the panel rejecting two of PMI’s claims, but accepting a third that backs up the first two, doesn’t make any sense. After all the reduction in harmful chemicals is the whole point of iQOS, and the reason behind it is to reduce risks.

It does start to make sense if you look at it from an ideological, rather than a scientific, perspective. The panel can’t really argue with the fact that iQOS vapour has a fraction of the problematic chemicals found in tobacco smoke; that’s hard data, collected by independent labs and published in peer-reviewed journals. It cannot be disputed. Denying it is equivalent to Flat Earthism, so it’s actually impressive that only one member of the panel went down that road.

On the other hand, the claims about reduced risks to health are tentative. They’re based on the best analysis of the data, but – hypothetically, at least – they could be wrong. They aren’t, of course; that would require what tobacco control expert Clive Bates called “a novel and implausible theory of the human body”. But, nevertheless, the panel seem to have seized the chance to show how much they hate the tobacco industry.

Now what?

As annoying as it is, the panel’s conclusions aren’t the end of the road for iQOS. When the FDA makes its final decision there are still two open questions. One is whether or not to grant MRTP status anyway, despite the vote. Recommendations from the advisory panel carry a lot of weight, but the agency can disregard them. It’s definitely possible that under director Scott Gottlieb, who at least on paper is committed to harm reduction, they’ll decide to grant it.

Even if they don’t award MRTP, the FDA can decide to let iQOS go on sale anyway. In that scenario the packaging would have to carry standard health warnings and PMI wouldn’t be able to market it as a safer option, but word would get round anyway and we could expect to see a lot of smokers make the switch. iQOS is demolishing the cigarette market in Japan at an impressive rate and there’s no reason why it couldn’t do the same in the USA; it would be hard for even the USA to object to that.

The worst case scenario is that Gottlieb decides not to allow iQOS to be sold in the USA. That seems unlikely, but if it does happen the result is likely to be disastrous for HnB in America. PMI have spent a vast amount of money preparing this application, and if it’s rejected on openly ideological grounds it’s hard to see other companies lining up to apply. There’s a lot of lives hanging on the FA’s decision, so let’s hope that unlike their advisory panel they get it right.

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PMI want to give up cigarettes – but not everyone’s happy

In the last post we talked about New Year resolutions and how switching to heated tobacco might be one of yours. That turned out to be quite prophetic, because somebody else made a resolution that features HnB products, and they didn’t exactly keep it quiet either. That somebody was Philip Morris, the world’s largest and most successful tobacco company, and they announced their resolution with a series of full-page ads in major newspapers.

On the 2nd of January, a large PMI advert appeared in three of the UK’s best-selling papers, The Times, The Sun and The Daily Mirror. To say it was attention-grabbing doesn’t really do it justice. The banner headline read:

OUR NEW YEAR’S RESOLUTION

WE’RE TRYING TO GIVE UP CIGARETTES

Just to make sure everyone got the message there was a big, bold PMI logo at the bottom of the ad, which certainly must have piqued a lot of people’s interest. After all, PMI are pretty much famous for one thing, and that thing is selling cigarettes. So why on Earth would they want to give them up?

If you read on, you’ll find out. The next line says “Philip Morris is known for cigarettes. Every year, many smokers give them up. Now it’s our turn.” That doesn’t leave a lot of room for doubt – PMI are saying, very clearly, that they want to stop selling cigarettes.

Predictably, this has sparked a lot of comments. Many people are very supportive – we at Heat not Burn UK are, for example. So are most libertarians, many vaping advocates and at least one major tobacco control group, the Foundation for a Smoke-Free World.

Equally predictably, not everyone is so happy. A whole alphabet of agencies, pressure groups and nanny state advocates are jumping up and down, squeaking in outrage. How very dare Philip Morris say they’re going to stop selling cigarettes! Isn’t it awful that they’re allowed to say such horrible things?

Well, maybe not. Let’s look at exactly what PMI are proposing, seeing as they helpfully listed it all in their adverts:

  • Launch a new website, with an associated marketing campaign, to give smokers information on how to quit and what safer alternatives are available.
  • Offer support to smoking cessation services in areas where smoking rates are highest.
  • Put a card with information on how to quit or switch to a safer product in packs of cigarettes.
  • Make more safe alternatives available to British smokers.

Of course PMI have already spent more than £2.5 billion on the last of these, and the first products are on sale in the UK right now – iQOS and the Mesh e-cigarette. Over the next year or two more will follow, including at least one more heated tobacco product and a completely different one that uses chemical reactions to create a nicotine mist.

So what’s the problem? Why are people like Deborah Arnott, the perpetually outraged CEO of Action on Smoking and Health, so angry that PMI are willing to spend a lot of money helping smokers to quit? Well, that’s where it gets complicated. There seem to be two main themes at work here, so let’s look at those.

PMI don’t mean it!

The first objection is that Philip Morris don’t really mean it. After all, if they want to stop selling cigarettes they could just stop, couldn’t they? In fact tobacco control come out with this argument every time a tobacco company does anything related to harm reduction or alternative products – “Why don’t you just stop making cigarettes, then?”

Well, mostly because it’s not that simple. Last Tuesday, when the PMI advert appeared, the BBC asked a company spokesman the same question, and it got an obvious answer: Basically, “Because if we stopped selling cigarettes tomorrow, smokers would just buy them from someone else.”

I suppose you could argue that if all the tobacco companies stopped selling cigarettes there would be nobody else to buy them from, but let’s be realistic here: There’s a large, organised criminal industry making counterfeit cigarettes already, despite the tobacco companies selling over five trillion real ones every year.

Just imagine what would happen if the legitimate supply dried up. Does anyone seriously think all of the world’s one billion smokers would just quit? Not a chance; most of them would start buying on the black market. The people who run that black market would become, overnight, the richest and most powerful criminals in the history of the world. Cocaine, heroin, even America’s Prohibition-era bootleggers would pale into insignificance.

There’s another point, too. Tobacco companies have a legal duty to their shareholders to make a profit, so if they all trashed their businesses tomorrow they’d go to jail. Meanwhile the pension funds who are the biggest owners of tobacco shares would collapse, leaving millions of pensioners in poverty. The economic damage alone could trigger another global recession.

So, for a couple of reasons, PMI can’t just stop making cigarettes. It’s only going to work once the majority of smokers have either quit or switched to reduced risk products, like Heat not Burn or e-cigarettes. Philip Morris have already spent a lot of time and money encouraging that, and now they’re offering to spend more.

 

It’s against the rules!

Arnott also claims that PMI’s second proposal – offering support to stop smoking services – is illegal. The basis for this claim is that under Article 5.3 of the WHO’s tobacco control treaty, governments aren’t allowed to accept donations from the tobacco industry. This obviously looks like a problem, except for one tiny detail: Somebody is lying here, and it isn’t PMI.

Article 5.3 says no such thing, and Deborah Arnott knows that. All the article actually says is that any interaction between government and the tobacco industry must be transparent, so as long as PMI are supporting stop-smoking services openly there’s no problem. I’ve met Arnott more than once and it would be safe to say she is not my favourite person (I’m not hers, either), but it’s still unpleasant to have to state that she is being completely dishonest here.

Arnott says that, instead of donating to stop smoking services, tobacco companies should be forced to give the government more of their profits. It’s not hard to guess why: ASH has lost a significant amount of its government funding in the last year, and its response has been to push for a Tobacco Levy. This would be an extra tax on the industry, with a big chunk of the proceeds going to – you guessed it! – ASH.

Back to reality

The truth is, it’s not hard to understand why PMI are serious about moving to safer products. Why wouldn’t they be? There’s obviously a demand for safer ways to use nicotine – just look at the way vaping has taken off in the UK, and how fast iQOS is growing in Japan. If PMI don’t sell those products they’ll lose out to companies that do, and if they are selling them, why not work to steer customers towards them and away from the more dangerous ones?

What it comes down to is that smoking isn’t good for you, and everyone knows that. The tobacco companies know it, although they denied it once – but that was decades ago and the people who did it are all long gone. Arnott knows it; after all, she’s made a lot of money telling people. You know it, too; that’s why you’re on this site reading about safer products.

Heated tobacco, and other reduced-risk products like e-cigarettes, have turned the world of tobacco control upside down. Now we have Philip Morris offering to spend their own money to help people quit smoking, while the old guard like Deborah Arnott shout abuse from the sidelines because it’s not all about them anymore. At Heat not Burn UK we’re just interested in safer alternatives to smoking, and we’re on the side of anyone that makes them available. So well done on your New Year’s resolution, PMI – we’re sure you’ll do all you can to make it happen.

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PAX 3 Review – Does it match the hype?

A couple of weeks ago I mentioned that the next device we looked at on Heat not Burn UK would be the PAX 3 from Pax Labs. That’s sparked some excitement from just about everyone I know who’s ever used a loose-leaf vaporiser to inhale anything, which didn’t really come as a surprise. After all, if there’s a device that every other vaporiser on the market ends up being measured against, the PAX 3 is it.

This gadget is the follow-on to the already legendary PAX 2, and it follows the same basic principles. There are some significant upgrades, though, including improved battery life and better software. It also adds the ability to use wax concentrates, but that isn’t something we’ll be looking at – our only interest in the device is how good it is for vaping tobacco.

Last month we reviewed the Vapour 2 Pro Series 7, which works on the same principle as the PAX 3; it has an internal chamber that you can load up with tobacco, and when you power it up the contents of the chamber get heated enough to release a vapour that you can inhale. It doesn’t get heated enough to actually burn the tobacco, so you avoid all the tar, carbon monoxide and other assorted cag that cigarettes create.

Although the basic principle is the same as the Series 7, the PAX 3 has a few major differences in how it’s laid out. In fact, while the Series 7 turned out to be pretty impressive after I figured out how to use it, the PAX feels like it’s in a whole different class. The question is, did its performance measure up? Let’s find out.

The Review

I think I mentioned in one of my videos that HnB products tend to come in really nice boxes. Well, the PAX 3 takes that to a whole new level. This is the nicest box I’ve seen for any kind of vaporiser. In fact it’s probably the nicest box I’ve ever seen for anything that didn’t come from a jeweller’s shop and cost a month’s wages.

The usual cardboard sleeve slides off to reveal a box that opens like a book, revealing two fold-out covers. One has a discreet Pax logo in the middle; the other side says, equally discreetly, “Accessories”. The two halves of the box don’t flap about, by the way. They stay respectably closed, although there aren’t any visible magnets. I investigated with a magnetic field detector (I have some odd stuff) and, sure enough, there are two small but powerful magnets actually embedded in the sides of the box.

Desperate to get to the good stuff, I opened the flap with the Pax logo and there was the vaporiser, sitting all alone in a little cut-out. It’s much simpler than the Vapour 2 Pro, bordering on minimalist; the body is a single piece of anodised aluminium, polished to a glassy finish, with a rubber top cap and plastic base. It’s slightly chunkier than the PAX 2 but still very compact and slim. There are no visible controls; on the front there’s just a Pax logo illuminated by four LEDs; on the back you’ll find two brass contacts, the device name and serial number.

It turns out the only control is under the rubber top cap, which also serves as a mouthpiece; to turn it on you just press down on the centre of the cap until the Pax logo lights up. Holding the button for two seconds opens the temperature select mode. There are four temperature options; press the button to cycle through them, and the petals on the logo light up one by one to show how hot it will get.

The plastic bottom cap covers the heating chamber; just press one side of it and it pops out. The chamber itself looks slightly smaller than the Vapour 2 Pro’s, and there’s a replaceable metal screen at the bottom to keep tobacco out of the device’s innards.

The PAX 3 is beautifully made; there’s no other words for it. The finish is perfect (although a bit of a fingerprint magnet) and everything fits together immaculately. It’s also very light – lighter than the Vapour 2 Pro or any e-cig I own – but feels strong and solid. A definite ten out of ten for workmanship.

Anyway, as I took the vaporiser out, I noticed that the card around it was loose. Removing that, I found it concealed two more items – the charger and USB cable. The charger is a simple cradle that you lay the device on, and magnets will line the contacts up correctly. It’s very simple to use, and should also be well sealed and robust.

The other side of the box has lots of stuff in it, and some of it’s not too obvious at first. There’s a card on top, giving instructions on how to register the device and download the Pax app (do both). Then, underneath, is an assortment of bits and pieces. A white pad conceals the tiny instruction manual, which you should definitely read. There’s a key ring, which turns out to be a simple multitool; its rubber body is for tamping leaves into the heating chamber, and the inlaid metal strip with the Pax logo is a cleaning tool. A box marked “Maintenance kit” holds some pipe cleaners and a brush.

Next, there’s another mouthpiece and two bases. The standard mouthpiece is flat, with a slot at one side for the vapour. The spare one is raised, if you prefer that shape. There’s also a base with an inner chamber for wax concentrates, which we won’t bother with, and a second dry herb one with an insert to let you half-fill the chamber. That might be important for certain herbs, but it isn’t with tobacco – the chamber isn’t huge. So we won’t bother with that one either. Finally, you get three spare screens for the heating chamber and an extra O-ring for the concentrate chamber.

The next step was to charge the battery, which was easy and only took a couple of hours. The charger really is easy to use, and the Pax logo shows how the battery’s doing. The four “petals” of the logo will pulse white and progressively light up as the charge rises, and glow solidly when it hits 100%.

So, back to how it works. As you might have guessed, the heating chamber and mouthpiece are at opposite ends on the PAX 3. To load the chamber you remove the bottom cap, load your tobacco and put the cap back on. A narrow tube runs through the body and opens into a small chamber just under the mouthpiece. This arrangement lets the vapour cool down before you inhale it; apparently this helps when you’re vaping herbs, but I’m not sure it’s so necessary with tobacco.

Right, on to the test! I loaded the chamber with tobacco from a fresh pouch, taking care not to pack it too tightly, then activated the PAX 3. This is easy; just press the button – don’t hold; just press. Instantly the LEDs in the logo flash white, then turn purple – when they’re purple that means the PAX is heating up. And it heats up fast. Even with the temperature set to maximum the logo turned from purple to green in less than 25 seconds, and that was it ready to go. All that was left was to start vaping it.

This is where things get a bit mixed. Here’s the good news: With the temperature set at maximum, the vapour from the PAX 3 is the best I’ve found from any Heat not Burn device so far. There’s plenty of it and the taste is great. After one puff I was extremely impressed. After the second I was pretty much ecstatic. Then it started to go downhill.

The third puff gave almost no vapour at all, and the next couple were the same. There was still a faint taste, but it wasn’t very satisfying. At this point I put the device down and let it sit for a moment to build up vapour, then tried again. By doing that I got a couple more reasonable puffs out of it, but then it dried up for good.

Unlike the Vapour 2 Pro the PAX 3 doesn’t automatically cut off after a set time; you have to switch it off using the button (it will turn off if it’s left untouched for three minutes). So I turned it off, let it cool down, emptied the chamber (the cleaning tool works very well) and had a poke at the tobacco. It was bone dry, so my guess is that it stopped producing vapour because there was nothing left to evaporate.

What I think is happening is that the PAX 3 is a victim of its own success. The design of the heating chamber is obviously great. It’s very efficient, probably because of its shape – it’s quite long and narrow, so the contents heat up very quickly and evenly. That means the first couple of puffs are great. The problem is, the first couple of puffs basically contain all the moisture in the tobacco. I also tried it on a lower temperature setting, but this radically dropped the quality of the first puffs and didn’t really extend the session by much; you might get five puffs instead of two, but they were nowhere near as good.

If you’re trying to replicate the experience of smoking this is a bit of a drawback. You can expect to get about ten good puffs from a cigarette, but you’re going to have to reload the PAX 3 four or five times to match that.

Conclusion

From everything I’ve heard about the PAX 3, it’s unrivalled as a device for vaping substances of a more herbal nature – but, for tobacco, it doesn’t have the same edge. It’s a beautifully made device with good battery life (it packs in 3,500mAh, compared to the PAX 2’s 3,000mAh), and it’s simple to use, but if you’re mainly interested in tobacco I don’t think it’s the best option. If you really want a loose-leaf tobacco vaporiser the Vapour 2 is at least as good and a lot cheaper; if convenience and performance are what matters most, go for an iQOS.

Video Review

 

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HnB “as bad as smoking” says study – but what’s the truth?

HnB

And so it begins. A new paper presented to the American Heart Association claims that Heat not Burn products harm blood vessel function in the same way as smoking. No doubt there are a dozen other studies underway right now that will soon produce papers linking HnB to heart attacks, lung disease and various cancers. Carefully tailored press releases, all including some form of the phrase “as bad as smoking”, will be leaked to sympathetic journalists. Public health activists don’t even need to go looking for friendly hacks; they can just get in touch with the ones who wrote negative articles about e-cigarettes.

If I sound cynical about the new paper, it’s because I am. I switched from smoking to vaping five years ago, just in time to see the tobacco control industry gearing up its campaign against e-cigs. I have to confess that, at the time, I watched it unfold with total incredulity. Here was a product that got smokers to stop smoking, but the activists and scientists who’re always demanding new action to stop smokers from smoking were opposed to it! What the hell was going on?

Well, five years later, I know what’s going on. The tobacco control industry is, in big-picture terms, split between two main factions – and neither of them is really interested in helping smokers to quit. One faction is motivated by a blind, unreasoning hatred of the tobacco companies; if Philip Morris invented a cure for cancer tomorrow, this group would try to have it banned.

The other faction is no fan of the tobacco companies either, but it has different priorities. Its goal isn’t to stop smokers from smoking; it’s to campaign to stop smokers from smoking. Obviously, if all the smokers become vapers or Heat not Burn users, there won’t be any smoking to campaign against – and that means they’ll have to find new jobs, which might involve some actual hard work rather than just being handed taxpayers’ money to complain about things.

Tinfoil hat time?

Claiming that public health campaigners are more worried about their jobs than public health sounds a bit paranoid, but what’s happening in the UK right now tends to back it up. Local councils who’re trying to save money are starting to take a good look at the stop smoking services they fund – and it appears that some of them don’t like what they see. Several services, including Smokefree South West, have had their council funding stopped, and for nanny state groups that’s usually a death blow. Nobody actually wants to give them money, so if the tax tap is turned off that’s the end of them. Smokefree Southwest announced its closure within 24 hours of being defunded.

The reason councils are starting to defund anti-smoking groups is that it’s obvious they aren’t doing anything. Most councillors aren’t daft; they see smokers switching to e-cigs by the thousand, and the UK’s smoking rate falling faster than ever before. Then they see so-called “public health” groups demanding that e-cigs are taxed, restricted and banned out of existence. Finally it occurs to them that not only are these groups not doing anything to reduce smoking; they’re actively campaigning against products that are. So they pull the plug, and another dozen tobacco controllers are forced to get a proper job.

And all this is happening because of e-cigs. Just imagine what’s going to happen when HnB goes mainstream. Personally, I wouldn’t be surprised if a decade from now the UK’s smoking rate has fallen from its current 16% to around 5%. If that happens a lot more tobacco control funding is going to evaporate, which is why all the usual suspects are already moving to condemn HnB.

What does the science say?

Anyway, back to the paper. What exactly is it saying, and should we take it seriously? The short answer is “Not much and no.” That isn’t very informative, though, so let’s look at it in slightly more detail.

The paper was written by the tobacco research department at the University of California, San Francisco. If you follow the vaping debate that’s probably ringing alarm bells already, because who runs UCSF’s tobacco research department? Yep, it’s Stanton Glantz, the failed aircraft engineer who’s managed to get a job as a professor of medicine despite never having studied medicine in his life. The reality is that Glantz is an activist, not an academic, and this department is shaped in his image: Before they even start doing any research, they know exactly what results they plan to get.

What they wanted to find here was evidence that HnB is just as bad for you as smoking. Now, this is obviously a ridiculous idea. Probably the most harmful single ingredient in cigarette smoke is carbon monoxide, which is produced by combustion, and HnB doesn’t involve combustion.

What they actually mean is that one specific effect of HnB is the same as an effect of smoking. That is obviously not the same thing as saying that using HnB is as bad for you as smoking is. In this case they’re talking about something that isn’t really bad for you at all.

The paper claims that using a HnB product – specifically, iQOS – has the same effect on “Flow-Mediated Dilation”, a way of measuring the efficiency of blood vessels, as smoking a cigarette. In general terms this is true; it’s likely (not certain, but we’ll come back to that) that iQOS will cause a similar short-term effect on blood vessels to a cigarette. Where it all comes unstuck is that the authors go on to say that HnB “does not necessarily avoid the adverse cardiovascular effects of smoking cigarettes”. That statement is a massive problem.

Smoking cigarettes is really bad for your heart. Smoking cigarettes also causes short-term stiffness in your arteries every time you light up and take a puff. But these two facts are not connected. It isn’t the short-term stiffness that makes cigarettes bad for your heart; it’s the couple of hundred daily doses of carbon monoxide, which causes long-term stiffness and the build-up of arterial plaque. Many other things also cause short-term stiffness – caffeine, watching scary movies and exercise are among them. It doesn’t matter, though, because it only lasts a few minutes. Smoking is dangerous because it makes your arteries stiffer all the time, plus promote the build-up of plaque which slowly blocks them. iQOS, being free of carbon monoxide, doesn’t do this.

So what’s really going on with this paper? Leading e-cig expert and cardiologist Dr Konstantinos Farsalinos has the answer, as already reported on this site. According to the UCSF paper, the iQOS delivered 4.5 times as much nicotine to the test subjects (who, it should be pointed out, weren’t people – they were mice) as a cigarette did. As nicotine is known to cause temporary stiffening, that would certainly explain the effect. It would also suggest that it’s nothing to worry about. After all, licensed nicotine products like patches and gum cause an identical effect, and they’re sold over the counter and approved for long-term use.

If we take its data at face value, this paper shows that HnB has the same effect on blood vessels as a nicotine patch, which is regarded as very safe – in other words, there’s nothing to worry about. In fact, what the data show is that the researchers have made a very serious mistake somewhere. According to them, iQOS delivers about 350% more nicotine than a cigarette does – but three independent studies all agree that it delivers about 30% less nicotine. As Dr Farsalinos points out, it is impossible for iQOS to deliver that much nicotine. Therefore the UCSF team have screwed up somewhere, and if they’re working on terminally flawed data, that the whole paper can safely be ignored.

Unfortunately, while this one might be (it doesn’t seem to have gained much traction outside crank medical websites), as HnB becomes more popular we can expect to see more “research” being done and negative stories starting to appear in the press. It’s likely that all the smear stories that have been aimed at e-cigs will be recycled to attack HnB too. If you doubt that, consider this: Just two months ago, a paper from Sweden claimed that e-cigs have the same effect on arterial stiffness as smoking does. Sound familiar?

Heat not Burn is going to get exactly the same treatment as vaping did; I guarantee it. In fact, if anything it will be worse, because the leading HnB products actually are made by the dreaded tobacco companies. Vapers couldn’t really believe what was happening at first, and lost a lot of ground to bad science and scaremongering media before advocates started fighting back. If you’re a fan of HnB, don’t make the same mistakes; start pushing back now.