The Smoking Debate’s Biggest Blind Spot

Over the decades, all the awareness campaigns against smoking have been highlighting the health-hazards of smoking, while blaming tobacco itself as the main culprit. This is not entirely true. Extensive research now indicates that the primary risks to a smoker’s health are not from tobacco alone, but from the combustion process.

So, what is combustion and why is it so risky?

In simple terms, combustion is the process of burning. When a cigarette is lit, the tobacco inside does not just heat up, it burns at very high temperatures. This burning breaks down the tobacco into smoke, releasing a complex mix of chemicals into the air. Many of these substances are not originally present in the tobacco in the same form but are created during the burning process itself. It is this smoke, filled with these newly formed toxic compounds, that a smoker inhales into the lungs.

This is where the real danger lies. Studies show that when tobacco burns, it produces a wide range of harmful chemicals, along with reactive compounds and free radicals. According to the World Health Organization, these emissions can damage living tissues and are linked to serious health conditions, including respiratory illnesses, cancers, cardiovascular disease, and chronic obstructive pulmonary disease (COPD), as well as effects on reproductive and developmental health.

Evidence from a leading cancer research organisation has identified numerous chemicals in cigarette smoke that can damage DNA, while triggering genetic mutations, which cause cancer. Tar is among the most hazardous by-products of tobacco combustion. It comprises multiple toxic chemicals that can impair the tiny air-sacs called ‘alveoli’ inside the lungs.

Despite knowing the risks, however, many smokers find it difficult to quit smoking entirely. This is largely because nicotine, the addictive component in tobacco, makes it hard for users to stop immediately. As a result, the question is not only about quitting, but also about whether exposure to these harmful chemicals can be reduced.

The most effective solution remains quitting altogether. However, for those who are unable to do so immediately, the focus shifts to reducing harm.

Studies suggest that smokers who are not able to quit and if they completely switch from cigarettes to heated tobacco products, it can significantly reduce their exposure to cancer-causing chemicals. This is primarily because these products do not burn tobacco. Instead of combustion, they heat the tobacco to lower temperatures, which means far fewer harmful chemicals are produced compared to cigarette smoke.

In some cases, exposure to certain substances has been reported to approach levels seen in people who do not smoke.

These alternatives are now contributing to a global shift in consumer behaviour, with tens of millions of smokers already using them. Japan is at the forefront of this transition, with cigarette sales declining rapidly over the past ten years and sales of heated tobacco devices rising sharply. Such trends, particularly in more health-conscious societies, point to changing consumer attitudes.

For policymakers, this presents an important consideration. If the primary source of harm lies in combustion, then reducing reliance on products that burn tobacco could play a meaningful role in lowering the overall disease burden associated with smoking. This distinction can help shape more informed and pragmatic approaches to tobacco harm reduction.

At the same time, it is important to recognise that quitting tobacco and nicotine consumption altogether remains the healthiest option. None of these alternatives are completely risk-free. However, for those who continue to smoke, moving away from combustion-based products may offer a pathway to reduced exposure to harmful chemicals.

In the long term, the focus should remain on eliminating combustion altogether. Achieving this would require greater public awareness, behavioural change, and sustained policy commitment. Such a shift could also bring broader socio-economic benefits, including a reduction in public healthcare costs.