Heated tobacco and e-cigarettes: not a step toward quitting, but a step back to cigarettes
Are heated tobacco products (HTPs) and e-cigarettes a path to quitting smoking? No. New research in Tobacco Control, based on data from over 7.2 million South Korean adults who participated in a health checkup three times between 2019 and 2023, paints a completely different picture.
People who used HTPs or e-cigarettes at some point were not only more likely to quit regular cigarettes, but also significantly more likely to start smoking, relapse, and never completely quit all tobacco products. Among people who used both regular cigarettes and heated tobacco products, more than 70% eventually switched back to cigarettes. Quitting all tobacco products entirely was actually less common among dual and triple users of cigarettes, HTPs, and e-cigarettes than among people who smoked only regular cigarettes.
The researchers’ conclusion: although HTPs and e-cigarettes are associated with quitting cigarettes, they lead to more people taking up smoking, more relapses, and fewer permanent quits. Most users of multiple products eventually return to cigarettes. The net effects on public health are therefore uncertain—an important nuance to consider when marketing “smoke-free alternatives.”
