Heat-not-burn tobacco products are for sale around the world. Although they are not yet on the market in the United States, Phillip Morris International has applied to the US Food and Drug Administration (FDA) to sell these products. These products threaten the progress that has been made on decreasing the harms of second-hand smoke because existing bans may not apply to these heat-not-burn products. However, as convincingly reported by Auer and colleagues,1 although these products may or may not produce smoke, they release cancer-causing chemicals. As shown in their table, heat-not-burn cigarettes release similar levels of many volatile organic compounds and nicotine as conventional cigarettes and higher levels of the polycyclic aromatic hydrocarbon acenaphthene than conventional cigarettes. They are bad for health because they release cancer-causing chemicals, and I hope the FDA will not approve them for that important reason. If the FDA does approve the sale of these products, existing smoking bans should be amended to include these products.
Corresponding Author: Mitchell H. Katz, MD, Los Angeles County Department of Health Services, 313 N Figueroa St, Rm 912, Los Angeles, CA 90012 (firstname.lastname@example.org).
Conflict of Interest Disclosures: None reported.
Katz MH. No Smoke—Just Cancer-Causing Chemicals. JAMA Intern Med. 2017;177(7):1052. doi:10.1001/jamainternmed.2017.1425