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Smokeless cigarettes: are they really less harmful than traditional cigarettes?

Cigarette alternative heats tobacco instead of burning it, health-care experts skeptical
WATCH: New device promoted as better than regular cigarettes and vaping

E-cigarettes and now smokeless cigarettes like the IQOS, a heated tobacco product developed by Phillip Morris, offer alternatives for Canadian smokers, but are they actually any less harmful than a traditional cigarette?

The short answer, from one non-smoking advocate is “probably.”

READ MORE: Why a landmark study suggests e-cigarettes are safer than smoking

But Pippa Beck, a senior policy analyst with the Non- Smokers’ Rights Association, says there’s not enough research analyzing the potential harm these products could have on our health.

“It’s too early to say,” she said.

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“When we look at tobacco smoking, we have over six decades worth of studies that have helped provide us with this body of evidence.”

LISTEN: Smokeless cigarettes and how they work

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Heat-not-burn versus traditional cigarettes

Peter Luongo, the managing director of Rothmans Benson and Hedges Inc., which is a Canadian subsidiary of Phillip Morris, claims its heated tobacco product IQOS is less harmful because the tobacco is heated to a much lower temperature.

“It’s the burning that creates the smoke, it creates all the harmful chemicals that are in a cigarette,” Luongo said.

The product works by inserting a “tobacco stick” into a device that heats it up and then keeps it at a consistent temperature. Luongo claims that instead of smoke, the IQOS produces a vapor (similar to an e-cigarette).

He says the heat-not-burn cigarette produces 90 to 95 per cent fewer chemicals than a traditional cigarette.

Dr. Brent Friesen, a medical officer of health with Alberta Health Services’ Tobacco Reduction Program, says that’s true, but it’s not the whole story.

He says a study in the Journal of the American Medical Association (JAMA) found “higher concentrations of some carcinogens” in smokeless cigarettes “than would normally be present in regular cigarettes.”

“They clearly are not safe products. There are still risks attached to them and it’s difficult to quantify what those risks are,” he said.

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Friesen says questions about lab-testing of new tobacco products also make it difficult to accurately assess the harm. An example, he says, are the tests that were done prior to the initial release of low-tar tobacco products.

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Machines detected a lower yield of tar in these “light” cigarettes because of small holes in the filter, which brought in more air and diluted the tobacco smoke.

“In reality, what smokers did when they were holding their filter is they made sure they covered the holes,” Friesen said. “So, they were being exposed to the same amount of tar as in regular cigarettes.”

LISTEN: The Non-Smokers’ Rights Association on smokeless cigarettes and whether they are less harmful to your health

E-cigarettes versus heat-not-burn products

Friesen says there’s no way to really measure the potential harm of a smokeless cigarette compared to an e-cigarette because there’s a lack of regulation.

Both products are very new to the market. In Canada, e-cigarettes have been around since about 2007 and heat-not-burn tobacco products have been in Canada for only a few months.

READ MORE: To vape or not to vape: Alberta expert says research is lacking

WATCH BELOW: Debating the difference between e-cigarettes and regular cigarettes

The components found in e-liquids are not regulated by the Canadian government, Friesen says.

“You can’t really say, from one e-liquid manufacturer to another e-liquid manufacturer, how their product compares… which also makes it difficult to compare those e-cigarettes to heat-not-burn products.”

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As of June 15, a bill that would amend the Tobacco Act and Non-Smokers’ Health Act in order to regulate the manufacture, sale and labelling of e-cigarettes was in its second reading in the House of Commons.

Friesen says currently, because e-cigarettes are not regulated there are no “assurances over quality and what people are being exposed to.”

He adds that some testing has found heavy metals are present in some e-liquids.

“When [researchers] tested e-cigarettes on the very high power settings, they were able to produce almost like a burning effect, and so found that the e-cigarettes produced high levels of formaldehyde.”

Do they help you quit smoking?

 Friesen and Beck said there is some research to suggest e-cigarettes are comparable to other cessation therapies, like the nicotine patch and gum (including this one from Cochrane).

“The fact that e-cigaretttes are at least as effective is huge,” Beck said.

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WATCH BELOW: New study suggests e-cigarettes be used to help people quit smoking

New study suggests e-cigarettes be used to help people quit smoking
New study suggests e-cigarettes be used to help people quit smoking

But she added that there aren’t enough studies, on either e-cigarettes or heat-not-burn products, that researchers “can feel confident in the conclusions they’re making.”

Beck pointed to issues with methodology and bias.

Friesen says he’s not aware of any studies comparing heat-not-burn cigarettes to other forms of cessation therapy.

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He said researchers in the U.K, where e-cigarettes are widely available, have found smokers are using e-cigarettes in addition to traditional cigarettes, rather than to help them to quit smoking.

There is some data that suggests that is not accurate. A study by Action on Smoking and Health in the U.K, released in May 2017, found that out of 2.9 million people that used e-cigarettes in that country, more than half – or 1.5 million – had actually quit smoking.

Alberta Health Services has resources available to anyone who wants to quit smoking at albertaquits.ca. There are also resources available from the Non-Smokers’ Rights Association website.