Move over e-cigarettes, meet heat-not-burn tobacco

October 11, 2017
Dunhill Early Morning Pipe Tobacco, 1990's Murray. Credit: Sjschen/Wikipedia

If you haven't heard of heat-not-burn tobacco, you're not alone, but a new study published today in PLOS ONE from San Diego State University Graduate School of Public Health Associate Research Professor John W. Ayers suggests this new method for consuming tobacco is poised for explosive growth.

What is heat-not-burn tobacco?

One of the newest products on the market heats leaf tobacco to approximately 500 degrees Fahrenheit (260 C) using battery power to produce an inhalable tobacco aerosol.

Heat-not-burn tobacco is being introduced into markets around the world to appeal to trendy or potentially health-conscious consumers, Ayers said, who still demand the "throat-hit" delivered by combustible cigarettes, but not by most e-cigarettes. The first heat-not-burn device to enter the FDA-approval process in the United States did so in May.

Identifying trends

Because heat-not-burn tobacco products have only been sold in a handful of places around the world, little is known about their popular appeal or how they might fare in future markets such as the United States. How worried should tobacco control leaders be about this potential new fad?

Ayers and colleagues turned to Google search trends to understand the devices' appeal in Japan, the first country with nationwide availability. Popular devices there include Japan Tobacco's "Ploom TECH" released in March 2016, Philip Morris International's "iQOS" released in April 2016, and British American Tobacco's "Glo" released in December 2016. The team focused on internet searches for heat-not-burn tobacco, including generic terms and major brands, analyzing their relative popularity to all searches from 2015 through August 2017.

The team then compared the fraction of all Google queries for heat-not-burn tobacco in Japan to the fraction of all Google queries for e-cigarettes in the United States.

The total number of heat-not-burn queries in Japan grew by 1,426 percent their first year on the market in 2015. Between 2015 and 2017, the number of queries grew by 2,956 percent. Projections based on forecasts from the observed trends suggest that heat-not-burn queries will continue to grow at a similar rate through 2018.

"Heat-not-burn products have quickly become insanely popular," said study coauthor Mark Dredze, professor of computer science at Johns Hopkins University. "Two years ago, there were essentially no queries in Japan for heat-not-burn tobacco, but now there are between 5.9 and 7.5 million each month."

Moreover, the team found that interest in heat-not-burn tobacco in Japan is growing more rapidly than past interest in e-cigarettes when they were first introduced to market. This suggests that as heat-not-burn tobacco is introduced in new markets, its popularity may even eclipse e-cigarettes.

A public health challenge

Millions are seeking out heat-not-burn tobacco in Japan each month and demand is poised to surge across the globe as products are introduced into new markets, Ayers said. It's not clear if searches translate into actual demand, he said, but the team's previous studies of e-cigarettes first predicted the eventual rise of actual vaping rates.

"Tobacco companies try to outmaneuver protections by creating new products that make tobacco appear less dangerous and more appealing," said Theodore Caputi, an undergraduate researcher at the University of Pennsylvania and the study's first author. "People were caught off guard by e-cigarettes, for example. Our study is an early warning and a call to action for public health professionals to address heat-not-burn products now."

The team noted that tobacco control researchers might already be behind the figurative eight ball. "In the entire PubMed database—which catalogs millions of public health studies—just 26 studies even mention heat-not-burn tobacco," said Eric Leas, an alumnus of SDSU's Graduate School of Public Health alum and currently a postdoctoral fellow at Stanford. "There is a tremendous amount we need to learn about heat-not-burn tobacco."

Joanna Cohen, Bloomberg Professor at the Johns Hopkins Institute for Global Tobacco Control, added that many questions remain about the products' potential for harm. "Given heat-not-burn is a tobacco product, all existing policies to protect the public from other should be enforced," she said.

It is incumbent that leaders appreciate the potential demand for new products like these and respond proactive, Ayers concluded.

"Tobacco control is at a new crossroads," he said. "Leaders can reasonably respond to these new data and ready themselves by setting an agenda or wait for big tobacco to set the heat-not-burn agenda for them."

Explore further: Smokers with high psychological distress are smoking less and more are trying to quit

Related Stories

Smokers with high psychological distress are smoking less and more are trying to quit

October 11, 2017
Cigarette smokers with high levels of psychological distress are often heavy smokers, and thus identified as a "hard core" group who are less willing or able to quit than other smokers. However, a study by UC San Francisco ...

Tobacco use among US students dropped sharply in 2016: study

June 16, 2017
Tobacco use among American middle and high school students—especially electronic cigarette use—declined sharply in 2016 from the year before following several years of strong growth, according to a study out Thursday.

FDA will target e-cigs in health campaign for youth

August 8, 2017
(HealthDay)—The U.S. Food and Drug Administration will now include electronic cigarettes in a public health education campaign to discourage American youth from using tobacco and nicotine products.

New study examines use of multiple tobacco products in college students

May 27, 2016
A new study by University of Kentucky researchers found that roughly 15 percent of college students who had ever used tobacco currently use more than one tobacco product. Polytobacco use (using more than one tobacco product) ...

Philip Morris looking towards cigarette phase-out

November 30, 2016
Tobacco giant Philip Morris is aiming to stop selling conventional cigarettes and replace them with a less harmful product, its chief executive said Wednesday.

1 in 4 U.S. adults, 1 in 10 teens use tobacco

January 26, 2017
(HealthDay)—Despite the dangers, many American adults and teens still use tobacco products, a new study finds.

Recommended for you

Expert: Be concerned about how apps collect, share health data

October 20, 2017
As of 2016 there were more than 165,000 health and wellness apps available though the Apple App Store alone. According to Rice University medical media expert Kirsten Ostherr, the Food and Drug Administration (FDA) regulates ...

More teens than ever aren't getting enough sleep

October 19, 2017
If you're a young person who can't seem to get enough sleep, you're not alone: A new study led by San Diego State University Professor of Psychology Jean Twenge finds that adolescents today are sleeping fewer hours per night ...

Across Asia, liver cancer is linked to herbal remedies: study

October 18, 2017
Researchers have uncovered widespread evidence of a link between traditional Chinese herbal remedies and liver cancer across Asia, a study said Wednesday.

Eating better throughout adult years improves physical fitness in old age, suggests study

October 18, 2017
People who have a healthier diet throughout their adult lives are more likely to be stronger and fitter in older age than those who don't, according to a new study led by the University of Southampton.

Global calcium consumption appears low, especially in Asia

October 18, 2017
Daily calcium intake among adults appears to vary quite widely around the world in distinct regional patterns, according to a new systematic review of research data ahead of World Osteoporosis Day on Friday, Oct. 20.

New study: Nearly half of US medical care comes from emergency rooms

October 17, 2017
Nearly half of all US medical care is delivered by emergency departments, according to a new study by researchers at the University of Maryland School of Medicine (UMSOM). And in recent years, the percentage of care delivered ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.