Cigarettes, vaping and heated tobacco ALL ’cause serious lung damage’

Is any smoking safe? Cigarettes, vaping and heated tobacco ALL ’cause serious lung damage’

  • Smokeless devices are said to expose users to 90 per cent fewer chemicals 
  • Yet Australian researchers believe they can be just as damaging as cigarettes 
  • They may affect the airways much like emphysema, bronchitis and lung cancer 

Popular heated tobacco devices may cause the same damage to lung cells as traditional cigarettes.

Meanwhile, e-cigarettes are also toxic to the cells which protect the lungs, so might not be a safe alternative to smoking, a study suggests.

Both electronic devices, used by thousands of people to quit smoking, are now thought to cause the airway damage seen in people with emphysema, bronchitis and lung cancer.

Australian researchers found they harm the lung cells which protect the airways, just as cigarette smoke does.

Cell damage: Australian researchers found that heated tobacco devices and e-cigarettes harm the lung cells which protect the airways, just as cigarette smoke does

The study looked at the IQOS, a ‘next-generation’ heated tobacco device used by 6.6million people and sold in Britain. 

Priced at more than £50 for a starter kit from Amazon, the trendy product heats rather than burns tobacco to produce a similar flavour to cigarettes but lower levels of chemicals.

However it was found to damage human lung cells, changing their structure and triggering an inflammatory response.

Dr Sukhwinder Sohal led the study from the University of Tasmania, looking at cigarettes, e-cigarettes and the IQOS, which is made by tobacco giant Philip Morris International.

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He said: ‘Our results suggest that all three are toxic to the cells of our lungs and that these new heated tobacco devices are as harmful as smoking traditional cigarettes.

‘Damage to these two types of lung cells can destroy lung tissue leading to fatal diseases such as chronic obstructive pulmonary disease, lung cancer and pneumonia, and can increase the risk of developing asthma, including in unborn children.

‘So we should not assume that these devices are a safer option.’

Cigarettes, electronic cigarettes and heated tobacco devices all contain nicotine – the addictive substance which gets people hooked. 

But e-cigarettes contain a liquid form of nicotine that is heated into vapour to be inhaled, avoiding the harm caused by tobacco smoke.

Heated tobacco products like the IQOS are marketed as being safer than cigarettes because tobacco is not burned, which produces smoke containing many harmful chemicals. 

Instead it is heated, producing fewer chemicals and no fire, ash or smoke.

Risk: Cigarette smoke and heated tobacco vapour were highly toxic to the cells both at lower and higher concentrations while e-cigarette vapour was toxic mainly at higher levels

Researchers tested the effects of all three devices on epithelial cells and smooth muscle cells taken from the human airways.

In healthy lungs, epithelial cells act as the first line of defence to any foreign particles entering the airway while smooth muscle cells maintain its structure. 

When they are damaged, they cause the scarring and reshaping of the airway seen in lung patients.

The study found the electronic devices caused this damage, including changes to cell structure and function, as well as a ‘cry for help’ inflammatory response.

That inflammatory response was as strong for the heated tobacco device as when the lung cells were exposed to smoke from Marlboro Red cigarettes.


Heat-not-burn e-cigarettes were originally created by the tobacco giant Philip Morris International.

The pharma company is behind a smokeless device known as IQOS that is said to contain 90 per cent less toxins than conventional cigarettes.

Unlike e-cigarettes, the smokeless device contains mini tobacco sticks in the form of Marlboro HeatSticks or others as opposed to a nicotine-laced liquid.

These are then placed into the device before being heated, which experts say makes them much less harmful as they are not burning the tobacco.

Yet experts add the innovative devices will never be safer than e-cigarettes.

Cigarette smoke and heated tobacco vapour were highly toxic to the cells both at lower and higher concentrations while e-cigarette vapour, from e-liquid made by the company blu in a Chinese vaping device, was toxic mainly at higher levels.

Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, who was not involved in the research, said the study suggested a need for ‘considerable caution’ on heat-not-burn products, although their impact is not fully understood.

He added: ‘E-cigarettes are often presented as safer than cigarettes because they also deliver nicotine but contain no tar, the cause of lung cancer.

‘But they contain many things not found in conventional cigarettes.

‘We really have very little idea about the specific risks associated with e-cigarettes but the evidence that is emerging indicates that they are far from safe, with risks to the heart and lungs. This study adds to that body of evidence.’

Public Health England has urged smokers to use e-cigarettes, calling concerns over vaping ‘false fears’.

But the study, published in the journal ERJ Open Research, says both e-cigarettes and heated tobacco devices causes the same damage to cells seen in people with chronic obstructive pulmonary disease (COPD), asthma, bronchitis and emphysema who struggle to breathe.

Dr Moira Gilchrist, head of scientific and public communications at Philip Morris International, said: ‘The research letter lacks important scientific information that could significantly impact any conclusions about e-cigarettes and heated tobacco. ‘The author’s conclusion that both IQOS and e-cigarettes are as toxic as cigarettes is not in line with current available evidence and goes against the growing consensus from public health authorities such as Public Health England.’

Joe Thompson, director of group science at Imperial Brands, which owns blu, said there were ‘serious concerns’ about the study’s methods.

He added: ‘Our own recently published research has generated results that are far more representative to real human exposures.

‘Our study demonstrates that the vapour generated by blu e-liquids in a blu device displays no cytotoxic effects in a human lung model.’  


How do e-cigarettes work?

E-cigarettes are battery powered and contain a cartridge filled with nicotine. When the user inhales, the nicotine is drawn into an atomizing chamber, where it is heated and turned into a vapour. The vapour is inhaled like a normal cigarette and a nicotine hit is delivered to the lungs without tar or toxins.

How do HeatSticks work?

The cigarette-like sticks are heated to maximum of 350 degrees Celsius in a hollow pen-like device to create a tobacco-flavoured nicotine vapour. They contain tobacco which is heated instead of burned to eliminate toxins found in smoke.

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