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What role will heated tobacco products have if there is a menthol ban?

A pulmonologist and the American Lung Association are among those raising health concerns about heated tobacco products.
What role will heated tobacco products have if there is a menthol ban?
Posted at 5:41 PM, Oct 20, 2023

Health experts are concerned about a growing industry of heated tobacco products.

Pulmonologist Laeeq Shamsuddin has listened to lungs damaged from tobacco and nicotine for years. 

"You have what we call bronchospasm where your lungs, which are normally like balloons, would kind of spasm and close up. And when they close up, instead of making a nice gushing sound of wind or air, it would make it more of a whistling sound," said Shamsuddin. 

As the FDA moves closer to a proposed ban on menthol cigarettes, he worries about the growing popularity of heated tobacco products.  

Heated tobacco products — often called heat-not-burn products, or heat sticks — have been around for decades. They sit between cigarettes and nicotine products like vapes. They’re often made up of a device and small inserts with dried tobacco leaves. They electronically heat at a lower temperature, avoiding higher combustion temps and making a nicotine-containing aerosol. 

The international heated tobacco product market is expected to grow nearly 30% by 2027, according to market research group Technavio. 

SEE MORE: FDA sends proposed ban on menthol cigarettes to the White House

In January, the FDA authorized marketing for three Philip Morris heat sticks, saying "the net population-level benefits to adult smokers outweigh the risks to youth." One heat stick is tobacco-flavored, while the other two are menthol-flavored. 

The FDA previously authorized Philip Morris' heating device, called IQOS. Phillip Morris International plans to commercialize IQOS in two U.S. states as early as April of next year.

Friday, Philip Morris International announced they're asking the FDA for authorization of three new heated tobacco devices and five new inserts, two of which are menthol-flavored. They will be sold by online stores based in Switzerland, one country where they're already allowed. Inserts carried descriptions like an "aromatic tobacco blend with notes of cocoa and dried fruits" and "mixed with peppermint and creamy aroma notes."

"There's a lot we don't know when it comes to the long-term consequences of their use. They're just too new," said Erica Sward, the spokesperson for the American Lung Association. "Inhaling chemicals into your lungs is always dangerous and there is no safe tobacco product."

Since Oct. 12, the FDA has moved towards a proposed ban on menthol cigarettes and denied applications for several flavors, including menthol, for a top selling e-cigarette. In emails with Scripps News, Philip Morris' communications director declined to comment about the impact those bans would have on their menthol heat sticks until the ban is finalized, noting the FDA found that the menthol heat sticks were beneficial to public health, which included toxicology reviews.

"If someone uses the products long enough, it destroys the balloons that make up your lung, the little mini balloons that make up your lung that are called alveoli. And when these are destroyed, simply there's no air movement," said Shamsuddin.

Research shows there's still short-term lung and heart damage for smokers who switch to heated tobacco, like stiffening of the arteries and higher heart rate and blood pressure.

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