Is IQOS more addictive than cigarettes?
The simple answer is: IQOS is as addictive as cigarettes and this is by design. Tobacco products serve as a delivery system for nicotine which is a recreational drug and cause of addiction. IQOS-owner Philip Morris International (PMI) publicly states that “nicotine plays a role in whether adult smokers find IQOS to be acceptable as an alternative to cigarettes”. Thereby, IQOS is designed to deliver its users nicotine in a similar profile to cigarettes – in terms of both quantity and speed.
Nicotine exposure refers to the quantity of nicotine that ends up in the body of the user. In their own clinical studies, PMI measured the nicotine exposure and found that the nicotine exposure levels are very similar between IQOS users and smokers. Below is the graph of nicotine plasma concentration (i.e. the concentration of nicotine in the plasma derived from blood) over 120 minutes after the consumption of a cigarette and IQOS tobacco stick. The data comes from PMI’s own clinical study ZRHM-PK-05-JP.
Accordingly, the US Food and Drug Administration’s (FDA)’s premarket tobacco product review of IQOS-related evidence concluded that “IQOS tobacco sticks have nicotine delivery, addiction potential, and abuse liability similar to cigarettes. The nicotine levels do pose an addiction risk for non-tobacco users who initiate use of these products”. In short, similar nicotine delivery profile, thus similar addictiveness, by design.
IQOS Smoke: Does IQOS produce smoke?
Technically speaking, no. Smoke is defined as the visible suspension of particles in the air, emitted from a burning substance, or the mixture of gas and miniscule pieces of carbon produced when something burns. The keyword in the definition of smoke is the fact that it is the product (consequence) of burning. As IQOS device heats the tobacco, but does not burn it, the mixture of particles produced by this process cannot be called smoke. PMI Science website even has a dedicated section explaining the “fundamental difference” between cigarette smoke and heated tobacco product aerosol.
However, not producing smoke, but another aerosol (i.e. smoke is also an aerosol), does not render a product safe to use. Obviously, what matters is the composition of the aerosol produced and, in any case, IQOS aerosol contains nicotine which is a highly addictive and controversial (in terms of health effects) substance. Nevertheless, developing public awareness on the difference between cigarette smoke and heated tobacco product aerosol and, subsequently, establishing a favorable public opinion about the IQOS aerosol are critical missions in PMI’s profitable transformation to smoke-free products. Drawing a clear barrier between aerosolized tobacco (IQOS) and smoked tobacco (cigarettes) is a prerequisite to demand a better treatment from the society for IQOS (as a better alternative to cigarettes) – especially, in terms of product regulation & taxation.
