Philip Morris International’s heated tobacco product “iQOS,” which was authorized for market in the United States by the FDA in April 2019, was first rolled out in Atlanta, GA over the past month, and the product is now being rolled out in Richmond, VA.
What are these products?
According to the FDA, heated tobacco products, often called “heat-not-burn” products by the tobacco industry, “heat dry tobacco to create an aerosol that the user inhales.”
iQOS is a heated tobacco product that consists of a rechargeable heating device that Marlboro-branded “HeatSticks” containing tobacco are inserted into. When the HeatSticks are inserted, a glass-covered ceramic blade from the device pierces the tobacco in order to heat it. These HeatSticks, like cigarettes, are sold packs of 20 and are also being sold in menthol.
Other heated tobacco products like RJ Reynolds “Revo” have been introduced to the US market before, but none have gained much traction.
Learn more about heated tobacco products from the FDA here and from the WHO here.
Are they safer than cigarettes?
The FDA says that they “may help reduce the risk of tobacco-related harms for adult smokers who switch completely from combusted cigarettes.” A systematic review found that these types of products expose users and those around them to 62% fewer toxicants and 75% less particulate matter than cigarettes. However, this lower level of exposure does not necessarily translate into a lower risk for disease or death, and the products have also been found to produce higher concentrations of some carcinogens than conventional cigarettes  An FDA Tobacco Product Scientific Advisory Committee found that iQOS did not substantially reduce risks of tobacco related death and disease. Additionally, there is a lot variation in the studies that have been conducted to date, and the majority of studies have been conducted with tobacco industry funding or have otherwise been affiliated with the tobacco industry.
While Phillip Morris International has submitted an application to the FDA for approval to market iQOS as a modified risk tobacco product, the FDA has not yet issued a decision .
How are they being marketed and sold in the retail environment?
So far in Atlanta, they’re being sold at flagship stores in two malls, as well as at mobile units and kiosks around the city, sometimes in the parking lot of convenience stores. Some tobacco retailers are also selling the HeatSticks.
While the flagship stores require individuals to be at least 21 years old to enter and screeners are stationed at the door to narrow their customer base to current adult smokers only, there are still concerns about the products appealing to youth, based on their marketing efforts and perception of the products as it has been rolled out for sale in other countries.
While the products have made their US debut in Atlanta, they will soon be rolled out in Richmond, VA as well. While the device will only be sold (at least initially) at their flagship store and pop-up kiosks, the heatsticks will be available at 170 tobacco retailers across the city.
Learn more in Truth Initiative’s report, “IQOS in the US: Examining the Launch of the Country’s Newest Electronic Tobacco Product.”
How are they being regulated so far?
The FDA has classified them as cigarettes, so they are federally regulated as such. You can see how they are (or will be) regulated at the state level in the 50 state review from the Public Health Law Center. Also see their fact sheet, Heated Cigarettes: How States Can Avoid Getting Burned for more on the regulatory landscape.