WHO issues statement on US FDA’s decision regarding e-cigarettes

The World Health Organization (WHO) issued a statement on the US Food and Drug Administration’s (FDA) decision to authorise the marketing of a heated tobacco product, the IQOS Tobacco Heating System. The WHO stated that heated tobacco products (HTPs) are tobacco products and the WHO Framework Convention of Tobacco Control (FCTC) prohibits all forms of tobacco advertising, promotion, and sponsorship that advertises a tobacco product by any means that are false, misleading, or deceptive. IQOS, developed by Philip Morris International, is advertised to use ‘sophisticated electronics’ to heat specially designed heated tobacco units without burning the tobacco. While conventional cigarettes burn tobacco at temperatures of over 600C, generating smoke that contains harmful chemicals, IQOS heats tobacco at temperatures of 350C without combustion, fire, ash, or smoke.

On 7 July 2020, the FDA finalised its decision to authorise the marketing of IQOS with the reduced exposure claims; for instance, the IQOS system significantly reduces the production of harmful and potentially harmful chemicals. However, the FDA rejected the marketing of IQOS with reduced risk claims, meaning that the use of the product is not proven less harmful than conventional cigarettes nor reduces risks to health. The WHO said in the statement that the FDA’s decision may be misleading as health may be affected by exposure to some toxins that are present at higher levels in HTP aerosol than in conventional cigarette smoke, as well as additional toxins present in HTP aerosols that are not present in conventional cigarette smoke. The WHO reiterates its recommendation that uses interventions for cessation of all tobacco use, such as nicotine replacement therapies and cessation interventions sent via mobile text messaging.