Just prior to Christmas I spent an interesting week with an iQOS. I acquired one shortly after the London launch and decided to give it a fair try. I packed away my usual assortment of vape and snus and went pure HEETS (the tobacco-vape-sticks) for the duration.

In the intervening weeks, it's become clear the full scale of PMI's ambitions. Just days ago they launched a new website, confidently introducing a radically changed and humanized corporate image. This PMI is "Designing a smoke-free future"; preparing itself to be the company that spearheads the post-cigarette world.

Whatever your feelings are about the tobacco industry, it's an extraordinary statement of intent for what is still the world's largest cigarette seller (until the BAT/Reynolds merger completes, that is). I presume the public health community to be in meltdown, grappling with whether to take PMI at their word or to dismiss it as more corporate malfeasance from their biggest enemy.

This particular nicotine product is, of course, a tobacco product. By which I mean, very simply, it's made from actual tobacco (how's that for a definition, FDA?).

Now, a few things:

1. Tobacco products are not necessarily harmful. Harms from existing tobacco products range from "as safe as nicotine gum" to "extremely damaging to health". Gothiatek processed Snus, for example is probably the safest form of tobacco (although the difference between it and many other oral tobaccos is likely to be tiny), yet smoking is well understood to be disastrous to health.2
2. iQOS is a tobacco product and not a vape product and PMI doesn't, I believe, intend to do any co-marketing with vape products. It's clear to me that iQOS will to sit in its own tobacco category in the retail space.
3. PMI is not, however, dismissing the vape category. It has its Mesh "The Nose-Hair Trimmer" Vape trialling in the UK. Mesh will live or die on its own merits, but it's unlikely to receive the deep support which PMI are affording iQOS (unless it proves itself in the market, of course). Nicocigs is a wholly owned subsidiary of PMI, having been acquired a couple of year's back.
4. It's becoming increasingly plain through numerous conversations with industry contacts that PMI are in the process of making an extraordinary retail push into markets globally. Europe, Japan and the UK have well publicized marketing efforts afoot. Further, it's just been announced that PMI's sister company Altria, is gearing up for a major push into the USA.

This is all going to be very, very interesting.

Forgive my preamble but that's the stuff which interests me most. If you want epic unboxing and technical nerdage, that's going to be happening real soon, I guarantee. But I've spent time with the product and so will tell you how I found it:

Let's start with what it's like once the thing's in your mouth and it's Smaping (oh dear, did I do it again?).

Sensation: The inhale has a good amount of impact. There's a slight catch on the throat but nothing particularly unpleasant; noticeable but ephemeral. The tobacco vapor is not overwhelming and doesn't seem to leave a taste in your mouth.

Visuals: In terms of a visual cloud, it's approximately what you'd expect from a standard cigalike e-cig. It's not too small to be unsatisfying, but the volume is very reduced compared with smoking and dissipates very quickly.

Smell: There is a smell. It's tobacco, but not tobacco smoke. A light, toasted aroma that is a magnitude less penetrative than cigarette smoke. I smaped in bars; no-one complained. Taken together, the smell and lessened smoke/vape output lends iQOS towards stealthy usage.

Effects: It is, phenomenologically, very, very similar to smoking. It feels like smoking. I have not had a cigarette for 7 years, but I was transported back to the psychophysical effects of tobacco smoking: a very particular light-headedness that I think I'd always assumed was related to CO, but could just as plausibly be related to the smorgasbord of active alkaloids contained within real tobacco.

It was very surprising to get this effect from iQOS. I'm not quite sure, even now, how I feel about it: It was not unpleasant, it was familiar, but was not pleasant. For a long-term vaper, slightly odd and disquieting, but not bad.

Satisfaction: I found iQOS did the job well enough. I was able to substitute my typical nicotine behaviours (snus and vaping) with the device, and by using around 10-15 HEETS per day. I didn't like it as much as vaping because, well, it's not vaping: flavour, vapor volume, impact: imo, vaping does it better, but then maybe iQOS is better for smokers. I can't judge this because it's been so long since I was a smoker.

Effects on health: I found no "lung-burden" at all from iQOS. I can remember the days of smoking - in particular the time where I was rebounding between smoking and not smoking; I'd wake up the following day from a ciggie binge and have a real sense of discomfort in my lungs. I didn't find this at all from iQOS and there's no perceptible difference using iQOS and vaping in this regard. Please note, however, that I'm not making any claims over the safety of iQOS. I have no read on this aspect whatsoever at this time.

Visible signs of tar: The filter tip from a used HEET does have a slight yellowing after use, but it is nothing compared to smoking. I'd like to see a "smoke-spit test" comparison between the two (cue: 3, 2 , 1: YouTube!)

Product design

I almost fee a bit bad about saying this, but iQOS is a bit of a disaster from a product design standpoint. There are numerous pain points and the additive effect is towards a product that could not be more dissimilar from the smoking ritual if it tried. Yes, smoking is a ball-ache. You need a lighter, you stink, you need to be somewhere you're allowed to smoke, you need an ashtray. But, that's it! That's the burden of smoking. A product which supersedes smoking should obviously remove the social stigma, but it should also be as satisfying and easy to use as a cigarette - retaining the ritual, without all the downside. And this is where things get a bit bad for iQOS.

Firstly, if you're going to be an iQOSer, you need to get used to carrying around quite a bit of kit. You'll need your HEETS (the cigarette pack), your iQOS (the charging case) and, if you're traveling anywhere, the cleaning kit and a charger (microUSB). Oh, yes, a cleaning kit! - iQOS is more like running a tobacco pipe than smoking cigarettes; it requires a commitment to maintenance and ships with a little cleaner nubbin that you'll need to use every three or four days to remove the tobacco-ey deposits left inside your iQOS.

I imagine most people won't bother - they'll just smape an increasingly horrible iQOS until such a point as it becomes overwhelmingly horrid, at which point they begrudgingly pull out the nubbin and scrub. In vape terms, then, it will become that perennial question: "when should I replace my coil?" (er, when it becomes horrible!). I don't know what the solution to this looks like, but if I were an iQOS engineer it would be my number one priority.

Other problems with iQOS:

Huge butts! Since it doesn't burn, what goes in is what comes out (albeit a bit singed).

Charges between smapes. You need to put the iQOS back into the charger for a couple of minutes between each go. It does become quite irritating, especially if you want to chain vape.

Gets stuck on your lip and pulls the HEET out while you're smaping, ejecting tobacco from the stick inside the device and all over you.

Overall capacity. I think the battery might be a little small. If you're a serious iQOSer you may well vape more per day than the charging case can cope with.

Outlook

So, when all's said and done, will iQOS be a success?

Yes, it will be a success - but success is a relative term. For me, success means major reductions in the number of people smoking, for PMI success means making money while being seen to commit to their new corporate mantras.

There's no doubt in my mind that the PMI version of success will occur (see my first iQOS post for the math on this). Will it reduce the number of smokers significantly? No-one can say, but PMI are claiming to have converted more than a million people globally already.

What's clear though is that Heat not Burn is a technology whose time has come. The tobacco industry has made many false starts on HnB products but the stars seem to be aligning this time and PMI are staking everything on its success. They have the resources to make it so and are building out prodigious distribution, and distribution is everything. Also, they have long time-frames to play with, so the problems with the current version won't be an issue as they develop the technology over time.

But, why do smokers need iQOS if vaping is so good?

Vaping has made inroads into smoking internationally - albeit more so in supportive countries such as the UK and France than in others. This, I would contend, is behind much of the confidence being exhibited by PMI: the demand for risk-reduced products is now proven. The question is, which risk-reduced products will win?

In my view, vaping has gotten stuck for some time. The model of Chinese-made hardware and domestically-produced vape juice has served the industry participants well and served many vapers very well too, but the breakthrough products still aren't available (although, XOLO ;) ). There are, of course, other problems relating to misinformation from government bodies and health organizations who are confusing smokers with conflicting information.

On safety: Should smokers use iQOS?

I have no idea whatsoever about the safety of iQOS versus vaping.

The Royal College of Physicians estimates vaping to be less than 5% as harmful as smoking. PMI, on the other hand, seem to be anchoring iQOS at 10% the risk of smoking.

I find this all rather intriguing. No-one seems to have picked up on this, but 5% and 10% are dramatically different concepts: 10%, in this context, is NOT twice the harm of 5%¦. let me explain:

I was struck, at the first E-Cigarette Summit, that those scientists present, when asked, stated that they would anticipate vaping to be 1/20th (i.e. 5%) of the risk of smoking. Some commentators later criticized (fairly) this as a false reification, pointing out that a product that is 5% as harmful as smoking is still a very harmful product, and that this isn't sensible politics.

But there's something interesting about the 5% value: it's clearly not an actual estimation of risk. 5% is a statistical convention; it's the significance threshold by which a significant "result" is judged. in other words, If vaping creates < 5% the risk of smoking, we will never be able to untangle its health burden from the burdens caused by smoking (and a host of other behaviors). In this context, 5% means: "fundamentally harmless".

10% the harm of smoking, on the other hand, is something quite different. If a product is 10% the harm of smoking, we will be able to observe the harm it creates in the population over time, and that harm will be directly attributable to that product.

The irony is, that the best current medical science cannot realistically predict the precise harms from iQOS. For the health conscious smoker this represents a bit of a dilemma. Or does it?

Ultimately, if iQOS is a 10th the danger of smoking, a smoker should clearly at least use iQOS instead of smoking, and they should start now. Over time, a better picture of the safety of the various products will emerge - people like Marcus Munafo are developing unique bio-measures which will result in a clearer picture.a

What PMI are doing, then, is very, very smart. They're entering the 'alternative nicotine' product space with a smoking simulacra, and they're providing a baseline product for smokers to migrate to. It's not iQOS versus vape, it's just: here's a product that's safer than smoking. It's also quite like smoking, so why not give it a go?

Couple that will an unprecedented roll-out and you see that this is a fait-a-complis for the biggest cigarette company on the planet.

But I still think vaping has more potential long-term than HnB! And I promise never to use the word "smape" again.