Are HTPs really safer than cigarettes? What we know so far about new ‘no-smoke’ products hitting the US

The world’s top-selling heated tobacco device (HTP) recently relaunched in the US, with the industry touting it as a healthier alternative to traditional cigarettes. 

But is it really a smarter smoke — or just a rebranded risk?

Dr. Jamie Hartmann-Boyce, an assistant professor of health promotion and policy at UMass Amherst, and her colleagues sifted through dozens of studies to see if the science behind heated tobacco really holds up. 

She broke down their findings in The Conversation. Here’s everything you need to know. 

But first: What are HTPs?

Unlike traditional smokes, these high-tech devices heat real tobacco leaves instead of burning them, producing a nicotine-filled vapor for users to inhale.

They might look like e-cigarettes, but there’s a key difference: vapes heat a nicotine liquid, not tobacco. And unlike your standard cigarette, HTPs don’t burn the leaf — they just warm it up.

“These distinctions matter because it’s the burning of tobacco leaf – not the nicotine – that directly causes the disease and death associated with smoking,” Hartmann-Boyce explained.

Big tobacco’s latest pitch

Tobacco giants market HTPs as a safer smoke-free alternative to cigarettes – and they’ve got industry-backed research to support their claims. 

Several studies that have received funding from tobacco companies have found that the vapor from HTPs contains significantly lower levels of harmful toxins like heavy metals, aldehydes, and polycyclic aromatic hydrocarbons when compared to cigarette smoke.

There’s even some evidence suggesting that for certain users — like those with chronic lung disease — switching from cigarettes to heated tobacco could have some benefits, according to the BBC.

But when Jamie Hartmann-Boyce and her team reviewed 40 clinical trials on these devices, the results weren’t as clear-cut. In fact, they deemed the evidence on the health benefits or risks of HTPs as “inconclusive.”

Blowing smoke on HTPs

The researchers dug into molecular changes in the body — known as biomarkers — to understand the potential impact of HTPs. The 40 studies they reviewed revealed changes in 143 biomarkers, including those tied to heart disease and cancer.

But the results weren’t exactly clear-cut. “Most of the studies of heated tobacco products are small and relatively short term — they don’t give us a clear picture of their effects,” Hartmann-Boyce noted.

Here’s the kicker: a whopping 29 of the 40 trials were funded by the tobacco industry, which has a vested interest in proving HTPs are safer than regular cigarettes.

“While our findings do not rule out the possibility that HTPs are “reduced risk”, they provide little support for such claims,” Dr. Sophie Braznell, lead author of the study and a research associate at the University of Bath, said in a statement.

It’s not just Braznell and Hartmann-Boyce who are giving HTPs the side-eye. 

Efthimios Zervas, a chemical engineer at the National Technical University of Athens, has spent over a decade analyzing the chemicals in HTP fumes. And just like cigarettes, he found that HTPs release dangerous fine particles that can seep deep into your body, per the BBC. 

While many toxins were present in lower concentrations than in cigarette smoke, Zervas discovered some harmful chemicals — like carbonyl methylglyoxal — that actually appear in higher concentrations in HTP vapor.

Other studies have found that HTPs can trigger similar cardiovascular issues as traditional cigarettes, including raising heart rate, blood pressure and causing arterial stiffness. Some research also suggests they may lead to airway obstruction and other lung problems.

Want to quit? Not so fast

The tobacco industry often promotes HTPs as a tool to help people quit smoking, but the CDC says there’s no scientific backing for this claim.

Researchers in Japan, where HTPs are widely popular, looked into the issue and found that the devices didn’t help smokers quit or prevent former smokers from relapsing.

In the US, a survey of young adults revealed that many use HTPs alongside other tobacco products, which increases the risk of nicotine dependence and harmful side effects.

Compare that to vapes, which some studies suggest can help people quit smoking traditional cigarettes.

“There is a large body of evidence on safe and effective ways to transition away from smoking, which makes the relative lack of robust scientific evidence on heated tobacco products particularly striking,” Hartmann-Boyce said. 

The road ahead

Hartmann-Boyce and Braznell are calling for longer, higher-quality studies — independent from the tobacco industry — to assess the true health impacts of HTPs.

This push comes as the use of HTPs continues to rise in the US. So far, the FDA has granted authorization for just one such device: IQOS, which relaunched in Austin, Texas, in March after being pulled from the U.S. market in 2021 due to a patent dispute. 

IQOS is owned by Philip Morris International, one of the world’s largest tobacco companies, which has poured billions into developing HTPs and funding research on their effects.

Philip Morris did not immediately respond to The Post’s request for comment.

Hartmann-Boyce emphasized that the long-term health effects of HTPs are still unknown, and it remains unclear whether they can effectively reduce the risk of disease or death for those switching from traditional cigarettes.

But she’s certain about one thing: “Quitting smoking is the best thing someone who smokes can do for their health,” Hartmann-Boyce said.