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Not all tobacco products are the same – Understanding smoke-free alternatives

September 13, 2019

In 2015, more than seven million men and women in South Africa smoked cigarettes. The World Health Organization (WHO) estimates that this number is unlikely to materially change by 2025. While smokers’ best choice would be to quit, many will not.

Today, a range of tobacco and nicotine products, such as e-cigarettes, heated tobacco, and Swedish snus deliver nicotine without burning tobacco. Many scientists, public health experts, and regulators agree that these smoke-free products are much better than continued smoking. If all of those smokers who will not quit would switch completely to these smoke-free alternatives, this would dramatically improve their lives and be the end of cigarette smoking in South Africa.

Sharmila Parsotam, Head of Scientific Engagement and Philip Morris South Africa explains the difference between cigarettes, e-cigarettes or vapes, and heat-not-burn or heated tobacco products:

Everyone knows what cigarettes are. They are the most popular tobacco product in South Africa and the rest of the world. Unfortunately, because they burn tobacco, they are also the most harmful. The burning of tobacco is responsible for the production and transfer of the vast majority of toxicants that experts agree are the primary cause of smoking-related disease. Smoke-free products, on the other hand, do not burn tobacco or produce smoke. Because of this, they are significantly less harmful than continued smoking.

E-cigarettes, also called electronic cigarettes, are a category of smoke-free products that use liquids instead of tobacco. These battery-powered devices vaporise the liquid solution that contains nicotine and/or flavours. Vaping is the term typically used to describe inhaling an aerosol (vapour) from an e-cigarette. In 2015, Public Health England, an advisory body to the U.K. Department of Health, stated “It has been previously estimated that [electronic cigarettes] are around 95% safer than smoking. This appears to remain a reasonable estimate”. These products don’t produce smoke or cigarette smell. However, for some smokers, the taste of tobacco is essential to their experience and since e-cigarettes don’t contain tobacco, they sometimes struggle to make the switch and return to cigarettes.

Heated tobacco products can also present less risk of harm than continued smoking. For example, IQOS, the first of the new generation of heated tobacco products, heats specially designed tobacco sticks to temperatures no higher than 350 degrees Celsius, well below that required for combustion (around 400 degrees Celsius). As a result, IQOS does not burn tobacco or produce smoke. IQOS is not an e-cigarette or vape, and doesn’t use liquids.

“By heating instead of burning tobacco, IQOS emits 95% less harmful chemicals compared to cigarettes, however, this doesn’t mean it’s risk-free,” Parsotam says. “For smokers who have tried to switch to e-cigarettes but find the tobacco flavour lacking, IQOS & HEETS may be the better alternative. What’s more, it doesn’t produce cigarette smell or second-hand smoke which can be offensive to smokers, their environments or those around them.”

She concludes, “From our experience globally more than 70% of smokers who use IQOS are able to switch from cigarettes completely and stay smoke-free.”

“Smoke-free products present an opportunity for governments to complement measures intended to prevent initiation and encourage smoking cessation with policies that enable and encourage existing smokers who will not quit to switch completely to smoke-free alternatives.”

W: Iqos

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