Heat-not-burn (HNB) tobacco products
Major tobacco companies have recently developed HNB products for consumption of real tobacco using a special electronic heating device. The tobacco stick or capsule is heated to produce an aerosol without combustion.
(i) Harmful effects of HNB products
Recent studies have shown that the tar and nicotine yields of HNB products are comparable to those of conventional cigarettes. The Government Laboratory tested seven samples of tobacco sticks in 2017 and all the aerosol samples were confirmed to contain nicotine and tar, with yields comparable to some conventional cigarettes available in Hong Kong. Nicotine can cause addiction and narrowing of blood vessels. Tar is carcinogenic and can irritate airways. Studies also detected other harmful substances including volatile organic compounds and carbon monoxide released by HNB products.
Apart from adverse health impact to users, these products also expose bystanders to side-stream emissions and second-hand smoke, (1, 2) and World Health Organization (“WHO”) has stated that there is no safe level of exposure to second-hand tobacco smoke. (3)
Currently there is no evidence to show that HNB products can help smokers quit smoking.
(ii) Prevalence of HNB products use
Evidences have shown that the use of HNB products is not only limited to smokers. Usage among never smokers has been observed. For example, current use of a HNB product in Japan increased more than 10 times from 0.3% in 2015 to 3.6% in 2017. Current use rate among never smokers increased from 0.1% in 2015 to 1.3% in 2017. (4)
(iii) Local consumption of HNB products
In Hong Kong, using data weighted by the 2017 population, a population-based survey revealed that 0.9% had ever used HNB products. (5)
(iv) WHO recommendation
WHO considers that all forms of tobacco use, including the use of HNB products, are harmful. The eighth Conference of the Parties to the WHO Framework Convention on Tobacco Control held on 1-6 October 2018 adopted the decision urging Parties to consider to “regulate, including restrict, or prohibit, as appropriate, the manufacture, importation, distribution, presentation, sale and use of novel and emerging tobacco products, as appropriate to their national laws, taking into account a high level of protection for human health”. (6)
(v) Prohibition on the use of HNB products in non-smoking areas
Cigarette smoking (including HNB products) is banned in no smoking areas under the Smoking (Public Health) Ordinance (Cap. 371). Offenders are subject to a fixed penalty of $1,500.
Members of the public are reminded not to use any tobacco products and smokers are encouraged to quit smoking. For more information on smoking cessation, please call the Integrated Smoking Cessation Hotline of the Department of Health at 1833 183.
Prevention of the Use on Heat-not-Burn (HnB) Tobacco Products
(1) Ruprecht A, et al. Environmental pollution and emission factors of electronic cigarettes, heat-not-burn tobacco products, and conventional cigarettes. Aerosol science and technology. 2017;51(6):674-84.
(2) Protano C, Manigrasso M, Avino P, Sernia S, Vitali M. Second-hand smoke exposure generated by new electronic devices (IQOS® and e-cigs) and traditional cigarettes: submicron particle behaviour in human respiratory system. Annali di igiene: medicina preventiva e di comunità. 2016;28(2):109.
(4) Tabuchi T, et al. Heat-not-burn tobacco product use in Japan: its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-burn tobacco aerosol. Tobacco Control. 2017;10.1136/tobaccocontrol-2017-053947
(5) Wu Y, Wang M, Ho D, Cheung Y, Tabuchi T, Kwong A, et al., editors. Heat-not-burn tobacco use and its associated factors in Chinese adults: a population-based survey in Hong Kong, China (poster and abstract). Society for Research on Nicotine and Tobacco (SRNT) Europe 18th Annual Conference in Munich, Germany, September 6-8, 2018; 2018.