Last updated: March 2018
Suggested citation: Greenhalgh, EM. 18C. Heated tobacco (‘heat-not-burn’) products. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2018. Available from: http://www.tobaccoinaustralia.org.au/chapter-18-harm-reduction/indepth-18c-non-combustible-cigarettes/18c-7-key-australian-and-international-position-statements
As heated tobacco products are relatively new, relatively few organisations have released official position statements on their use and regulation. Those major agencies that have issued information or expressed concerns regarding their risk to individual and public health have advocated caution, as outlined below.
The Australian Government Department of Health, in its enquiry into e-cigarettes, has stated that “There are concerns about the marketing and use of heat not burn tobacco products, because of the limited evidence on their ability to reduce the risk associated with conventional tobacco products and the risks they may pose to population health, such as their potential to disrupt the decline in tobacco use in Australia. The most reliable epidemiological evidence shows that the best way to avoid tobacco-related premature death and disease is to prevent exposure or to cease the use of tobacco products entirely. There is no safe level of tobacco consumption”.1
The World Health Organization, in its heat-not-burn (HNB) information sheet, states that “All forms of tobacco use are harmful, including HNB tobacco products. Tobacco is inherently toxic and contains carcinogens even in its natural form. Therefore, HNB tobacco products should be subject to policy and regulatory measures applied to all other tobacco products, in line with the WHO Framework Convention on Tobacco Control (WHO FCTC).2
The International Union Against Tuberculosis and Lung Disease’s position statement on heat-not-burn (HNB) products concludes:
Public Health England, in its latest evidence review, concluded that “…it is currently not clear whether heated tobacco products provide any advantage as an additional potential harm reduction product. Depending on emerging evidence on their relative risk to combustible tobacco and e-cigarettes, regulatory levers such as taxation and accessibility restrictions should be applied to favour the least harmful options alongside continued efforts to encourage and support complete cessation of tobacco use”.4
The French Alliance Against Tobacco’s position statement concludes that: independent data on heated tobacco is insufficient; heated tobacco must be subject to the rules on smoked tobacco products; and heated tobacco is more of a problem than a solution for tobacco control.5
1. Department of Health, Standing Committee on Health, Aged Care and sport - inquiry into the use and marketing of electronic cigarettes and personal vaporisers in Australia. Australian Government; 2017. Available from: https://www.aph.gov.au/DocumentStore.ashx?id=4f4d5093-5468-40c0-b573-986692900aad&subId=512734.
2. World Health Organization. Heated tobacco products (HTPs) information sheet. 2017. Available from: http://www.who.int/tobacco/publications/prod_regulation/heated-tobacco-products/en/
3. International Union Against Tuberculosis and Lung Disease. The Union's position on heat-not-burn (hnb) tobacco products. 2017. Available from: https://www.theunion.org/what-we-do/publications/official/body/Heat-not-burn-Union-Position-Statement-Final.pdf
4. Ruprecht AA, De Marco C, Saffari A, Pozzi P, Mazza R, et al. Environmental pollution and emission factors of electronic cigarettes, heat-not-burn tobacco products, and conventional cigarettes. Aerosol Science and Technology, 2017; 51(6):674–84. Available from: https://doi.org/10.1080/02786826.2017.1300231
5. French Alliance Against Tobacco. Heat not burn tobacco & related products. 2017. Available from: http://ensp.org/2017/11/24/position-paper-heat-not-burn-tobacco-related-products/