Article Text

Download PDFPDF
Impact of smoking intensity and device cleaning on IQOS emissions: comparison with an array of cigarettes
  1. Ola Ardati1,
  2. Ayomipo Adeniji2,3,
  3. Rachel El Hage1,4,
  4. Rola Salman4,5,
  5. Malak El-Kaassamani6,
  6. Amira Yassine7,
  7. Soha Talih4,5,
  8. Mario Hourani4,5,
  9. Nareg Karaoghlanian4,5,
  10. Alison Breland4,8,
  11. Thomas Eissenberg4,8,
  12. Najat Saliba1,4,
  13. Alan Shihadeh4,5,
  14. Ahmad El-Hellani2,3
  1. 1 Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
  2. 2 Division of Environmental Health Sciences, The Ohio State University College of Public Health, Columbus, Ohio, USA
  3. 3 Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
  4. 4 Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
  5. 5 Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
  6. 6 Department of Physical and Environmental Sciences, University of Toronto Faculty of Arts & Science, Toronto, Ontario, Canada
  7. 7 Department of Environmental Health and Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland, USA
  8. 8 Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
  1. Correspondence to Dr Ahmad El-Hellani, Division of Environmental Health Sciences, The Ohio State University College of Public Health, Columbus, OH 43210, USA; elhellani.1{at}


Significance IQOS is a heated tobacco product that has been widely advertised by Philip Morris International (PMI) as a reduced-exposure product compared with cigarettes. Reduced exposure results from reduced emission of toxicants which could be influenced by product constituents and user behaviour. This study aims to assess the influence of user behaviour, including device cleaning and puffing parameters, on toxicant emissions from IQOS.

Methods IQOS aerosols were generated by a smoking machine using the combination of two cleaning protocols (after 1 stick vs 20 sticks) and five puffing regimes (including standard cigarette puffing regimes and IQOS-tailored regimes). The generated aerosols were analysed by targeted methods for phenol and carbonyl quantification, and by chemical screening for the identification of unknown compounds.

Results Puffing parameters significantly affected phenol and carbonyl emissions while device cleaning had no effect. Harsher puffing conditions like more, longer, and larger puffs yielded higher levels for most toxicant emissions. Comparing the obtained data with data reported by PMI on 50 cigarette brands smoked under different puffing regimes showed various trends for phenol and carbonyl emissions, with IQOS emissions sometimes higher than cigarettes. Also, the chemical screening resulted in the tentative identification of ~100 compounds in the IQOS aerosols (most of limited toxicity data).

Conclusion This study showed that puffing parameters, but not device cleaning, have significant effects on carbonyl, phenol and other emissions. Data analysis highlighted the importance of comparing IQOS emissions with an array of commercial cigarettes tested under different puffing regimes before accepting reduced exposure claims.

  • Addiction
  • Carcinogens
  • Harm Reduction
  • Non-cigarette tobacco products
  • Smoking topography

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

View Full Text


  • X @aal_najat

  • OA and AA contributed equally.

  • Contributors AE-H conceived the study idea and study design. OA, ME-K, AA, AY, REH and RS conducted the experimental work. ST conducted the statistical analysis. AA, OA and AE-H wrote the first and final drafts of the manuscript. All authors approved the final version. AE-H is the guarantor of this manuscript.

  • Funding This research was supported by a Rapid Response Project award under grant number of U54DA036105 from the National Institute on Drug Abuse of the National Institutes of Health (NIH) and the Center for Tobacco Products (CTP) of the US Food and Drug Administration (FDA).

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA.

  • Competing interests TE and AS are paid consultants in litigation against the tobacco and e-cigarette industry and are named on one patent for a device that measures the puffing behaviour of e-cigarette users and a patent application for a smoking cessation intervention. TE is also named on a patent application for a smartphone app that determines e-cigarette device and liquid characteristics. All other authors declare no conflict of interest.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.