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Despite the small number of patients in their study (n=38), Polosa et al

However, because heated tobacco did not exist in 2002, it is not explicitly named in the legislation which defines a tobacco product as consisting wholly or partly of tobacco and intended to be smoked, sniffed, sucked or chewed. Although the Act was clearly intended to prohibit advertising of tobacco in all forms, tobacco companies exploited this wording, arguing that heated tobacco is not covered because it is heated , not smoked

A review of relative risk perceptions across smokeless tobacco, e-cigarettes, nicotine replacement therapy and combustible cigarettes

Other companies (such as ITG brands and state specific companies and trade associations) saw an increase from 161 registrations in 2024 to 228 registrations in 2025, a 42% increase

Fragile states are particularly so because the normal rules do not apply, taxes can be avoided, and cigarettes can still be sold profitably