UAE doctors warn against smoke-free cigarettes after US approves its marketing

Hind Al Soulia - Riyadh - UAE doctors have warned against all inhalation devices after the US Food and Drug Administration supported the marketing of a new cigarette alternative.

In a landmark ruling in America, the FDA authorised marketing of the iQOS, a heated tobacco-stick system.

The nicotine product has been developed by Philip Morris International (PMI).

Since there is no burning, the levels of harmful chemicals are significantly reduced compared to cigarette smoke, according to the company.

UAE regulators legalised the sale of devices like iQOS and liquid nicotine vapes in the country in July last year.

This could be a lesser evil, but it is still an evil and is certainly not safe.

Dr Sreekumar Sreedharan

But doctors in the Emirates said that vulnerable teenagers could now be exposed to a nicotine habit by aggressive industry advertising.

“It must be emphasised it is preferable not to take up any kind of smoking or inhaling of fumes no matter what the device is,” said Dr Sreekumar Sreedharan, an internal medicine specialist at Aster Clinic in Karama, Dubai.

“The kind of marketing to promote these devices could appeal to young people who will see these products as safe.

“The FDA has not approved these drugs, just the marketing associated with it.

“Any kind of nicotine product cannot be considered safe.”

iQOS cigarettes are rechargeable electronic devices that heat compressed tobacco at a lower temperature of 350°Celsius.

A conventional cigarette, on the other hand, slowly burns tobacco at about 800°Celsius.

The process significantly reduces the production of harmful chemicals and toxic carcinogens.

Vaping, another smoking alternative, has soared in global popularity with the use of electronic devices to deliver nicotine reaching epidemic levels among US teenagers.

The trend prompted the US Surgeon General, the operational head of the US Public Health, to declare any form of nicotine use among young people as unsafe.

Locally, Dr Sreedharan warned against mixed messages that could be misconstrued in marketing material promoting iQOS products.

“Studies have shown the toxicity maybe less, but it does not mean they are zero,” he said.

“It may be preferable for a smoker to use iQOS, but there is still concern about the use of these devices by young people.

“Maybe there were good intentions (to approve marketing) for people using cigarettes, but what about experimenting teenagers?

“This could be a lesser evil, but it is still an evil and is certainly not safe.”

Like vaping, the long term health impact of heat-not-burn products is largely unknown, yet advocates insist smokers should be allowed access to a tobacco alternative.

Since going on sale in the UAE last year, iQOS products have increased in popularity.

“This product is still tobacco, and from a medical perspective we know that is a problem,” said Dr Sukant Bagadia, a pulmonologist at NMC Royal Hospital in Dubai.

“But if it is advertised as a quitting aid, then I can see why it would be supported.

“Quitting should mean quitting, but if a heavy smoker wants to transition towards a less harmful product this could be beneficial.”

Critics of the heat-not-burn technology claim research to show less chemicals are emitted is based on industry funded data, rather than independently sourced studies.

In the UK, advertising iQOS devices and related tobacco products is banned.

Smoking accounts for about 90 per cent of the 150 new lung cancer cases reported in the UAE each year.

Of all global cancer deaths, almost a quarter are attributed to lung cancer.

Tobacco remains the leading cause of preventable death, killing around eight million people a year.

However, the FDA said available scientific evidence demonstrated iQOS would benefit the health of the population as a whole, taking into account both users of tobacco products and non-smokers.

Devices went on sale in the US in April 2019 as regulators hoped providing smoke-free alternatives would speed up the decline in cigarette use.

iQOS is now available in more than 52 countries, and is a success in Japan, South Korea, Russia and Italy.

PMI promised to stop selling cigarettes in the UK by 2030 while heavy promotion of smoke-free products have been seen at music festivals around the world.

“The FDA’s decision is a historic public health milestone, said André Calantzopoulos, the company’s chief cxecutive officer.

“Many of the tens of millions of American men and women who smoke today will quit—but many won’t.

“iQOS is a fundamentally different product than combustible cigarettes and must be regulated differently, as the FDA has recognised.”