Pubblicato: 2023-01-26

Nicotine in IQOS: what Philip Morris does not say

Medico Pneumologo, Bologna; Giornalista medico-scientifico
Presidente Società Italiana di Tabaccologia (SITAB); Dipartimento di Sanità Pubblica e Malattie Infettive, La Sapienza Università di Roma
Istituto di Ricerche Farmacologiche “Mario Negri”, Milano


We are the factory of doubt. This was stated in a document labelled as “confidential” and found in the archives of a tobacco company which were made public by order of a US court [1-4]. And, as we know, doubt is always preparatory to generating deception.

Thus, for decades, due to the systematic dissemination of doubts about any news of scientific research that could put their business in difficulty, Philip Morris International (PMI) and its sister companies managed to counter anti-smoking legislative initiatives by fueling doubts about scientific results for which there was clear and definitive evidence [1-4]. We range from the denial during the 1930s and 1950s of the carcinogenicity of tobacco smoke [5-7] and of the radioactivity problem from Polonium 210 in tobacco smoke since the 1960s [7,8], to the denial of the addictive properties of nicotine [9,10] up to concealing the addition of substances in tobacco products, such as ammonia [10,11].

The “woodworm” of doubt has inexorably continued to be fed up to the present day with the defense of “light cigarettes” [12], the mystification of the harmlessness of passive smoking by excessively emphasizing outdoor environmental pollution [1-3], up to the mass media and commercial harm reduction campaign of new tobacco products [13].

Now the latest pearl of PMI: the deception on the actual amount of nicotine present in its heated tobacco product (IQOS). In an article that appeared in Il Fatto Quotidiano signed by Chiara Margottini [14], an investigation by The Bureau of Investigative Journalism (TBIJ), an independent association of investigative journalism based in London, is taken up. This investigation denounces misleading information with respect to the quantity of nicotine in IQOS sticks and smoke. The problem is not of negligible importance given that the quantity of nicotine present in smoke affects the smoker’s addiction.

The investigation originates from the fact that some official PMI websites, as well as IQOS official shop assistants, inform consumers that each stick of tobacco contains 0.5 mg of nicotine, when in reality it contains 8 times as much. Despite the huge spread of heated tobacco products in Italy (where more than 2 million users are estimated) and in the world (20 million), there is still no internationally standardized methodology for analysing the quantity of substances contained in these products. At the request of the TBIJ, researchers from Unisanté, the University Center for Public Health in Switzerland, conducted the necessary tests to determine the nicotine contained in IQOS sticks. The results revealed that “each stick contains 4.1 mg of nicotine, which is 8 times more than Philip Morris claims to its consumers” [14].

In essence, the figure of 0.5 mg refers to how much nicotine you breathe when inhaling the aerosol of each IQOS stick and not to the amount actually included in the stick.

The difference between the two is substantial starting from the advertising communication phase as not all the nicotine included in the tobacco stick ends up in the inhaled aerosol. Thus, saying that 0.5 mg is the nicotine in the stick leads us to think that the one actually breathed is even less.

Unfortunately, “the information according to which the figure of 0.5 mg would be the nicotine contained in the tobacco stick of IQOS is present on the Swiss Philip Morris website and, until recently, also on the British one” [14].

In its investigation, the TBIJ found that this wrong information is also being provided by live chat operators on IQOS official websites around the world. In fact, except in Germany and Austria - where the operators declared that 0.5 mg actually refers to the nicotine inhaled - in 9 other countries worldwide, including Italy, the operators of the online chats continued to give wrong information.

Finally, as if that were not enough, the tests commissioned by the TBIJ, using the analysis method recommended by the World Health Organization (WHO), reveal that the nicotine present in each IQOS aerosol draw is equal to 1.2 mg, more than twice the 0.5 mg declared.

In this analysis, the other toxic substances present in the aerosol of the heated sticks were not taken into consideration. Instead, a review conducted by the Istituto Superiore di Sanità (ISS) did so, confirming that there are at least 80 substances in the IQOS aerosol alone in even higher concentrations than what is observed in traditional cigarette smoke. Of these, 4 are classified as carcinogenic.

The results of this independent TBIJ investigation call into questions about the alleged reduced toxicity of Philip Morris’s heated tobacco product.


  1. Ong EK, Glantz SA. Tobacco industry efforts subverting International Agency for Research on Cancer’s second-hand smoke study. Lancet. 2000; 355:1253-9.
  2. Clementi ML. Breve viaggio negli archivi della Philip Morris. Epid Prev. 2000; 24:103-7.
  3. Zagà V, Salvati F. La tela del ragno della lobby del tabacco. Gole profonde. Quello che i fumatori (e i non fumatori) non sanno. Pneumorama. 2005; 42:16-20.
  4. Michaels D. Doubt is their product: how industry’s assault on science threatens your health. Oxford University Press: Oxford; 2008.
  5. Roffo AH. Tobacco as a carcinogen. Boletin del Instituto de Medicina Experimental. 1936; 42:287-336.
  6. Doll R, Hill AB. Mortality in relation to smoking: ten years’ observations of British doctors. Br Med J. 1964; 1:1399-410. DOI
  7. Zagà V, Lygidakis C, Chaouachi K, Gattavecchia E. Polonium and lung cancer. J Oncol. 2011;860103. DOI
  8. Muggli ME, Ebbert JO, Robertson C, Hurt R. Waking a sleeping giant: the tobacco industry’s response to the polonium-210 issue. Am J Public Health. 2008; 98:1643-50. DOI
  9. Dunn WL, Philip Morris Research Center. Motives and incentives in cigarette smoking. 1973. Publisher Full Text
  10. Cattaruzza MS, Giordano F, Osborn JF, Zagà V. History of nicotine addiction. Tabaccologia. 2014; XII(1-2):10-9.
  11. United States, Public Health Service, Office of the Surgeon General. Smoking and health: a report of the Surgeon General. US Office on Smoking and Health: Washington D.C.; 1979.
  12. Zagà V, Mura M. L’insostenibile leggerezza delle... light. Tabaccologia. 2003; I(2):13-4.
  13. Zagà V, Gorini G, Cattaruzza MS, Gallus S. New “cigarettes”, old dangers, usual deceptions. Tabaccologia. 2018; XVI(4):5-10.
  14. Margottini C. La Philip Morris inganna i clienti sulla nicotina presente nelle iQqos. Il Fatto Quotidiano. 2022.


Vincenzo Zagà

Medico Pneumologo, Bologna
Giornalista medico-scientifico

Maria Sofia Cattaruzza

Presidente Società Italiana di Tabaccologia (SITAB)
Dipartimento di Sanità Pubblica e Malattie Infettive, La Sapienza Università di Roma

Silvano Gallus

Istituto di Ricerche Farmacologiche “Mario Negri”, Milano


© SITAB , 2022

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