Heated tobacco products are often marketed by tobacco companies as less harmful than cigarettes, but they can pose health risks to users, according to a new review I co-authored in the journal Tobacco Control. Evidence on their health risks in people who smoke is limited, sometimes contradictory, and hard to make sense of.
Heated tobacco products are electronic devices that heat tobacco so users can inhale nicotine. Common brands include IQOS, available in the U.S., and Ploom and Glo, sold in other countries.
Heated tobacco products are different from e-cigarettes, though they may look similar. E-cigarettes, which are also called vapes, heat a liquid containing nicotine but not tobacco, whereas heated tobacco products heat actual tobacco leaf. Heated tobacco products are also different from traditional cigarettes, which burn tobacco rather than heating it. These distinctions matter because it’s the burning of tobacco leaf – not the nicotine – that directly causes the disease and death associated with smoking.
There is limited long-term data about the health harms of heated tobacco products. My colleagues and I analyzed the available data, drawn from 40 clinical trials, that followed participants who used these products for a year or less. We looked at molecular changes in the blood, breath and urine, called biomarkers, to explore the potential risks of heated tobacco products.
The studies we reviewed reported changes in 143 different biomarkers, including measures linked to heart disease and cancer. But drawing clear conclusions from the data was hard because of issues with the available evidence. Of the 40 studies, 29 were funded by the tobacco industry. Furthermore, 31 of the 40 studies were conducted in confined settings, meaning that participants’ activities and their use of the assigned product were controlled. This may not reflect heated tobacco products’ real-world use.
If heated tobacco products are less harmful than cigarettes, we would expect to see largely beneficial effects in smokers who switched to them. However, the evidence we reviewed was inconclusive. Though most studies suggested that heated tobacco products might reduce risks of disease compared with smoking, other studies found no difference, or even the potential of increased risk. Compared with quitting smoking completely, use of heated tobacco products had more consistently harmful effects.
Tobacco companies claim that heated tobacco products pose less of a health risk than cigarettes.
Few studies have directly compared the effects of heated tobacco products with e-cigarettes. However, many independently funded, longer-term studies have examined e-cigarettes and have shown they can help people stop smoking and reduce health risks in people who switch completely from smoking to vaping.
Why it matters
Heated tobacco products may be coming to a town near you – or already be there. They are already widely used in Japan. IQOS was removed from the U.S. market in 2021 after a court ruled that the product had infringed on an existing patent. However, following a flurry of promotional activities, IQOS relaunched in March 2025 in Austin, Texas. Like most heated tobacco product brands, IQOS is owned by one of the largest cigarette companies in the world, Philip Morris International.
The company claims it wants to bring IQOS to the U.S. market to provide smoking adults a “better alternative” to cigarettes. But the science we’ve reviewed on whether heated tobacco products are truly healthier is inconclusive. Our review found inconsistencies in data on health effects, and other research suggests these products may not help smokers quit.
What still isn’t known
We do not know the long-term health effects of heated tobacco products, nor whether they can actually reduce the risk of disease and death in people who switch from smoking to using heated tobacco products. It is also unclear how heated tobacco products fit into the wider tobacco and nicotine market, especially in light of other available products and interventions already proved to help smokers quit.
While our findings do not rule out the possibility that these products have fewer health risks than cigarettes, they provide little support for such claims.
LAKE COUNTY, Calif. — The Board of Supervisors this week will consider nine letters to federal and state agencies regarding legislation and budget matters, as well as amendments to multimillion-dollar county agreements for mental health programs.
The board will meet beginning at 9 a.m. Tuesday, May 6, in the board chambers on the first floor of the Lake County Courthouse, 255 N. Forbes St., Lakeport.
The meeting ID is 865 3354 4962, pass code 726865. The meeting also can be accessed via one tap mobile at +16694449171,,86533544962#,,,,*726865#. The meeting can also be accessed via phone at 669 900 6833.
At 10:30 a.m., the board will consider a proposed “findings of fact and decision” by county counsel which denies the appeal of a commercial cannabis cultivation permit by the appellant NinaStar LLC.
The permit was first denied by the Planning Commission in December. NinaStar LLC immediately filed an appeal to the Board of Supervisors.
On April 1, the board determined to deny the appeal by a vote of four to one, with Supervisor Eddie Crandell the only no vote.
According to the proposal to be considered this week, the appellant failed to provide sufficient evidence to its appeal and the board finds that “this project would have a significant effect on the environment.”
At 11:30 a.m., the board will hold a public hearing on proposed changes to the county’s master fee schedule, which would adjust service fees starting July 1.
In the untimed items, the board will consider a letter of opposition to proposed presidential budget that would eliminate Head Start funding for fiscal year 2026.
“Local programs providing critical Head Start services in Lake County also include the Lake Family Resource Center Early Head Start (serving 74 children and employing 22 staff), and the Kelseyville ‘E Center,’” the letter said. “Together, these programs offer an additional 108 slots, increasing access to essential early childhood education for families in the region.”
The letter highlighted the impact of eliminating the program: “Defunding Head Start would eliminate a vital safety net for some of the most vulnerable populations in our region, jeopardizing children’s futures, forcing parents and Head Start staff out of the workforce, and increasing the burden on already strained social systems.”
The board will also consider a letter to Gov. Gavin Newsom to support the extension of the BioMAT program, which requires procurement of 250 megawatts of energy from new, small-scale bioenergy projects.
The staff report says that California-based entities have received $30 million in federal funding that hinges on full BioMAT implementation. However, only 20% of the required megawatts have been procured to date.
If no action is taken, the BioMAT program will “sunset” by the end of 2025, and much of that $30 million will have to be returned to the Federal Government.
The board will also consider three letters of support for Federal Forest Health and Wildfire and Disaster Resiliency Legislation.
The proposed Disaster Resiliency and Coverage Act would establish a new state program that provides up to $10,000 for disaster mitigation work on homes and 30% tax credit for qualified mitigation activities undertaken by individuals and businesses, according to the staff memo.
The board will consider signing four coalition letters in support of state legislation focused on fire insurance.
The bills include: AB 1, which addresses how insurers incorporate wildfire risk mitigation into rate-setting; AB 441, which extends two wildfire resilience and mitigation programs; SB 547, which expands a moratorium on insurance non-renewals in wildfire disaster areas to include commercial properties; and SB 616, which revises the state’s wildfire mitigation program and establishes a Community Hardening Commission.
In four separate items, the board will also consider amendments to four agreements for mental health programs, totaling more than $5 million.
The full agenda follows.
CONSENT AGENDA
5.1: Approve continuation of proclamation declaring a Clear Lake Hitch emergency.
5.2: Approve continuation of proclamation of the existence of a local emergency due to pervasive tree mortality.
5.3: Approve continuation of emergency proclamation declaring a shelter crisis in the county of Lake.
5.4: Adopt proclamation designating May 2025 as Lake County Month of Awareness for Missing and Murdered Indigenous Women and People.
5.5: Adopt proclamation designating May 1 to 7, 2025, as Elks National Youth Week in Lake County.
5.6: Adopt proclamation designating May 2025 as Community Action Month.
5.7: Adopt proclamation designating May 2025 as Wildfire Community Preparedness Month in Lake County.
5.8: Adopt a proclamation designating May 2025 as Mental Health Matters Month.
5.9: Adopt resolution authorizing Amendment No. 2 to the standard agreement between the county of Lake and the Behavioral Health Services Oversight and Accountability Commission (BHSOAC) for the period ending December 31, 2026 and authorizing the Behavioral Health Director to sign the amendment.
5.10: Approve Board of Supervisors meeting minutes February 25, 2025, April 1, 2025, and April 8, 2025.
5.11: Approve first amendment of agreement between the county of Lake and 360 Junk Removal & Hauling annual compensation by $50,000; for a total compensation not to exceed $150,000 for abatement services and authorize the chair to sign.
5.12: (a) Rescind resolution 2024-19 approving an application for funding and the execution of a grant agreement and any amendments thereto form the 2023-2024 funding year of the State CDBG Mitigation (CDBG-MIT) Resilient Planning and Public Services (MIT-PPS) Program and (b) adopt resolution approving and application for funding and the execution of a grant agreement and any amendments thereto from the 2023-2024 funding year of the State CDBG Mitigation (CDBG-MIT) Resilient Planning and Public Services (MIT-PPS) Program.
5.13: Adopt proclamation designating the week of May 4-10, 2025 as Correctional Officers Week in Lake County.
5.14: Adopt proclamation designating May 2025 as CalFresh Awareness Month.
TIMED ITEMS
6.1, 9:02 a.m.: Public input.
6.2, 9:03 a.m.: Pet of the week.
6.3, 9:04 a.m.: New and noteworthy at the library.
6.4, 9:05 a.m.: (a) Presentation of proclamation designating May 2025 as Lake County Month of Awareness for Missing and Murdered Indigenous Women and People; and (b) authorize Public Services to hang the flag at the courthouse for the month of May 2025.
6.5, 9:10 a.m.: Presentation of proclamation designating May 1-7, 2025, as Elks National Youth Week in Lake County.
6.6, 9:15 a.m.: Presentation of proclamation designating May 2025 as Community Action Month.
6.7, 9:20 a.m.: (a) Presentation of proclamation designating May 2025 as Wildfire Community Preparedness Month in Lake County.
6.8, 9:25 a.m.: Presentation of proclamation designating May 2025 as Mental Health Matters Month.
6.9, 9:30 a.m.: Presentation of proclamation designating the week of May 4 to 10, 2025 as Correctional Officers Week in Lake County.
6.10, 9:35 a.m.: Presentation of proclamation designating May 2025 as CalFresh Awareness Month.
6.11, 10:30 a.m.: Consideration of proposed findings of fact and decision in the appeal of NinaStar LLC (AB 24-05).
6.12, 11:30 a.m.: Public hearing, consideration of a resolution amending the master fee schedule for departmental services rendered by the county.
NONTIMED ITEMS
7.1: Supervisors’ weekly calendar, travel and reports.
7.2: Consideration of use of staff time in excess of 8 hours to research the feasibility of a dedicated special tax for county roads.
7.3: Consideration of a letter of opposition to proposed defunding of Head Start programs.
7.4: Consideration of a letter to Governor Newsom supporting extension of the BioMAT Program.
7.5: Consideration of three letters of support for federal forest health and wildfire and disaster resiliency legislation, in furtherance of established Board of Supervisors federal legislative priorities (a) the Disaster Resiliency and Coverage Act (H.R. 1105, Thompson); (b) the Facilitating Increased Resilience, Environmental Weatherization, and Lowered Liability (FIREWALL) Act (S. 1323, Schiff and Sheehy); and (c) the Fix Our Forests Act (FOFA, H.R. 471; S. 1462).
7.6: Consideration of four coalition letters related to fire insurance in consistency with Board-adopted 2025 state legislative priorities.
7.7: Consideration of the agreement between county of Lake and Community Behavioral Health for substance use disorder medication assisted treatment services for FY 2025-26 in the amount of $1,000,000.
7.8: Consideration of amendment No. 4 to the agreement between county of Lake and Lake County Office of Education for the Mental Health Student Services Act Grant Program based specialty mental health services for fiscal year 2021-26 in the amount of $2,112,250.
7.9: Consideration of amendment No.1 to the agreement between county of Lake and Parkview Healthcare Center for adult residential and skilled nursing support services and specialty mental health services for fiscal year 2024-25 in the amount of $340,000.
7.10: Consideration of amendment No.1 to the agreement between county of Lake and Hilltop Recovery Services for ASAM Level 1.0, 2.0, 3.1 & 3.5 services for FY 2024-25 in the amount of $1,963,200.
7.11: Consideration of administrative encroachment permit #25-06 - temporary closure of a portion of Clear Lake near Buckingham Homes Association office from May 16 to 18, 2025 for the Buckingham Test and Tune Boat and Car Show.
CLOSED SESSION
8.1: Conference with legal counsel: significant exposure to litigation pursuant to Gov. Code section 54956.9(d)(2), (e)(1) – one potential case
8.2: Conference with labor negotiator: (a) Chief negotiator: C. Torrez; county negotiators: S. Parker, S. Carter, C. Moreno, P. Samac and D. Rico; and (b) employee organizations: LCDDAA, LCDSA, LCCOA, LCEA, LCSEA and LCSMA
8.3: Public employee evaluation: Air Pollution Control Director Doug Gearhart.
8.4: Public employee evaluation: Community Development Director Mireya Turner.
Email staff reporter Lingzi Chen at This email address is being protected from spambots. You need JavaScript enabled to view it..
LAKEPORT, Calif. — The Lakeport City Council this week will consider updates to local regulations that prevent drinking water contamination caused by backflow and restrict residential water shutoffs due to nonpayment.
The council will meet Tuesday, May 6, at 6 p.m. in the council chambers at Lakeport City Hall, 225 Park St.
If you cannot attend in person, and would like to speak on an agenda item, you can access the Zoom meeting remotely at this link or join by phone by calling toll-free 669-900-9128 or 346-248-7799.
The webinar ID is 973 6820 1787, access code is 477973; the audio pin will be shown after joining the webinar. Those phoning in without using the web link will be in “listen mode” only and will not be able to participate or comment.
Comments can be submitted by email to This email address is being protected from spambots. You need JavaScript enabled to view it.. To give the city clerk adequate time to print out comments for consideration at the meeting, please submit written comments before 3:30 p.m. on Tuesday, May 6.
At the meeting, the council will hear a presentation by Lake County Land Trust and Supervisor Bruno Sabatier’s annual update on PEG TV.
It will be followed by a public hearing on proposed amendments to a city law that governs water safety.
A new statewide rule took effect on July 1, 2024, that changes how cities must protect their water systems from backflow — that’s when dirty or unsafe water flows backward into clean drinking water pipes.
The new rule replaces the old state rule, which is now outdated. But parts of Lakeport's city laws still refer to that old rule, which are required to be updated.
In council business, the council will consider an update to its utilities billing policy, bringing it into compliance with Senate Bill 3. The bill expands protections for residents behind on their water bills by limiting shutoffs and requiring alternative payment plans.
On the consent agenda — items considered noncontroversial and usually accepted as a slate on one vote — are ordinances; minutes of the previous meeting on April 15; approval of application 2025-024, with staff recommendations, for the 2025 Concerts in the Park; approval of application 2025-025, with staff recommendations, for the Lake County Pride Health Fair; approval of application 2025-026, with staff recommendations, for the street closure for the Vet Connect award presentation to the county.
Email staff reporter Lingzi Chen at This email address is being protected from spambots. You need JavaScript enabled to view it..
LAKE COUNTY, Calif. — California faces a year-round wildfire threat.
Wildfire Preparedness Week 2025, observed May 4 to 10, serves as a vital call to action for all Californians to take steps now to prepare and reduce wildfire risk at home and in your community.
Cal Fire and partners are intensifying their efforts to help communities prepare for the peak of the fire year through collaboration, innovation, and public engagement.
This year’s theme — “Building a Fire-Ready Future: Strengthening Our Defenses, Together” — underscores the collective responsibility of individuals, communities, and agencies to prepare for and defend against wildfire threats.
Cal Fire continues to lead proactive wildfire mitigation through strategic fuel reduction, forest health initiatives, and an expanded grant program supporting private landowners, Fire Safe Councils, and Firewise Communities.
“Building a fire-ready future means working together — by doing your part to protect your property through home hardening efforts, creating defensible space, and creating an emergency plan for your family, you are helping first responders protect lives, property, and natural resources,” Cal Fire Director and Fire Chief Joe Tyler said.
This Wildfire Preparedness Week, Californians are urged to:
• Create defensible space, focus on Zone 0, the first five feet around your home. • Harden structures against flying embers with ignition resistant building materials. • Develop and practice a wildfire action plan so you are prepared when wildfire strikes. • Stay informed with emergency alerts –sign up today • Pack a ‘go bag’ and be ready to evacuate.
“Wildfire safety begins with being prepared,” said State Fire Marshal Daniel Berlant. “Protecting our homes and communities takes all of us — neighbors, local groups, and state agencies — working side by side to reduce risk and save lives.”
Cal Fire encourages Californians to access the Ready for Wildfire web-based FirePLANNER that includes local alerts, checklists for preparedness, evacuation plans, and other kits. To download the free app, visit https://plan.readyforwildfire.org/.
The Women’s Health Initiative was established in response to a growing realization that very little medical research existed to inform health care that was specifically relevant to women. In the U.S. in the 1970s, for example, almost 40% of postmenopausal women were taking estrogen, but no large clinical trials had studied the risks and benefits. In 1985 an NIH task force outlined the need for long-term research on women’s health.
Between 1993 and 1998, the project enrolled 161,808 postmenopausal women ages 50 to 79 to participate in four randomized clinical trials. Two of them investigated how menopausal hormone therapy affects the risk of heart disease, breast cancer, hip fractures and cognition. Another examined the effects of a low-fat, high-fiber diet on breast and colorectal cancers as well as heart disease. The fourth looked at whether taking calcium plus vitamin D supplements helps prevent hip fractures and colorectal cancer.
Women could participate in just one or in multiple trials. More than 90,000 also took part in a long-term observational study that used medical records and surveys to probe the link between risk factors and disease outcomes over time.
Clarifying the effects of hormone therapy
Some of the most important findings from the Women’s Health Initiative addressed the effects of menopausal hormone therapy.
The hormone therapy trial testing a combination of estrogen and progesterone was set to run until 2005. However, it was terminated early, in 2002, when results showed an increased risk in heart disease, stroke, blood clotting disorders and breast cancer, as well as cognitive decline and dementia. The trial of estrogen alone also raised safety concerns, though both types of therapy reduced the risk of bone fractures.
Although the Women’s Health Initiative’s four original clinical trials ended by 2005, researchers have continued to follow participants, collect new data and launch spinoff studies that shape health recommendations for women over 65.
One of the Women’s Health Initiative’s biggest yields is its vast repository of health data collected annually from tens of thousands of women over more than 30 years. The data consists of survey responses on topics such as diet, physical activity and family history; information on major health outcomes such as heart disease, diabetes, cancer and cause of death, verified using medical records; and a trove of biological samples, including 5 million blood vials and genetic information from 50,000 participants.
The Women’s Health Initiative set out to prevent heart disease, cancer and osteoporosis in menopausal women.
Any researcher can access this repository to explore associations between blood biomarkers, disease outcomes, genes, lifestyle factors and other health features. More than 300 such studies are investigating health outcomes related to stroke, cancer, diabetes, eye diseases, mental health, physical frailty and more. Thirty are currently running.
What does the future hold?
In addition to data amassed by the Women’s Health Initiative until now, about 42,000 participants from all 50 states, now ages 78 to 108, are still actively contributing to the study. This cohort is a rare treasure: Very few studies have collected such detailed, long-term information on a broad group of women of this age. Meanwhile, the demographic of older women is growing quickly.
Continuing to shed light on aging, disease risk and prevention in this population is vital. The questions guiding the project’s ongoing and planned research directly address the chronic diseases that Health Secretary Robert F. Kennedy Jr. has announced as national priorities.
So I hope that the Women’s Health Initiative can continue to generate discoveries that support women’s health well into the future.
“Silvy.” Photo courtesy of Animal Care and Control. LAKE COUNTY, Calif. — Lake County Animal Care and Control has more dogs at the shelter this week waiting for their new families.
The dogs available for adoption this week include mixes of bulldog, Catahoula leopard dog, cattle dog, German shepherd, husky, Labrador Retriever, pit bull terrier and terrier.
Dogs that are adopted from Lake County Animal Care and Control are either neutered or spayed, microchipped and, if old enough, given a rabies shot and county license before being released to their new owner. License fees do not apply to residents of the cities of Lakeport or Clearlake.
Those dogs and the others shown on this page at the Lake County Animal Care and Control shelter have been cleared for adoption.
Call Lake County Animal Care and Control at 707-263-0278 or visit the shelter online for information on visiting or adopting.
The shelter is located at 4949 Helbush in Lakeport.
Email Elizabeth Larson at This email address is being protected from spambots. You need JavaScript enabled to view it.. Follow her on Twitter, @ERLarson, and on Bluesky, @erlarson.bsky.social. Find Lake County News on the following platforms: Facebook, @LakeCoNews; X, @LakeCoNews; Threads, @lakeconews, and on Bluesky, @lakeconews.bsky.social.
LAKEPORT, Calif. — The American Red Cross California Gold Country Region is planning a special event this month to welcome the community to its Lakeport office and share volunteer opportunities.
The Red Cross will host an open house at its Lakeport office, 140 Nine St., Lakeport, on Wednesday, May 14, from 10 a.m. to noon.
A ribbon cutting will take place at 10:30 a.m.
This family-friendly event, which will include refreshments, is an opportunity for the community to meet local Red Cross volunteers and staff and learn about the wide range of services their volunteers provide in the Lakeport area and throughout the organization’s 26-county region.
Red Cross will also share information on how to become a Red Cross volunteer.
“It is a critical time for us to expand our volunteer workforce in Lakeport — especially those who serve as disaster response volunteers — so we can address the needs of people who experience home fires, as well as those who may be displaced during wildfires and other disasters,” Red Cross said in a statement.
The Red Cross will also host two volunteer information open houses at the Lakeport office on May 20 and 27. Refreshments will be served.
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