“Heat not burn” is a method of delivering the tobacco experience by heating, rather than igniting it. The potential benefits of this approach involve its ability either to reduce or eliminate completely many of the potentially harmful compounds that form at high temperatures when tobacco is combusted. While not a new technology—R.J. Reynolds Tobacco Co. introduced the Premier brand of “smokeless cigarettes” in 1988—some emerging heat-not-burn (HNB) applications could help reshape the tobacco harm reduction landscape by offering a means to deliver nicotine in ways that more closely reproduce the experience of smoking.
Newer devices that use HNB technology ought to be included in the category of electronic nicotine delivery systems (ENDS), a class that also includes nicotine vaporizers, vape pens, hookah pens, electronic cigarettes and e-pipes. Despite significant evidence that all of these various products are significantly less harmful than traditional combustible cigarettes, the goal of advancing a consistent public-health message urging a harm-reduction approach to tobacco use has been hampered by longstanding biases of the public-health community, evolving understanding of teen exposure and concerns about residual health risks.
Experts agree in principle that moving current smokers to products with lower risk profiles could save millions of lives. E-cigarettes have been quite popular among smokers, especially those who intend to quit. However, most of the 36.5 million remaining U.S. smokers reject e-cigarettes as unsatisfying. HNB technologies could allow a larger fraction of current smokers to practice tobacco harm reduction.
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