Is Heated Tobacco Safer Than Smoking
Is heated tobacco safer than smoking?
A clear UK 2026 evidence-based answer. Short answer: inconclusive and disputed. FDA authorised reduced-exposure but NOT reduced-risk claims for IQOS. Independent research cautious.
The short answer
Disputed evidenceInconclusive. Long-term unknown.
FDA approved reduced-exposure claims but not reduced-risk. Independent research more cautious. Vapes have stronger UK evidence base for harm reduction.
23/24
Biomarkers no diff vs cigs
0.7%
UK adults using HTPs
The evidence is inconclusive and disputed. Heated tobacco products (HTPs) including IQOS, glo and Ploom heat processed tobacco rather than burning it. The tobacco industry markets HTPs as reduced-risk vs cigarettes; independent researchers including the University of Bath Tobacco Control Research Group dispute these claims. The honest answer. The US FDA authorised IQOS for marketing as a modified-risk tobacco product with reduced-exposure claims (lower levels of some chemicals than cigarette smoke) but explicitly did NOT authorise reduced-risk claims (i.e. did not say HTPs cause less disease). Independent biomarker research found that of 24 biomarkers of potential harm tested in PMI's own studies, no statistically significant difference was found between IQOS users and cigarette smokers in 23 of 24 markers. UK ASH 2025 data: only 0.7% of UK adults (400,000 people) currently use HTPs vs 5 million who vape. The Tobacco and Vapes Act 2026 explicitly extends regulations to heated tobacco products. The current UK consensus: HTPs are tobacco products with unknown long-term risks, not proven safer than cigarettes. UK health bodies treat vaping more favourably than HTPs as a harm reduction tool for adult smokers.
UK heated tobacco in figures
Three figures every UK smoker considering HTPs should know.
23/24
Biomarkers no statistical difference
PMI's own studies in US adults found no significant difference between IQOS users and cigarette smokers in 23 of 24 biomarkers of potential harm.
0.7%
UK adults currently use HTPs
ASH 2025 data: 400,000 UK adults. Vs 5 million UK adults who vape. Awareness up from 9% (2017) to 28% (2025).
350°C
HTP heating temperature
Below combustion (600-800°C) but well above vape e-liquid heating (200-300°C). Still produces aerosol with tobacco compounds.
Heated tobacco vs cigarettes: the evidence
Six categories where the evidence is examined. The honest answer is more complex than tobacco industry marketing suggests.
What heated tobacco actually is
Heated tobacco products (HTPs) heat processed tobacco leaf to release nicotine in aerosol form without combustion (no flame, no burning). The main UK brands. IQOS by Philip Morris International (PMI); the market leader globally. Heat sticks branded HEETS or TEREA. Glo by British American Tobacco (BAT). Heat sticks branded neo. Ploom by Japan Tobacco International (JTI). Heat sticks branded Ploom Tobacco Vapor. The devices heat tobacco to around 350°C; below combustion (600-800°C in cigarettes) but enough to vaporise nicotine and produce an aerosol. Independent researchers note the aerosol fits the definition of both vapour and smoke.
FDA position: reduced-exposure not reduced-risk
The US FDA authorised IQOS for marketing in 2019 with very specific and limited claims. FDA-authorised claims. The IQOS system heats tobacco but does not burn it. This significantly reduces the production of harmful and potentially harmful chemicals. Scientific studies have shown that switching completely from conventional cigarettes to IQOS significantly reduces your body's exposure to harmful chemicals. FDA-prohibited claims (PMI cannot say). IQOS reduces the risk of disease. IQOS is endorsed or approved by FDA. FDA deems IQOS safe for use. The distinction is crucial. Reduced-exposure: lower chemical levels confirmed by analysis. Reduced-risk: lower disease incidence; requires long-term human studies and has NOT been established. HTPs are not FDA-approved as quit-smoking aids; UK MHRA has not granted any HTP a medicinal authorisation either.
Independent research findings 2021-2025
A peer-reviewed narrative review published in 2025 covering 55 studies on humans and human cells. Cardiovascular effects: HTPs cause increases in blood pressure, heart rate, platelet clot formation, and enhanced inflammatory response. Often followed by endothelial dysfunction. Respiratory effects: HTPs cause cell damage in human lung epithelial cells. Case reports of subacute lung injury including a 56-year-old IQOS user with fibroatelectatic lung changes after 2.5 years. Cancer risk: of 16 biomarkers used to assess lung cancer risk, only 3 improved when smokers switched to HTPs; 13 showed no improvement, worsened, or had inconsistent results. Pregnancy risks: children of mothers using HTP during pregnancy showed increased allergies, atopic dermatitis, asthma; prevalence 15.2% (PR 1.98). The University of Bath Tobacco Control Research Group concluded the evidence does NOT support PMI's reduced-risk claims.
UK ASH data 2025
The annual ASH/YouGov Smokefree Adult Survey 2025 (n=13,314) gives the clearest UK picture. Current use: 0.7% of UK adults (400,000 people). Unchanged since 2017. Ever tried: 3.3% (1.7 million). Awareness: 28% in 2025 vs 9% in 2017. Awareness higher among smokers (50%), 18-24 year olds (37%), 25-39 year olds (36%). Past use stopped: increased from 0.9% (2017) to 2.6% (2025); many people try HTPs and stop. Youth use: 0.7% of 11-17 year olds currently use HTPs; 2.7% have tried. Awareness in 11-17 year olds: rose from 7.1% (2022) to 24% (2025) driven by aggressive industry marketing despite UK advertising restrictions. ASH and the Tobacco Control Research Group note HTPs are sometimes promoted via pop-up stores, celebrity partnerships, social media which technically violates the Tobacco Advertising and Promotion Act 2002.
Heated tobacco vs vaping
UK health bodies clearly distinguish the two. Public Health England 2018 estimate: vaping is 95% less harmful than cigarettes. Position on HTPs: more cautious; UK government has not endorsed similar claims for HTPs. Five reasons UK treats vaping more favourably. Vapes contain no tobacco; HTPs contain real tobacco with all its tobacco-specific carcinogens. Vape ingredients well characterised (PG, VG, nicotine, flavourings); HTP tobacco more complex. UK regulatory framework treats vapes as harm reduction tools; HTPs as tobacco products. NHS Stop Smoking Services may recommend vapes; do not recommend HTPs. Independent research more positive on vapes; more cautious on HTPs. UK ASH data 2025: 5 million adults vape; 400,000 use HTPs. Tobacco and Vapes Act 2026 maintains 18+ vape age but applies the 2027 generational ban to HTPs the same as cigarettes.
Better-evidenced alternatives
UK NHS guidance recommends these for adult smokers wanting to quit. Vaping: NHS-recognised harm reduction tool. NRT (Nicorette QuickMist, patches, gum, lozenges, inhalator): MHRA-approved; combination NRT (patch + QuickMist) most effective; available without prescription. Varenicline (Champix): NHS prescription tablet; doubles success rates. NHS Stop Smoking Service: free 12-week behavioural support; users 3x more likely to succeed than going alone. Smokefree Helpline: 0300 123 1044 (England). HTPs are tobacco products with unknown long-term safety and disputed reduced-risk claims. Even if HTPs are somewhat less harmful than cigarettes (unproven), they are likely more harmful than vapes or NRT. Dual use is common with HTPs; many users continue to smoke alongside HTPs rather than fully switching, undermining any potential harm reduction.
For vape vs smoking see is vaping better than smoking. For UK pod kit options head to our pod kit collection.
Four facts every UK smoker should know
FDA: reduced-exposure not reduced-risk
Lower chemical levels does NOT mean lower disease risk. Long-term effects unknown.
UK NHS prefers vapes
Vaping recognised as harm reduction tool. HTPs not recommended for smoking cessation.
Dual use common with HTPs
Many users continue cigarettes alongside HTPs, undermining any potential harm reduction.
2027 ban applies to HTPs
UK generational tobacco ban from 1 January 2027 includes heated tobacco. Vape age stays at 18+.
Heated tobacco vs vaping comparison
A simple comparison of UK regulated harm reduction options.
UK harm reduction
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✓NHS-recognised harm reduction tool: for adult smokers.
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✓PHE 2018 estimate: 95% less harmful than cigarettes.
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✓No tobacco: e-liquid only. PG, VG, nicotine.
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✓5 million UK adult vapers: mass-market established.
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✓Vape age 18+: kept at 18+ under 2026 Act.
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✓Stronger UK evidence base: for relative harm reduction.
UK tobacco product
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✗NHS does not recommend: not a cessation tool.
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✗FDA: reduced-exposure not reduced-risk: disease risk unproven.
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✗Real tobacco leaf: tobacco-specific carcinogens present.
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✗Only 400,000 UK users: mass-market rejected.
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✗2027 generational ban applies: same as cigarettes.
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✗Long-term effects unknown: widespread use only since 2014.
For more on UK quitting and harm reduction head over to our full vaping guides hub.
UK pod kits as a vape alternative
Vaporesso XROS, OXVA Xlim, Uwell Caliburn and other UK pod kits with stronger evidence base for harm reduction than heated tobacco. Recognised by NHS Stop Smoking Service.
More on alternatives to smoking
For vape vs smoking see is vaping better than smoking. For HTP basics see what is heated tobacco. For quitting see how to quit vaping.
