Smoking alternatives

Smoking alternatives
A test tube rack that had been stocked with examples of various electronic cigarettes, referred to as e-cigarettes, or e-cigs, and vaping pens. (Photo: Unsplash)
In Jordan, smoking is a prevalent and terrible habit. In 2016, Jordan was ranked 8th internationally for the highest consumption of about 2,300 cigarettes per person per year. Based on a Ministry of Health 2019 report, 70.3 percent of men between the ages of 18 and 44 and 18.6 percent of women within the same age demographic were smokers at the time.اضافة اعلان

Of the smoking men, 89 percent smoked on average a little over a pack a day. With advancements in technology, though, more people are switching to alternative forms of smoking such as vaping and HEETS using an IQOS device.

Traditional smoking

Nicotine is an “active ingredient” in cigarettes whose effects are sought after. Unfortunately, manufactured and even raw forms of tobacco contain a plethora of other chemicals. At least 70 of the known chemicals found within cigarettes are carcinogens, chemicals that are known to cause cancer.

One of the common and well-studied chemicals in cigarettes is formaldehyde, a carcinogen that may be used as a pesticide, disinfectant or preservative. A classic example of formaldehyde use is as the preservative fluid in jars of frogs for biology classes. Cigarettes can contain 2.3-6.1 ppm (parts per million) of formaldehyde, whereas the air around us only contains 0.005-0.01 ppm. Other harmful chemicals and carcinogens include heavy metals, such as lead and arsenic, as well as radioactive elements such as polonium-210.

At least 70 of the known chemicals found within cigarettes are carcinogens, chemicals that are known to cause cancer. (Photo: Envato Elements)

Cigarettes smoke contains other harmful chemicals. One such chemical is carbon monoxide which is detrimental to the health as it displaces oxygen in the blood stream. Tar, another produced when smoking, is a black residue produced from plant-based materials; when inhaled, the droplets coat the lung’s interior, damaging cells and causing many complications.


Vaping is a form of electronic cigarette (e-cigarette) that delivers nicotine through a hand-held device. e-cigarettes were commonly disposable, but now most devices have a refillable pod that can be filled and reused. The device itself has little bearing on the delivery of nicotine, which depends on the formulation of the vape juice. The most common type of vape juice is nicotine salt, often referred to as SaltNic, which is the natural form of nicotine as found in the tobacco plant. Due to its chemistry, nicotine salt only aerosolizes at extremely high temperatures, which are difficult for a hand-held device to replicate.

A vape, which is a form of electronic cigarette that delivers nicotine through a hand-held device.  (Photo: Unsplash)

In order to solve this issue, a weak acid (most commonly benzoic acid) is added to lower the temperature nicotine salt needs to vaporize, as well as to reduce the pH which helps reduce harshness and enhances nicotine delivery. The juice itself comes in many different flavors and does not produce a smell that lingers on the hands or clothing, making it an appealing option for those considering switching. Furthermore, vaping tends to be smoother, resulting in higher user satisfaction, and is a more cost-effective option compared to other forms of smoking.


IQOS is a device developed by Philip Morris International, which uses specialized cigarettes called HEETS. The device is a heating system that heats the tobacco, as opposed to burning it, and does not produce fire, ash or smoke. By heating the tobacco, a vapor is produced that contains nicotine and lasts for six minutes or 14 puffs, which is comparable to a traditional cigarette. The claim is that because there is no combustion, the amount of harmful chemicals produced from tobacco is significantly lower compared to cigarette smoke.

An IQOS device system which heats the tobacco, instead of burning it.  (Photo: Wikipedia)

HEETS do produce a smell, but it does not linger or stick to clothing. Additionally, the cost of switching is comparable to that of cigarettes. HEETS maintains a similar taste and use to that of traditional means, thus making switching feel more natural.

Health benefits of switching

At this point, it is important to note that there is no true health benefit to switching because ultimately you are still smoking. In order to actually gain health benefits, one must quit smoking entirely, in all of its forms. It is this concept that makes it ever more imperative for those who never smoked to never try either of these alternatives. These products are not without risk and are especially toxic on developing brains. Those who switch to an alternative method do so in hopes of reducing risks associated with smoking, since they will not quit otherwise.

Research on smoking alternatives is still in its infancy. There are few studies on the subject and no long-term studies yet. What few studies do exist are largely done by the Philip Morris company and has the potential for bias. Nevertheless, information is still available and it is up to the consumer to make an informed decision.

One study evaluated the amount of free radicals and Nitric oxide two vaping devices, HEETS and a reference cigarette. Free radicals are highly unstable atoms that can damage cells, which can result in various illness. Nitric oxide (NO) is a hazardous substance that can produce coughing, shortness of breath, and burning in the throat and chest. When testing for free radicals, the reference cigarette contained approximately 26 nmols (nano moles), HEETS contained only 0.394 nmols, and, more interestingly, the two vaping products contained 0.251 nmols and 0.193 nmols. Similarly, NO was found to be 13.7 micrograms (mcg) in the reference cigarette.

In contrast, HEETS only contained 1.17 mcg, whereas the vape products contained no detectable traces. Significance testing was not performed on these values, but anecdotally, there is substance to Phillip Morris’ claims.


Owing to the fact that these products are still relatively new, researchers do not yet fully understand the possible ramifications, both short term and long. Vaping may seem more appealing, but there have been several reported deaths and pulmonary complications around the world. The primary cause for these were counterfeit juices or juice containing some form of a narcotic.

If you decide to switch, be sure to purchase original and trusted brands. Additionally, it is important to note that ingredients, such as benzoic acid, have not been all tested and the health effects are still unknown.

In pregnant women, these alternatives are still prohibited as nicotine is the main toxin and easily crosses through the placenta. Smoking while pregnant may cause numerous diseases in the child and carries with it the potential for miscarriage and preterm births.

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