Heated tobacco products are gaining popularity worldwide, especially among smokers looking for alternatives. Companies like Philip Morris International (PMI) claim these products are safer than regular cigarettes. But health experts warn the long-term risks are still unknown. Devices like IQOS, which heat tobacco instead of burning it, are now sold in over 60 countries. In the U.S., IQOS returned to the market in Austin, Texas, in 2025. As heated tobacco use grows, so do questions about its safety and impact on young people.
What Is Heated Tobacco?
Heated tobacco products (HTPs) use devices to heat tobacco leaves without setting them on fire. This creates a tobacco vapor instead of smoke. One well-known product is IQOS by PMI. It looks like a pen and uses a blade to heat tobacco-filled sticks.
Unlike e-cigarettes, which use nicotine liquids, IQOS heats real tobacco. Users say it offers a closer feel to smoking. Ben Taylor, a long-time smoker from the UK, shared in his blog that IQOS satisfied him more than vaping. “I could taste real tobacco,” he wrote. He also said his chronic cough disappeared.
Tobacco Industry Pushes Heated Devices
PMI, Japan Tobacco International (JTI), and British American Tobacco (BAT) are investing heavily in HTPs. These companies say the devices reduce harm compared to traditional cigarettes. PMI claims over 22 million people worldwide have switched to heated tobacco.
Since 2014, countries like Japan and Italy have seen strong sales growth. In 2019, the U.S. FDA allowed IQOS to be sold in the U.S. In 2025, IQOS returned to the American market through Austin.
PMI wants to stop selling cigarettes altogether and hopes two-thirds of its revenue will come from smoke-free products by 2030.
Flashy Marketing Draws Scrutiny
The tobacco industry uses celebrity events and influencer marketing to boost sales. Musicians like Jamiroquai and DJs like Steve Aoki have performed at IQOS events in Europe. Influencer-led campaigns have shown heated tobacco devices next to luxury cars and fashion models on social media.
Experts say these marketing methods often appeal to young non-smokers. Epidemiologist Silvano Gallus found heated tobacco was widely promoted in cities like Milan and Nagoya. He says young people, not adult smokers, are becoming the top users.
In 2019, PMI paused a campaign after a 21-year-old influencer was linked to promotional content. The company later admitted the campaign broke its internal rules.
Youth Appeal Raises Alarms
Surveys show that awareness of heated tobacco in the U.S. is still low. Only 8% of people know about it, and just 0.5% have tried it. But in countries like Italy, Gallus found many teens were using the devices.
PMI says youth use is low. It cites a 2021 Japanese survey showing under 1.5% of teens used HTPs. But Gallus led a 2020 study that followed over 3,000 Italians. He found non-smokers who used heated tobacco were nearly six times more likely to start smoking.
Critics fear these products act as a gateway to cigarettes.
Are Heated Tobacco Products Safe?
PMI claims heated tobacco is a safer choice. But many studies come from industry-funded labs. Independent research paints a different picture.
Swiss researchers found that IQOS heats tobacco to about 330°C — enough to produce harmful chemicals. They argued that the vapor should be called “smoke” and fall under indoor smoking bans.
Chemical engineer Efthimios Zervas in Greece found toxic particles in IQOS and glo emissions. Some harmful substances were even present in higher amounts than in cigarette smoke.
PMI says its tests show no solid particles in the vapor. But the World Health Organization (WHO) remains cautious. In 2023, it warned that cheap heated sticks may reverse progress made through tobacco taxes and price controls.
Mixed Signals from Health Agencies
The U.S. FDA approved IQOS for sale, but said this does not mean it is safe. “No tobacco product is safe,” the agency stressed.
The European Respiratory Society released a 2024 paper that challenged company claims. It said HTPs still emit cancer-causing chemicals and other harmful substances.
A 2022 report from the University of Bath criticized PMI’s clinical trials, saying they lacked quality and were biased. PMI denied the claim but did not release counter-studies.
Dual Use and Industry Profits
One big issue is dual use. Many people use both cigarettes and heated tobacco devices. A UK study found little evidence that HTPs help people quit. WHO’s report said two-thirds of users also smoked cigarettes.
Sandra Mullin from Vital Strategies says dual use cancels out any health gains. “It profits the industry twice,” she explained.
Still, PMI claims that 72% of IQOS users have quit smoking.
The future of heated tobacco remains unclear. These devices are part of a changing nicotine landscape that includes e-cigarettes and nicotine pouches.
Yolonda Richardson from the Campaign for Tobacco-Free Kids said it will become harder to track which product causes what harm. She and others call for stricter rules and better research before products hit the market.
Zervas says, “We test drugs and food before approving them. Why not do the same for tobacco?”
Heated tobacco products like IQOS are gaining traction across the world, offering smokers a new kind of nicotine experience. But serious questions remain about their long-term health effects, their marketing tactics, and their impact on youth. As these devices return to the U.S. market, public health leaders urge caution, better research, and stronger regulations to protect future generations.