Reintroduction of Heated Tobacco Products in the US Sparks Concerns Over Limited Safety Evidence

Heated tobacco products, often promoted as less harmful alternatives to traditional cigarettes, are making a resurgence in the US market amid limited and inconclusive evidence about their safety. These electronic devices heat tobacco to create inhalable nicotine aerosols, with popular brands like IQOS, Ploom, and Glo. Unlike e-cigarettes, which vaporize a nicotine-laden liquid, heated tobacco products use actual tobacco leaves, yet they are marketed similarly.

Research indicates a lack of comprehensive long-term data on health risks associated with heated tobacco use. A recent review of 40 clinical trials examining molecular biomarkers in blood, breath, and urine found changes linked to heart disease and cancer. However, the evidence was often contradictory and hampered by biases, such as industry funding and controlled study settings that don’t reflect real-world usage.

Most studies suggest that switching from traditional smoking to heated tobacco products might lower some health risks; yet, others show no benefit or potential increased risks. Notably, the majority of the research was industry-funded and short-term, which limits the reliability of these findings.

Heated tobacco products are already prevalent in Japan and have been reintroduced in the US, notably IQOS relaunching in Texas in March 2025 after a temporary removal due to patent disputes. Philip Morris International, a major tobacco corporation, owns many of these products, claiming they offer a "better alternative" for adult smokers. Nonetheless, independent research indicates these claims are unsubstantiated, and the products may not aid cessation efforts, with some data hinting at ongoing health risks.

The long-term impacts remain uncertain, and current evidence does not convincingly demonstrate that heated tobacco products are safer than cigarettes. More independent, long-term studies are needed to assess whether they can truly reduce disease risk and help smokers quit. Until then, health authorities and consumers should be cautious about these products as their safety profile is still unclear.