Cannabis Indica

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Source says "Figure 1. Comparaison des émissions des cigarettes conventionnelles de référence (3R4F et 1R5F) avec celles de l’IQOS avec des mini-cigarettes Heets standards (THS2.2r) et mentholés (THS2.2 m) [28]." It is about the IQOS. It is not about all products in general.
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The three main products have limiters, so that a cigarette or aluminum capsule cigarette must be smoked within 3.5 - 10 minutes.<ref name="systematic_review_timelimit"/> This is not technically necessary, but causes more variable levels of blood nicotine, increasing addictiveness.<ref name="systematic_review_timelimit">{{cite journal |last1=Dautzenberg |first1=B. |last2=Dautzenberg |first2=M.-D. |title=Le tabac chauffé : revue systématique de la littérature |trans-title=Systematic analysis of the scientific literature on heated tobacco |language=French |journal=Revue des Maladies Respiratoires |volume=36 |pages=82–103 |date=11 November 2018 |doi=10.1016/j.rmr.2018.10.010 |pmid=30429092 |quote=''Le tabac chauffé a lui été concu pour obliger le fumeur à prendre la dose de nicotine en quelques minutes (de 3,5 minutes à 10 minutes) avant que le dispositif ne s’arrête obligatoirement. Ce mode de fonctionnement de tabac chauffé permet de maintenir des pics de nicotine et une ''up régulation'' des récepteurs nicotiniques qui, en semultipliant et se désensibilisant, maintiennent un niveau très élevé de dépendance nicotinique. Alors que la vape est concue pour être un produit de sortie du tabac, le tabac chauffé est concu pour être un produit de maintien en dépendance nicotinique, voire d’entrée en tabagisme, donc un produit concu pour maintenir ou augmenter les profits de l’IT.'' "Heated tobacco has been designed to oblige the smoker to take the dose of nicotine within a few minutes (3.5 to 10 minutes) before the dispenser forcibly stops. This heated-tobacco operating pattern permits the maintenance of peaks of nicotine, and upregulation of the nicotine receptors, which, in multiplying and becomeing less sensitive, maintain a very high level of nicotine dependence. Where vaping is designed as a tobacco-exit product, heated tobacco is designed as a product for the maintenance of nicotine dependence, and indeed of entry into tobaccoism; it is a product designed to maintain or augment the profits of the tobacco industry." (Wikipedian's translation)''}}</ref>
The three main products have limiters, so that a cigarette or aluminum capsule cigarette must be smoked within 3.5 - 10 minutes.<ref name="systematic_review_timelimit"/> This is not technically necessary, but causes more variable levels of blood nicotine, increasing addictiveness.<ref name="systematic_review_timelimit">{{cite journal |last1=Dautzenberg |first1=B. |last2=Dautzenberg |first2=M.-D. |title=Le tabac chauffé : revue systématique de la littérature |trans-title=Systematic analysis of the scientific literature on heated tobacco |language=French |journal=Revue des Maladies Respiratoires |volume=36 |pages=82–103 |date=11 November 2018 |doi=10.1016/j.rmr.2018.10.010 |pmid=30429092 |quote=''Le tabac chauffé a lui été concu pour obliger le fumeur à prendre la dose de nicotine en quelques minutes (de 3,5 minutes à 10 minutes) avant que le dispositif ne s’arrête obligatoirement. Ce mode de fonctionnement de tabac chauffé permet de maintenir des pics de nicotine et une ''up régulation'' des récepteurs nicotiniques qui, en semultipliant et se désensibilisant, maintiennent un niveau très élevé de dépendance nicotinique. Alors que la vape est concue pour être un produit de sortie du tabac, le tabac chauffé est concu pour être un produit de maintien en dépendance nicotinique, voire d’entrée en tabagisme, donc un produit concu pour maintenir ou augmenter les profits de l’IT.'' "Heated tobacco has been designed to oblige the smoker to take the dose of nicotine within a few minutes (3.5 to 10 minutes) before the dispenser forcibly stops. This heated-tobacco operating pattern permits the maintenance of peaks of nicotine, and upregulation of the nicotine receptors, which, in multiplying and becomeing less sensitive, maintain a very high level of nicotine dependence. Where vaping is designed as a tobacco-exit product, heated tobacco is designed as a product for the maintenance of nicotine dependence, and indeed of entry into tobaccoism; it is a product designed to maintain or augment the profits of the tobacco industry." (Wikipedian's translation)''}}</ref>


The tobacco in these products contains additives not found in conventional cigarettes.<ref name=WHO2018/> The smoke contains three to four times the amount of water (steam) found in the smoke of conventional cigarettes, according to filter collection.<ref name="systematic_review/>{{rp|Figure 1}}
The tobacco in these products contains additives not found in conventional cigarettes.<ref name=WHO2018/>


== History ==
== History ==

Revision as of 18:10, 23 February 2019

Not to be confused with Electronic cigarette.
An electric smoking system with packs of cigarettes.

An electrically-heated smoking system, also known as a heated tobacco product (HTP) or heat-not-burn tobacco product (HnB), uses an electric heating element to produce a smoke that contains nicotine, tar,[1] other chemicals, and particulates.[2] These products may match some of the behavioral aspects of conventional smoking.[3] Tobacco companies claim these products are less harmful to consumers than[4] other types of cigarettes,[2] but "there is no evidence to demonstrate that HTPs are less harmful than conventional tobacco products", according the to the World Health Organization.[2][5]

There are products that take loose-leaf tobacco in a heated chamber;[6] others require product-specific cigarettes.[2] Products heating cigarettes using an external heat source first came to market in 1988, however they were not a commercial success.[4] These products are being introduced by large tobacco companies.[7]

Health effects

E-cigarette smoking machine smoking four electrically-heated smoking devices in parallel. There is a lack of independent research,[5] and the trustworthiness of internal industry research has been challenged.[8]

A 2016 Cochrane review found that it was unclear whether using these products instead of conventional cigarettes would "substantially alter the risk of harm".[9] Also in 2016, the WHO noted that some scientists believe these products to be as harmful as traditional cigarettes, and stated that no convincing evidence had been presented for industry claims of lowered risk and health benefits, which are based on industry-funded research, as independent research to support them is not available.[5] Tobacco companies have been contradictory in internal and external documents, saying that they both do and don't have evidence that heated tobacco products are safer than regular cigarettes.[10]

Action on Smoking and Health stated in 2016 that due to "the tobacco industry's long record of deceit" regarding the health risks involving smoking, it is important to conduct independent studies into the health effects of these products.[8]

The effects of second-hand exposure are unknown.[2]

Addiction and quitting

HTPs have an addictiveness potential similar to that of conventional cigarettes.[11] There is not enough evidence to know if HnB products help with quitting smoking.[12]

People who had never smoked conventional cigarettes made up 20-45% of those using the most common product, according to surveys, and one survey found that half of those interested in the product were never-smokers.[13]: 95  86% of conventional smokers using the product did not stop using regular cigarettes; they used both.[13]: 95  There is not thought to be any possibility of harm reduction among these dual users.[13][clarification needed] It is therefore[improper synthesis?] expected that these products will worsen the risks of tobacco addiction in society as a whole.[14]: abstract, essential points 

Nicotine delivery

Tests of smokers switching to the most common HTP products show that they take shorter, much more frequent, and larger-volume puffs.[15]: 97, 99  Users experience a sudden, sharp peak in blood nicotine levels; levels rise just as abruptly, and just as high, as with a regular cigarette, peaking after 6-7 minutes.[failed verification][16]: 90  However, a HTP cigarette delivers slightly less nicotine overall than a regular cigarette;[16]: 90  blood nicotine must therefore drop more quickly after smoking.[17] Sharper peaks in blood nicotine levels cause greater addictiveness.[18] Nicotine replacement therapy medications, for instance, deliver nicotine in a slow, stable maneer, and are thus less addictive.[18] Rapid nicotine delivery is reinforcing[19] and rapid blood nicotine decline causes withdrawal onset.[18] Withdrawal causes worse-than-normal mood, driving craving for renewed nicotine consumption.[18]

Smoking trial volunteers switching to exclusive use of an HnB cigarette product, after an initial adjustment period, usually smoked more cigarettes than those not switching, while reporting that they were less satisfying and rewarding than regular cigarettes.[13]: 93–94, Table 8 

Pregnancy

There is no information on the effects of smoking HnB devices during pregnancy, as of 2018.[12] However, they are nicotine-containing products.[2] Nicotine harms brain development, in the fetus[20][failed verification] and infant.[21]

Nature and function

Heated tobacco products emit smoke, which contains pyrolysis products (including tar), as well as nicotine.[1] Heated tobacco products vary, but the main brands heat to temperatures of 340-180 Celsius,[22]: Table 4  hot enough to pyrolize the tobacco.[1] Pyrolysis is a process causing charring,[23][unreliable medical source?] and char is a solid pyrolysis product;[24][unreliable medical source?] tar is liquid at high temperatures, but may be more solid once cooled.[25]

There is debate over the terminology used for these products.[citation needed] The tobacco industry has called them "heat-not-burn" products, although it has more recently abandoned this claim.[26] It has also advertised[27] and marketed them as "smoke-free".[28] Independent researchers disagree with the claim that they are smokeless,[29][30] stating that the emissions contain pyrolysis products and are smoke.[1] Until 2016, Phillip Morris researchers also called the emissions "smoke".[30] The solids in the emissions are also called "Nicotine Free Dry Particulate Matter" rather than "tar" in papers written by people connected to the tobacco industry.[31] The tobacco industry calls its tobacco refills "Heets" and "Neosticks",[32] while the World Health Organization calls them "cigarettes".[2] One brand's tobacco powder comes packed in aluminum capsules.[33]

The three main products have limiters, so that a cigarette or aluminum capsule cigarette must be smoked within 3.5 - 10 minutes.[34] This is not technically necessary, but causes more variable levels of blood nicotine, increasing addictiveness.[34]

The tobacco in these products contains additives not found in conventional cigarettes.[2]

History

Steam Hot One, a Japanese variant of the Eclipse made by Japan Tobacco
Philip Morris' Heatbar pictured without a specifically designed cigarette

The first commercial heat-not-burn product was the R.J. Reynolds Premier,[35] a smokeless cigarette launched in 1988 and described as difficult to use.[36] Many smokers disliked the taste.[37] It was shaped like a traditional cigarette, and when heated the smoldered charcoal moved past processed tobacco containing more than 50 percent glycerin to create a smoke including aerosolized nicotine.[38] It did require some combustion.[39] In 1989,[40] after spending $325 million,[41] R.J. Reynolds pulled it from the market months later after organisations recommended to the US Food and Drug Administration (FDA) to restrict it or classify it as a drug.[42]

The Premier product concept went on to be further developed and re-launched as Eclipse[40] in the mid-1990s,[43] and was available in limited distribution as of 2015.[44] Reynolds American stated that the Revo was a "repositioning" of its Eclipse.[45] R.J. Reynolds' Revo was withdrawn in 2015.[44]

Philip Morris International (PMI) launched a cigarette in 1998 that was placed into an electronic heating device as Accord.[46] The battery-powered product was the size of a pager.[47] The product was marketed as "low-smoke". Ads claiming reduced risk were drafted, but never released; an attempt was made to get the Surgeon General of the United States to endorse it without requiring long-term studies on its health effects. Few people started using the Accord, and almost all users also continued to use regular cigarettes. The Accord was discontinued in 2006, eight years after it came on the market.[48]

In 2007 PMI launched the Heatbar,[49] which was nearly identical to the Accord.[48] The Heatbar was around the size of a mobile phone and was said to heat specifically designed cigarettes rather than burning them.[50] The only benefit was to lower second-hand smoke, which lead to Heatbar being discontinued.[51] Heatbar did not obtain any significant user reception.[52] Accord and Heatbar are predecessors of PMI's current heat-not-burn tobacco products.[53]

The ubiquitousness of electronic cigarettes and growing dissatisfaction with not providing a throat-hit may present an opportunity for heat-not-burn tobacco products.[4] These products are currently being introduced by large tobacco companies.[7] PMI anticipates a future without traditional cigarettes, but campaigners and industry analysts call into question the probability of traditional cigarettes being dissolved, by either e-cigarettes or other products like iQOS.[54]

Products

  • Electrically-heated cigarette system. a) Charger (left) and cigarette holder (right), b) low-temperature[failed verification] cigarette (left) and holder with cigarette inserted (right), c) Disassembled holder, with heating element visible (left) and the holder's lid (right)
    Electrically-heated cigarette system. a) Charger (left) and cigarette holder (right), b) low-temperature[failed verification] cigarette (left) and holder with cigarette inserted (right), c) Disassembled holder, with heating element visible (left) and the holder's lid (right)
Low-temperature cigarette; above, disassembled, below, intact. A: Reconstituted tobacco film, made of dried tobacco suspension. 70% tobacco, humectants (water and glycerin) to encourage wet steam formation, binding agents, and aroma agents. B: Hollow acetate tube. C: Polymer film to cool the smoke. D: Soft cellulose acetate mouthpiece, which imitates the feel of a conventional cigarette.

The products are designed to be similar their conventional counterparts.[45] A tobacco stick along with a heating element will provide the user a choice across the different heat-not-burn tobacco products available.[45][clarification needed] Another type of heat-not-burn tobacco product is the loose-leaf tobacco vaporizer that entails putting loose-leaf tobacco into a chamber, which is electrically heated using an element.[6]

3T

The 3T from Vapor Tobacco Manufacturing was launched in December 2014.[55] The product employs a patented, aqueous system whereby desired components are extracted into water.[56] The liquid is mixed with glycerin and aerosolized producing a smoke without combustion by an electronic heating system.[56] Their organic liquids are made from organic tobacco, organic glycerin, and water.[55]

Glo

In 2016 British American Tobacco (BAT) launched a heat-not-burn product called glo in Japan.[57] glo is battery-powered.[57] It uses a heating element with a tobacco stick.[45] In May 2017 they released i-glo in Canada.[58] The glo iFuse debuted in Romania by BAT in 2015.[45] It uses a cartridge with a tobacco stick and a flavored nicotine liquid.[45] Bonnie Herzog, a senior analyst at Wells Fargo Securities stated that the proposed acquisition of R. J. Reynolds by BAT in 2016 would let them catch up in the technology competition.[59]

IQOS

The introduction of IQOS was announced on June 26, 2014.[60] Although it is marketed as a novel product, it is very similar to the "Accord" product released by the same company in 1998; however, the IQOS cigarettes have more nicotine, less tar, and more tobacco. They are heated to a lower temperature, and the kit costs about US$40 more in 2018 dollars.[48] The product is marketed by Philip Morris International (PMI) under the Marlboro and Parliament brands.[61]

Initially launched in 2014 in Nagoya, Japan and Milan, Italy, IQOS is being gradually rolled out to other countries.[62] By end of 2016 it was available in over 20 countries, with expansion plans into several more in 2017 as manufacturing capacity increases.[63] PMI has projected that when 30 billions units are sold, iQOS would increase profits by $700 million.[64] To date, the company claims that total investments made in the development and assessment of these products have exceeded $3 billion.[65] Phillip Morris spent €500 million on iQOS in 2016 alone.[66]

iQOS consists of a charger around the size of a mobile phone and a holder that looks like a pen.[67] The disposable tobacco stick, which looks somewhat like a short cigarette, has been dipped in propylene glycol,[68] is inserted into the holder which then heats it to temperatures up to 350 °C.[46] The smoke released contains nicotine and other chemicals.[3] The amount of nicotine provided may be a little strong for light cigarette smokers.[69] Users have reported less smell and odour on clothing.[39] The smoke generated by iQOS contains substances from pyrolysis and thermogenic degradation that are identical to the constituents found in traditional tobacco cigarette smoke.[68] A 2017 review found "little research on what substances are released after the device heats the tobacco-based paste. The physical effects on users are also not yet known."[70]

One independent study of the iQOS criticized[failed verification] Phillip Morris, saying "Dancing around the definition of smoke to avoid indoor-smoking bans is unethical" and called for more independent research, saying "Smokers and non-smokers need accurate information about toxic compounds released in IQOS smoke. This information should come from sources independent of the tobacco industry".[68] After the study was published, the heads of the three Swiss universities where the authors worked received letters from Phillip Morris, accusing the authors of faulty methodology, and subsequently the researchers were not willing to talk to a journalist.[71] JAMA Internal Medicine, which published the study, described the letters as unusual and smacking of intimidation.[71][neutrality is disputed] Phillip Morris also published an online academic counter-argument.[71]

In December 2016, PMI submitted a multi-million page application[66] to the US FDA for iQOS to be authorized as a modified risk tobacco product.[72] The FDA reviewed Phillip Morris's data, some independent studies, including the May 2017 Swiss paper about toxic compounds in iQOS smoke mentioned above, a December 2017 amendment to the application by Phillip Morris on the same topic, and the FDA's own laboratory testing data.[73]

In January 2018, the FDA advisory panel ruled that Phillip Morris had not shown that their product cut health risks;[74] the panel also "expressed concerns about the lack of data" on risk relative to cigarettes.[75] The Campaign for Tobacco-Free Kids criticized[failed verification] the product, saying that it looks like the e-cigarettes which children use the most.[76] IQOS is marketed in stores and packaging which resemble those of high-end smartphones, a strategy expected to appeal to youth by associating it with their interests in new technology.[77]

PMI intends to convert its customers in Japan to using heat-not-burn products.[78] iQOS is sold as an alternative to cigarettes.[79] PMI states that they understand that its iQOS product will be as addictive as tobacco smoking.[8] iQOS is sold with a warning that the best option is to avoid tobacco use altogether.[80]

iSmoke OneHitter

iSmoke OneHitter by iSmoke was launched in 2015.[81] It can be used as a loose-leaf tobacco vaporizer.[82] It has a chamber that can be filled with up to 800-milligrams of tobacco.[82]

Korea Tobacco & Ginseng Corporation

Korea Tobacco & Ginseng Corporation announced on 8 June 2017 that they will launch a heat-not-burn tobacco product in September 2017.[83]

Pax 2

PAX Labs, formerly known as Ploom,[84] sells PAX vaporizers.[85] In 2010 they launched Ploom, a butane-powered product used for the heating tobacco or botanical products.[86] Later models replaced butane heating with an electric system.[87] After its initial partnership with Japan Tobacco was abandoned, the company became known as Pax Labs.[88] The Pax 2 uses loose-leaf tobacco.[45] The surface of the Pax 2 remains cool, while the oven heats to temperatures up to 455 °F.[89] It has four temperature options.[89]

Ploom Tech

In January 2016 Japan Tobacco (JT) released Ploom TECH.[90] JT's Ploom has been withdrawn from the US.[45] The Ploom brand, however, remained with JT and the product itself has been replaced with a different product called Ploom Tech, in which an aerosol passes through a capsule of granulated tobacco leaves.[91] The capsules are aluminum.[13] Sales are being expanded throughout Japan in 2017.[92] They intend to spend $500 million to increase their heated tobacco manufacturing capacity by late 2018.[93]

V2 Pro

V2 originally released their vaporizer line named V2 Pro in July 2014.[94] The initial product was named Series 3.[94] Series 3 comes with 3 cartridges including a loose-leaf cartridge, which heats the material by conduction.[95] It comes with a battery and USB changer, among other things.[95] Pro Series 3X also by V2 can be used with dry material.[96] It has three different air flow options that can be adjusted with a slight turn of the mouthpiece.[96] Series 7 comes with a loose-leaf cartridge, among other things.[97] Series 7 lets the user change the temperature by using a single button.[94]

Marketing

These products are marketed as "smoke-free".[28]

Regulations

Tobacco companies have used these products to seek exemptions and relaxations of existing tobacco control policies.[98]

"There is concern that heat-not-burn tobacco will skirt local ordinances that prevent smoking in public areas," Mitchell H. Katz, director of the Los Angeles County Health Agency, wrote in 2017.[99] Action on Smoking and Health stated in 2016 that "unless and until independent evidence shows that IQOS and similar products are substantially less harmful than smoking then these products should be regulated in the same way as other tobacco products."[8] Tobacco control activist Stanton Glantz stated that the US FDA should halt new tobacco products until tobacco companies stop selling traditional cigarettes.[100] As of 2016, 19 countries have permitted the sale of iQOS.[68]

In the US, these products fall under the jurisdiction of the Food and Drug Administration.[6]

Advertisement for the iQOS, but not iQOS' tobacco stick, is unregulated under the European Union Tobacco Products Directive.[45] In Italy, taxes, smoking bans, ad bands, and health warnings have all been scaled back from what is required of conventional cigarettes; for instance, the warning labels required are less than half as large, and do not have to include images.[101]

Heat-not-burn tobacco products are not restricted for sale in Israel by the Ministry of Health.[102] However, after intervention by three voluntary organizations, they are now taxed at the same rate as other cigarettes.[103]

Ploom and iQOS are governed by the Tobacco Industries Act regulations as tobacco products in Japan.[104] Nicotine e-cigarettes are illegal in Japan, and rare, while IQOS product made up nearly 5% of tobacco sales in October 2016.[105] The Liberal Democratic Party will deliberate over increasing the tax rate for heat-not-burn tobacco products in April 2018.[106]

Electronic tobacco products using dry material are regulated as e-cigarettes in South Korea by the Ministry of Health and Welfare.[107] Korea regulates e-cigarettes differently than traditional cigarettes for tax reasons.[108] As a result, iQOS are taxed at a decreased rate, compared to the 75% incurred on normal cigarettes.[108] Emerging tobacco products are banned in Singapore by the Ministry of Health.[109]

After iQOS launched a marketing campaign in New Zealand, the Ministry of Health, which has the authority to regulate nicotine products, stated that the refill sticks are not legal for sale in New Zealand.[110]

References

  1. ^ a b c d Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. « la fumée est composée de particules solides et liquides et de gaz formés dans l'air quand un matériel est soumis à une pyrolyse ou une combustion » :les émissions du tabac chauffé (THS2.2), même si elles comportent dans les données publiées une moindre concentration de particules solides que la fumée des cigarettes conventionnelles, répondent parfaitement à cette définition de la fumée. "Smoke is composed of particles of solid, liquid, and gas formed in the air when a material is subjected to pyrolysis or combustion": the emissions of heated tobacco (THS2.2) [IQOS], even if they have, according to published data, a lower concentration of solid particles than the smoke of conventional cigarettes, fit this definition of smoke perfectly... Les émissions du tabac chauffé comprennent des produits de la vaporisation, de la pyrolyse et peut-être dans certains cas de la combustion The emissions of heated tobacco contain products of vapourisation, pyrolysis, and perhaps in some cases combustion. ...les tabacs chauffés émettent de la fumée contenant de la nicotine, des particules solides (goudrons), des gouttelettes et des gaz... heated tobacco products emit smoke containing nicotine, solid particles (tar), droplets, and gasses. (Wikipedian's translations)
  2. ^ a b c d e f g h "Heated tobacco products (HTPs) information sheet". World Health Organization. 2018.
  3. ^ a b Bentley, Guy (15 March 2017). "Heat-Not-Burn Tobacco: The Next Wave Of A Harm-Reduction Revolution". Forbes.
  4. ^ a b c Caputi, Theodore L. (2017). "Industry watch: Heat-not-burn tobacco products are about to reach their boiling point". Tobacco Control. 26 (5): 609–610. doi:10.1136/tobaccocontrol-2016-053264. PMID 27558827.
  5. ^ a b c "Further development of the partial guidelines for implementation of Articles 9 and 10 of the WHO FCTC" (PDF). World Health Organization. 12 July 2016. pp. 5–6.
  6. ^ a b c Lopez, Alexa A; Hiler, Marzena; Maloney, Sarah; Eissenberg, Thomas; Breland, Alison B (2016). "Expanding clinical laboratory tobacco product evaluation methods to loose-leaf tobacco vaporizers". Drug and Alcohol Dependence. 169: 33–40. doi:10.1016/j.drugalcdep.2016.10.005. PMC 5140724. PMID 27768968.
  7. ^ a b Neo Chai Chin (2 March 2017). "Heated tobacco products just as bad as cigarettes: Amy Khor". Today (Singapore newspaper). Mediacorp.
  8. ^ a b c d "ASH reaction to new Philip Morris IQOS 'heat not burn' product". Action on Smoking and Health. 30 November 2016.
  9. ^ Lindson-Hawley, Nicola; Hartmann-Boyce, Jamie; Fanshawe, Thomas R.; Begh, Rachna; Farley, Amanda; Lancaster, Tim (2016). "Interventions to reduce harm from continued tobacco use". Cochrane Database of Systematic Reviews. 10: CD005231. doi:10.1002/14651858.CD005231.pub3. PMID 27734465.
  10. ^ https://tobaccocontrol.bmj.com/content/27/Suppl_1/s102
  11. ^ Pieper, Elke; Mallock, Nadja; Henkler-Stephani, Frank; Luch, Andreas (2018). "Tabakerhitzer als neues Produkt der Tabakindustrie: Gesundheitliche Risiken" ['Heat not burn' tobacco devices as new tobacco industry products: health risks]. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz (in German). 61 (11): 1422–1428. doi:10.1007/s00103-018-2823-y. PMID 30284624. The nicotine content in the emissions is in the same range as the nicotine emissions of conventional cigarettes, which suggests a comparable addictiveness and dependence potential... Der Nikotingehalt in den Emissionen des Tabakhitzers ist vergleichbar mit dem konventionellen Zigaretten. Daher ist von einem vergleichbaren Sucht- und Abhaengigkeitspotentzial auszugehen... Das Suchtpotential bleibt bestehen (Wikipedian's translation) The nicotine content in the emissions is in the same range as the nicotine emissions of conventional cigarettes. A comparable addictiveness and dependence potential is therefore expected... The addictive potential remains
  12. ^ a b Li, Gerard; Saad, Sonia; Oliver, Brian G.; Chen, Hui (1 August 2018). "Heat or Burn? Impacts of Intrauterine Tobacco Smoke and E-Cigarette Vapor Exposure on the Offspring's Health Outcome". Toxics. 6 (3): 43. doi:10.3390/toxics6030043. PMC 6160993. PMID 30071638. There is insufficient evidence on the efficacy of heat-not-burn tobacco on smoking cessation. Neither is there information on the potential impact of maternal inhalation of heat-not-burn tobacco smoke during pregnancy on fetal outcomes, all of which require urgent attention.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  13. ^ a b c d e Dautzenberg, B.; Dautzenberg, M.-D. (2019). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36 (1): 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092.
  14. ^ Dautzenberg, B.; Dautzenberg, M.-D. (2019). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36 (1): 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. l'aggravation du risque tabagique globale liée aux promotions des tabacs chauffés par l'IT industrie du tabac] est probable "the worsening of the global tobacco risk related to the promotion of the [heated tobacco] products by the TI [tobacco industry] is anticipated" (publisher's translation)..."Points essentiels. Au niveau individuel : • la réduction des émissions du tabac chauffé versus cigarette conventionnelle, en condition expérimentale, est confirmée par de nombreuses études, mais ces produits restent toxiques ; • la réduction du risque pour la santé n'est qu'une hypothèse non confirmée ; • les 4/5 des usagers de tabac chauffé dans le mois qui précède sont aussi fumeurs et aucun bénéfice de cet usage mixte n'est évoqué ou démontré. Au niveau de la société, la promotion ainsi que le statut juridique et fiscal de ces produits conduisent à ce que : • il y a plus de THS2.2 utilisés par des non-fumeurs que par des ex-fumeurs de cigarettes conventionnelles. Le tabac chauffé est, selon les 2 études publiées, plus souvent un produit d'entrée qu'un produit de sortie du tabagisme. Ainsi, les données scientifiques disponibles montrent qu'à l'échelle des populations, les tabacs chauffés sont des produits qui aggravent le risque tabagique pour la société, et ce malgré une moindre production de toxiques. Le tabac chauffé doit être taxé et réglementé comme tous les autres produits du tabac fumé et toute référence directe à une moindre toxicité ne peut être alléguée en Europe. "Essential points At the individual level: • a reduction of emissions in heated tobacco, as compared to conventional cigarettes, under experimental conditions, is confirmed by many studies, but these products remain toxic; • a reduction in risk to health is no more than an unconfirmed hypothesis; • 4/5 of those who have used heated tobacco in the last month are also smokers and no benefit to this dual use is forseeable or demonstrated At the level of society as a whole: • there are more THS2.2 used by non-smokers than by ex-smokers of convetional cigarettes. Heated tobacco is, according to the two published studies, more often an entry product than an exit product of addiction. Thus, the available scientific evidence shows that at the population scale, heated tobacco products worsen the risk of tobaccoism to society, despite lower toxin production. Heated tobacco ought to be taxed and regulated like all other tobacco products, and no direct reference to reduced risk may be alleged in Europe." (Wikipedian's translation {{cite journal}}: line feed character in |quote= at position 322 (help)
  15. ^ : 99 Dautzenberg, B.; Dautzenberg, M.-D. (2019). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36 (1): 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. Les quelques données sur la consommation montre queles fumeurs de tabac chauffé utilisent des bouffées de 60—65 mL, des bouffées courtes (1,8 s), que l'espace inter-puffs est très court et que les perforations des filtres ne sont pas obstruées. Il serait nécessaire d'établir un régime standard de fumage pour les tabacs chauffés :The evidence on consumption show that smokers of heated tobacco use puffs of 60-65 mL, that they use short puffs (1.8 seconds), that the spacing between puffs is very short, and that the filter perforations are not obscured. It will be necessary to establish a standard [machine] smooking regimen for heated tobacco"... Lors des tests avec le tabac chauffé, il existe un plus grand volume des bouffées et un espace inter-puffs plus court qu'avec les cigarettes conventionnelles. In tests with heated tobacco, the puff volume was larger and the interval between the puffs was shorter than with conventional cigarettes (Wikipedian's translation)
  16. ^ a b Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. Le pic plasmatique est atteint en 6/7 minutes pour la cigarette et le tabac chauffé. Pour les produits non mentholés, le pic est à 13,82 ng/mL avec la cigarette, 14,30 ng/mL et 11,53 ng/mL avec la THS2.2 et 4,8 ng/mL avec la gomme nicotinique 2 mg, alors que les aires sous la courbe sont respectivement de 24,66 ng*h/mL avec la cigarette, 23,75 et 19,92 ng*h/mL avec la THS2.2 et 14,88 ng*h/mL avec la gomme non mentholée. Ainsi, la THS2.2 apporte un peu moins de nicotine qu'une cigarette, mais plus qu'une gomme... "The [blood] plasma peak is attained in 6-7 minutes for both the cigarette and the heated tobacco. For non-metholated products,the peak is 13.82 ng/mL for the cigarette, 14.30 ng/mL and 11.53 ng/mL with the THS2.2 [IQOS] and 4.8 ng/mL with the 2 mg nicotine gum, while the areas under the curve [of plotted blood-nicotine levels] are 24.66 ng*h/mL with the cigarette, 23.75 and 19.92 ng*h/mL with the THS2.2, and 14.88 ng*h/mL with non-menthol gum, respectively. Thus the THS2.2 supplies a bit less nicotine than a cigarette, but more than the gum" (Wikipedian's translation)}}
  17. ^ trivial calculation from previous reference; if one peak has a smaller under-curve area than another, and the left sides of the peaks are the same, the smaller-area peak must be narrower, and thus steeper on the other side
  18. ^ a b c d Ziedonis, Douglas; Das, Smita; Larkin, Celine (2017). "Tobacco use disorder and treatment: new challenges and opportunities". Dialogues in Clinical Neuroscience. 19 (3): 271–280. PMC 5741110. PMID 29302224. Nicotine's short half-life of 1 to 2 hours leads to withdrawal symptoms of irritability, frustration, anxiety, difficulty concentrating, restlessness, depressed mood, insomnia, increased appetite, weight gain, and cravings... smoking cessation leads to significant reductions in anxiety, depression, and stress in both psychiatric and nonpsychiatric populations
  19. ^ Ziedonis, Douglas; Das, Smita; Larkin, Celine (2017). "Tobacco use disorder and treatment: new challenges and opportunities". Dialogues in Clinical Neuroscience. 19 (3): 271–280. PMC 5741110. PMID 29302224. When nicotine or tobacco is administered orally (nicotine-replacement therapy [NRT] medication, dissolvable tobacco, tobacco chew, snuff, etc), absorption is slow and takes 10 to 15 minutes. When nicotine is inhaled as smoke, it quickly reaches the alveoli of the lungs, and within 11 seconds of a puff, reaches the brain through the blood stream and crossing the blood-brain barrier... In dependent smokers, repeated exposure to nicotine peaks can desensitize nAChRs so that they are less responsive, requiring a smoker to smoke more. In contrast, nicotine replacement patches release a stable amount of nicotine in the blood, eliminating peaks and alleviating dependence... Whereas plasma nicotine sharply peaks within 5 minutes of cigarette use, NRTs offer a more steady delivery of nicotine, thereby satisfying but not reinforcing.
  20. ^ England, Lucinda J.; Kim, Shin Y.; Tomar, Scott L.; Ray, Cecily S.; Gupta, Prakash C.; Eissenberg, Thomas; Cnattingius, Sven; Bernert, John T.; Tita, Alan Thevenet N.; Winn, Deborah M.; Djordjevic, Mirjana V.; Lambe, Mats; Stamilio, David; Chipato, Tsungai; Tolosa, Jorge E. (31 December 2010). "Non-cigarette tobacco use among women and adverse pregnancy outcomes". Acta Obstetricia et Gynecologica Scandinavica. 89 (4): 454–464. doi:10.3109/00016341003605719. PMC 5881107. PMID 20225987. The use of any products containing nicotine likely will have adverse effects of fetal neurological development.
  21. ^ Jenssen, Brian P.; Walley, Susan C.; McGrath-Morrow, Sharon A. (12 December 2017). "Heat-not-Burn Tobacco Products: Tobacco Industry Claims No Substitute for Science". Pediatrics. 141 (1): e20172383. doi:10.1542/peds.2017-2383. PMID 29233936. Additionally, the IQOS smoke had nicotine levels similar to levels in conventional cigarette smoke. Nicotine, the highly addictive substance found in tobacco, is unsafe to youth and harms infant and adolescent brain development, as has been summarized in a recent report from the US Surgeon General.
  22. ^ Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. ... alors que les premiers tabacs chauffés l'étaient à plus de 500 °C, la THS2.2 est chauffée à 340 °C, la THP1.0 à 240 °C et la Ploom ® à 180 °C "...while the first heated tobacco products were [heated] at over 500 °C, the THS2.2 [IQOS version] is heated to 340 °C, the THP1.0 to 240 °C, and Ploom® to 180 °C" (Wikipedian's translation)
  23. ^ Davis, Barbara; Williams, Monique; Talbot, Prue (2018). "IQOS: Evidence of pyrolysis and release of a toxicant from plastic". Tobacco Control. 28 (1): tobaccocontrol–2017–054104. doi:10.1136/tobaccocontrol-2017-054104 (inactive 21 February 2019). PMID 29535257. Charring due to pyrolysis (a form of organic matter thermochemical decomposition) was observed in the tobacco plug after use. When the manufacturer's cleaning instructions were followed, both charring of the tobacco plug and melting of the polymer-film filter increased. Headspace analysis of the polymer-film filter revealed the release of formaldehyde cyanohydrin at 90°C, which is well below the maximum temperature reached during normal usage... iQOS is not strictly a 'heat not burn' tobacco product {{cite journal}}: Unknown parameter |laysource= ignored (help); Unknown parameter |laysummary= ignored (help)CS1 maint: DOI inactive as of February 2019 (link)
  24. ^ Sharma, Ramesh K.; Wooten, Jan B.; Baliga, Vicki L.; Martoglio-Smith, Pamela A.; Hajaligol, Mohammad R. (13 February 2002). "Characterization of char from the pyrolysis of tobacco". Journal of Agricultural and Food Chemistry. 50 (4): 771–783. doi:10.1021/jf0107398. PMID 11829644.
  25. ^ "tar and pitch" (6th ed.). The Columbia Electronic Encyclopedia. Retrieved 14 March 2013. "The terms tar and pitch are loosely applied to the many varieties of the two substances, sometimes interchangeably. For example, asphalt, which is naturally occurring pitch, is called mineral tar and mineral pitch. Tar is more or less fluid, depending upon its origin and the temperature to which it is exposed. Pitch tends to be more solid."
  26. ^ Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. Nous avons analysé les données publiées entre février 2008 et février 2018 afin de mieux connaître ces nouveaux produits du « tabac chauffé » , qualifiés, un temps, de « non-brulés » (hnb) avant que l'IT ne fasse marche arrière et ne dise plus que le tabac chauffé est non brûlé. We analysed documents published between February 2008 and February 2018 for information on these new "heated tobacco" products, which were once described as "non-burnt" (hnb), until the tobacco industry, retreating from this position, ceased saying that heated tobacco is not burned.Wikipedian's translation; note that "hnb" stands for "heat-not-burn".
  27. ^ Auer, Reto; Cornuz, Jacques; Berthet, Aurélie (2017). "Perplexing Conclusions Concerning Heat-Not-Burn Tobacco Cigarettes—Reply". JAMA Internal Medicine. 177 (11): 1699–1700. doi:10.1001/jamainternmed.2017.5861. PMID 29114801.
  28. ^ a b "Tobacco company charged over importing prohibited product". NZ Herald. 18 May 2017. ISSN 1170-0777. Retrieved 6 June 2018.
  29. ^ Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. R. Auer [36] , un scientifique suisse indépendant dans une lettre au JAMA Internal Medecine , a provoqué la fureur de PMI [37—39] en affirmant que le produit produisait de la fumé... "R. Auer, a Swiss independent scientist, wrote a letter in JAMA Internal Medicine, which provoked the fury of PMI by affirming that the product produced smoke" (Wikipedian's translation)
  30. ^ a b Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. Cette étude comme d'autres confirme que les émissions de ces produits contiennent des particules solides et que la THS2.2 n'est pas un produit « non fumé » , mais bien « un nouveau produit du tabac fumé »... This study, like others, confirms that the emissions of these products contain solid particles, and that THS2.2 [IQOS, see legend of Table 4] is not a "smoke-free" product, but indeed "a new smoked tobacco product"... Les émissions des trois principaux tabacs fumés contiennent des particules solides, des gouttelettes et des gaz qui répondent à la définition d'une fumée, comme l'annoncait jusqu'en 2016 les chercheurs de PMI. Le tabac chauffé est bien un produit qui produit de la fumée, donc un nouveau produit du tabac fumé. The emissions of the three main [heated] tobacco products smoked contain solid particles, droplets, and gasses which meet the definition of smoke, as PMI researchers proclaimed until 2016. Heated tobacco is indeed a product that produces smoke, and thus a new smoked tobacco product. (Wikipedian's translation; note that this systematic review paper also painstakingly attributes the papers it reviews to either independent academics or nicotine-industry-funded ones, see Table 1)
  31. ^ Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. Il est à noter que les auteurs liés à l'IT qualifient cette masse solide émise de NFDPM ou Nicotine Free Dry Particule Mater et non pas de goudron quand ils parlent de la masse solide des émissions de tabac chauffé It is notable that [academic paper] authors connected to the tobacco industry call the emitted solid matter NFDPM or Nicotine Free Dry Particule Mater [sic], and not tar, when they are speaking of solid matter from the emissions of heated tobacco. (Wikipedian's translation; note that the English has been "corrected" by a French-language spellchecker in the published paper)
  32. ^ Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. La THS2.2 (Iqos®) de PMI utilise des mini-cigarettes (Heets®), la PHT1.0 (Glo®) de BAT utilise des mini-cigarettes (nommées en France Neostiks®) et la Ploom® de JTI utilise des capsules nommées Vapodes®. PMI's [Phillip Morris International's] THS2.2 (Iqos®) uses mini-cigarettes (Heets®), BAT's [British American Tobbacco's] PHT1.0 (Glo®) uses mini-cigarettes (called Neostiks® in France), and JTI's [Japan Tobacco International's] Ploom® uses capsules which have been named Vapodes®. (Wikipedian's translation)
  33. ^ Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. Le poids de tabac introduit dans les mini-cigarettes pour THS2.2 n'est pas publié et apparaît comme une donnée « confidentielle » dans les documents publics tels celui du rapport à la FDA [16]. On ne peut, sur les données publiées, qu'extrapoler un poids de tabac de l'ordre de 300 mg de tabac par mini-cigarette pour THS2.2 en se basant sur la concentration en nicotine du produit publié par K.E. Farsalinos [27] et sur le rendement en nicotine et la quantité de nicotine publiés par K. Bekki [28]. La quantité de tabac chauffé est de 260 mg dans les Neostiks® de PTH1.1 et de 490 mg dans la Ploom® (capsule d'aluminium incluse), pour 700 à 800 mg dans une cigarette conventionnelle.
  34. ^ a b Dautzenberg, B.; Dautzenberg, M.-D. (11 November 2018). "Le tabac chauffé : revue systématique de la littérature" [Systematic analysis of the scientific literature on heated tobacco]. Revue des Maladies Respiratoires (in French). 36: 82–103. doi:10.1016/j.rmr.2018.10.010. PMID 30429092. Le tabac chauffé a lui été concu pour obliger le fumeur à prendre la dose de nicotine en quelques minutes (de 3,5 minutes à 10 minutes) avant que le dispositif ne s'arrête obligatoirement. Ce mode de fonctionnement de tabac chauffé permet de maintenir des pics de nicotine et une up régulation des récepteurs nicotiniques qui, en semultipliant et se désensibilisant, maintiennent un niveau très élevé de dépendance nicotinique. Alors que la vape est concue pour être un produit de sortie du tabac, le tabac chauffé est concu pour être un produit de maintien en dépendance nicotinique, voire d'entrée en tabagisme, donc un produit concu pour maintenir ou augmenter les profits de l'IT. "Heated tobacco has been designed to oblige the smoker to take the dose of nicotine within a few minutes (3.5 to 10 minutes) before the dispenser forcibly stops. This heated-tobacco operating pattern permits the maintenance of peaks of nicotine, and upregulation of the nicotine receptors, which, in multiplying and becomeing less sensitive, maintain a very high level of nicotine dependence. Where vaping is designed as a tobacco-exit product, heated tobacco is designed as a product for the maintenance of nicotine dependence, and indeed of entry into tobaccoism; it is a product designed to maintain or augment the profits of the tobacco industry." (Wikipedian's translation)
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source: https://en.wikipedia.org/w/index.php?title=Electric_smoking_system&type=revision&diff=884738915&oldid=884735384

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