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Heat-not-burn products bring wave of change in smoking cessation efforts

Dr Joslyn Ngu
30 Oct 2017

The introduction of heat-not-burn cigarettes may lead to dramatic changes in lung cancer incidences and types of lung cancers, says an expert.

Speaking at the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer (WCLC), held recently in Yokohama, Japan, Dr Carolyn Dresler said the company that markets Marlboro cigarettes—one of the largest brands in the world—recently introduced a heat-not-burn product called iQOS, an acronym for I Quit Ordinary Smoking. It is a product that claims to not combust tobacco and is supposedly less hazardous to health. Dresler works with both the US Human Rights and Tobacco Control Network and the Center for Tobacco Products, US FDA.

The reason this is an important event to note is because the market follows the lead of Marlboro, said Dresler. At the moment, Philip Morris International (PMI)—the company that markets Marlboro—has already launched iQOS in 30 countries and are planning to expand to more countries. Furthermore, in the US, PMI has an application for the ability to claim iQOS as a ‘reduced-harm’ product.

Most smokers want to quit smoking cigarettes to reduce the risk of tobacco-induced diseases for themselves and others. Heat-not-burn products claim to remove the ‘harm’ from smoking and yet still provide smokers with the nicotine they are addicted to. The IASLC hopes that e-cigarettes and heat-not-burn products do cause less lung cancer as cigarette smokers quit smoking and transition to the newer products, but that remains to be proven, said Dresler. Nevertheless, dramatic changes in smoking practices will likely lead to a shift in the incidence and type of lung cancer.

E-cigarettes have also impacted the market and claimed to cause less tobacco-related disease. Globally, the uptake of e-cigarettes varies because of different country regulations and marketing decisions. Also, e-cigarettes do not have the marketing strength of heat-not-burn products, which is backed by the largest trans-national tobacco company, PMI, she said.

Besides PMI, there are two other major trans-national tobacco companies in the world: British American Tobacco (BAT) and Japan Tobacco International (JTI). Another major tobacco company is the Chinese National Tobacco Corporation, whose scope is currently limited to China and has yet to expand internationally.

Heat-not-burn products heat instead of combust tobacco, explained Dresler. However, its route of delivery is still via the lungs and it is still an aerosol. It is also not ‘smokeless.’ Besides PMI’s iQOS, other companies such as BAT and JTI also have their own heat-not-burn products, namely Glo™ and Ploom TECH™.

In the near future, the smoking epidemic will change and smoking cessation efforts need to adapt quickly, advised Dresler. 

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Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
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Pearl Toh, 04 Feb 2020
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