霍恩·里克的父親煙癮很大，兩千零幾年時診斷出了肺癌。霍恩住在中國沈陽，經過培訓成為一名藥劑師，同樣也有煙癮。自身狀況，加上父親不容樂觀的消息促使霍恩發明了如今大多數電子煙的前身產品。

霍恩相信，將尼古丁混合在水蒸氣中“霧化”，而不是煙草散發的煙霧進入人體，可能有助于煙民在繼續抽煙的同時避免自己的生命面臨焦油和有害化學物質帶來的風險。霍恩的產品于2003年問世。此后不久他的父親就去世了。但在短短幾年時間里，電子煙就發展到了全世界，人們相信電子煙比傳統香煙安全，令其得以迅速普及。

16年后，僅美國的電子煙和蒸汽型電子煙產品就已經成為一門價值90億美元的生意。但對其安全性的信任已經變成了懷疑，相關廠商也遭到了來自于方方面面的“攻擊”。首先是出現了此類產品的營銷丑聞，包括有人指責電子煙制造商向未成年人推薦這些產品。隨后出現的問題則嚴重得多，最近主要在美國爆發的類似流感和肺炎的神秘流行性疾病看來和電子煙有關。

從今年夏初開始，美國已經出現近1300名這樣的病患（截至發稿時，已經有29人確認死亡）。患者中既有已經退休的老煙槍，也有還不到投票年齡的青少年。10月8日，紐約州州長安德魯·庫默宣布，紐約市布朗克斯區的一位17歲居民成為死于這種疾病的最年輕的美國人。

雖然近期出現的許多重病號都曾經使用非法的大麻或尼古丁煙彈，但危機還是籠罩了整個電子煙行業。特朗普政府最近提議全面封禁調味型煙彈；幾十位州檢察官以營銷和消費者安全顧慮為由對電子煙廠商提起訴訟；中國和印度等巨大市場的監管部門也開始打擊電子煙。

對不太操心的觀察者來說，電子煙行業陷入困境對老牌煙草巨頭來說似乎是件好事。但在很大程度上，電子煙行業就是那些煙草巨頭。由于美國和其他市場的可燃香煙消費量穩步下滑，傳統煙草公司開始抓緊機會來銷售更吸引人的高科技產品。同時，這種產品身上套著一層光環，那就是即便不是絕對健康，至少也比一包好彩香煙對身體更好。

通過合作、投資和收購，這些煙草巨頭已經把自己的產品延伸到了電子煙領域。銷售Salem和Kool香煙的Imperial Brands推出了電子煙品牌Blu。英美煙草旗下的子公司雷諾茲煙草（香煙產品有Newport和Camel）則有Vuse電子煙。尼爾森的數據顯示，Vuse是市場上第二受歡迎的電子煙產品，約占便利店電子煙銷售額的13%。

接下來要說的是這個行業的王者，在電子煙領域里處于主導位置的舊金山初創公司Juul。作為非上市公司，Juul沒有公布過銷售數字。但富國銀行的分析師伯尼·赫爾佐格估算，Juul在美國電子煙市場中的份額約為70%。這家公司還聯手了美國最大的煙草企業。2018年12月，推出萬寶路香煙的高特利集團斥資128億美元收購了Juul 35%的股權，從而使Juul的估值達到380億美元。

在監管、法律和公眾領域連續受挫后，Juul的估值一瀉千里。高特利的股價也從今年春天的高點下跌了25%以上，和9月1日相比滑落逾一成。兩家公司一起遇到麻煩體現出整個無煙香煙行業面臨的窘境，如果滾雪球般的爭議促使消費者遠離電子煙，那么誰以及什么產品可以為大型煙草公司填補這個空缺呢？

In the early 2000s, Hon Lik’s father, a heavy smoker, was diagnosed with lung cancer. Hon, a pharmacist by training living in Shenyang, China, had a tobacco dependency of his own. That fact, along with the sobering news, spurred him to invent the device that became the precursor of most of today’s e-cigarettes.

Hon believed that “aerosolizing” nicotine, infusing it in a vapor rather than delivering it through smoke from tobacco, could help addicts sustain their habit without risking their life from exposure to tar and toxic chemicals. Hon’s product made its debut in 2003. His father died shortly afterward, but within a few years, e-cigarettes proliferated worldwide—their rapid adoption driven by the belief that they were safer than traditional cigarettes.

Sixteen years later, e-cigarettes and “vaping” devices represent a $9 billion business in the U.S. alone. But belief in their safety has been replaced by doubt—and manufacturers are under attack from all sides. First came scandals around the devices’ marketing claims, including allegations that e-cig makers were pitching them to children. Then came something far more grave: a recent epidemic of mysterious flu- and pneumonia-like lung illnesses, predominantly in the U.S., that appear to be connected to vaping.

Since the beginning of summer, nearly 1,300 of these cases (and 29 confirmed deaths, as of press time) have emerged. The victims include lifelong smokers of retirement age and children too young to vote: On Oct. 8, New York Governor Andrew Cuomo announced that a 17-year-old Bronx teen had become the youngest person nationally to die of such an ailment.

While many of the serious recent cases have been linked to the use of illicit marijuana or nicotine pods, the crisis has put the entire industry on its haunches. The Trump administration recently proposed a total ban on flavored e-cigarette pods; dozens of state attorneys general are suing e-cig manufacturers over marketing and consumer safety concerns; and regulators in huge markets like China and India are cracking down on vaping.

To a casual observer, the e-cigarette industry’s stumbles may seem like a lucky break for old-school Big Tobacco. But to a large extent, the e-cigarette industry is Big Tobacco. With combustible cigarette use in steady decline in the U.S. and other markets, traditional tobacco companies have latched on to the opportunity to sell sexier, high-tech products that carry an aura of being, if not objectively healthy, at least healthier than a pack of Lucky Strikes.

Through partnerships, investments, and acquisitions, the tobacco giants have fielded their own nicotine ponies in the vaping race. Imperial Brands, which sells Salem and Kool cigarettes, also sells the Blu e-cig brand. British American Tobacco subsidiary Reynolds American (Newport and Camel) sells Vuse, the second-most-popular e-cigarette on the market, according to Nielsen data, with about 13% of convenience store sales.

And then there’s the sector’s, well, crown Juul. That San Francisco startup dominates the e-cig industry. As a private company, it doesn’t report sales figures, but Wells Fargo analyst Bonnie Herzog estimates Juul accounts for around 70% of the U.S. vaping market. It’s also in business with the country’s biggest tobacco company. In December 2018, Altria—the firm that markets Marlboro—took a 35% stake for $12.8 billion, awarding Juul a $38 billion valuation.

That valuation has come crashing down in the wake of the regulatory, legal, and public blowback. Shares of Altria are down, too, by more than 25% from their spring peak and more than 10% since Sept. 1. And their conjoined woes point to the dilemma facing the whole smokeless-cigarette sector: If snowballing controversies chase customers away from vaping, who and what fill the void for Big Tobacco?

這些年來，霍恩·里克的霧化尼古丁技術經歷了無數次的創新組合。最早出現的實際上是一次性圓筒裝產品，非常接近傳統香煙；隨后出現了像鋼筆一樣的電子煙，配備可充電電池；最后問世的電子煙像U盤，而且Juul已經讓它們流行開來。這種電子煙可以改造，零部件可以更換或互換。正因為如此，Juul的大多數常規產品都可以使用黑市上的四氫大麻酚（THC）煙彈。

這些產品形式讓電子煙的潛在價值變得難以捉摸。投資銀行Piper Jaffray的分析師邁克爾·萊弗里對《財富》雜志表示：“這個市場很難衡量，原因就在于在線銷售和銷售渠道未納入統計范圍等因素，包括電子煙商店。”富國銀行的赫爾佐格估算，今年美國的尼古丁電子煙銷售額將達到90億美元。大麻行業追蹤機構BDS Analytics預計，今年大麻煙彈和筆式電子煙將實現銷售額25億美元。這還只是合法產品的規模，如果包括非法的THC市場，以上數字有可能翻番。

可以確定的是，這個市場正在快速增長。美國疾病控制與預防中心的數據顯示，2012-2016年（有數據可循的最近時間段）電子煙平均月銷售額增幅為132%，2016年達到每10萬人1547件。該中心稱，截至2017年年底，僅Juul一家公司每個月就可以售出320萬件電子煙產品。

Juul的高歌猛進不光吸引了高特利的投資，它還有助于推動高特利和菲利普-莫里斯國際公司（PMI）開啟合并談判——高特利在2008年剝離了菲利普-莫里斯。隨著電子煙引發的爭議不斷升級，雙方的談判分崩離析。Juul似乎處于收縮狀態。該公司向《財富》雜志發出聲明稱，它致力于“負責任地領導”和對“青少年電子煙消費量處于不可接受水平”的現象予以打擊。但仍然在所有煙草產品上合作的高特利和菲利普-莫里斯可能懷揣一件秘密武器，那就是所謂的“加熱但不燃燒”技術。如果電子煙失去了立足之地，這項技術就有可能撐起煙草行業。

Hon Lik’s aerosolized-nicotine technology has taken on countless new permutations over the years. The earliest products were, essentially, disposable cylinders that closely resembled conventional cigarettes; then came devices that resembled pens, armed with rechargeable batteries; finally came the USB-drive-like products that Juul has made ubiquitous. These devices are modifiable, with parts that can be replaced and interchanged. That’s why Juul’s most common device can also be used to vape black-market THC cartridges.

Those permutations make the size of the opportunity hard to pin down. “This market is hard to measure because of things like online sales, sales through unmeasured channels, including vape shops,” Piper Jaffray analyst Michael Lavery tells Fortune. Wells Fargo’s Herzog estimates that nicotine e-cigarettes will reach $9 billion in U.S. sales this year. Marijuana vaping cartridges and pens are expected to ring in $2.5 billion in 2019 sales, according to cannabis tracking firm BDS Analytics. And that’s just the legal ones; taking the illicit THC market into account could double the figure.

What’s certain is that the market is growing fast. Between 2012 and 2016 (the most recent figures available), average monthly e-cigarette sales spiked 132%, growing to 1,547 units per 100,000 people in 2016, according to the Centers for Disease Control. By the end of 2017, Juul alone was selling 3.2 million devices each month, says the CDC.

The Juul juggernaut not only attracted Altria’s investment but also helped prompt merger talks between Altria and Philip Morris International (PMI)—the company that Altria spun off in 2008. Those talks fell apart as the e-cig controversy swelled. Juul seems to be in retrenchment mode; it directed Fortune to a statement in which it committed to “responsible leadership” and combating “unacceptable levels of youth usage.” But Altria and PMI, which still collaborate on all kinds of tobacco products, may have a secret weapon tucked into their vests. It’s called “heat not burn” technology—and it could buoy the industry if vaping becomes untenable.

從事無煙煙草產品經銷的亞切克·奧爾科扎克把自己的工作說的像個大麻煩。

奧爾科扎克是菲利普-莫里斯的首席運營官，他正在推廣的產品是“加熱但不燃燒”的IQOS（發音為“EYE-cose”），后者釋放的尼古丁包含在精細研磨的煙草制成的小球中（菲利普-莫里斯把它的IQOS產品稱為HeatStick）。使用者將煙桿插入充電盒后，煙桿里內置的刀尖狀發熱片就會把煙草加熱到足以釋放出含尼古丁蒸汽的溫度，但不至于把煙草點著。就像蒸汽型電子煙一樣，IQOS不會把煙草點著，因此既沒有煙灰，也沒有煙霧。

這款IQOS產品看起來就如同是蘋果公司的首席設計師喬尼·艾維設計的圓珠筆一樣，今年10月初首次在美國亮相，地點是在亞特蘭大市一家高檔購物中心的極簡主義IQOS品牌店里。但正如奧爾科扎克描述的那樣，買到這款產品可不是什么輕而易舉的事情。他說，大家可以在網上訂購，但必須到實體店提貨。購買者需要證明自己至少21歲了，而且是打算戒煙的主動抽煙者。你可以撒謊，但菲利普-莫里斯表示他們會詢問購買者的煙齡、抽煙頻率以及抽哪個牌子的香煙，從而驗明正身。

奧爾科扎克出生在波蘭，他說：“我大概22歲時開始抽煙。我的目標用戶是成年煙民。”他還打算構建起無煙電子煙消費者群體。菲利普-莫里斯希望到2025年無煙型產品的凈收入貢獻率可以達到40%左右，遠高于去年的13.8%。而由成年人負責任地使用是推廣IQOS的關鍵——其概念是通過不太容易濫用或超重度使用的產品形式讓抽煙者獲取尼古丁，以免重蹈蒸汽型電子煙的覆轍。

在美國以外，IQOS已經找到了受眾。該產品于2014年年底在美國以外上市。菲利普-莫里斯稱，截至去年，其用戶已經達到960萬，分布在44個國家和地區，其中最大的市場是俄羅斯和日本。美國食品與藥品管理局（FDA）于去年春天批準在美國銷售IQOS，后者在美國的營銷和經銷由高特利負責。和具有糖果口味的蒸汽型電子煙不同，監管部門要求IQOS的味道只能像香煙，因此該產品的口味只有普通香煙型以及兩種薄荷醇香型（美國以外的部分市場銷售薄荷味IQOS）。奧爾科扎克堅持說大多數用戶都是成年人：“年齡不夠的人使用IQOS的情況只占0.2%，或者0.3%。”

IQOS每次使用后都需要充電幾分鐘，這讓用戶體驗不太像抽煙，反而更像是煮開水泡茶。不過，雖然操作似乎很復雜，但IQOS已經有了擁躉。Piper Jaffray的分析師萊弗里說：“在美國以外，60%-80%的抽煙時間已經從傳統香煙變為使用IQOS。”菲利普-莫里斯表示，今年第一財務季度，該公司的HeatStick發貨量為115億支。該公司沒有披露收入結構，但實際情況可能證明HeatStick是一款高利潤產品，而且尚未被公眾的電子煙健康顧慮所波及。

華爾街當然看到了機會。富國銀行在最近發布的分析師報告中指出，電子煙市場的收縮應該促使高特利大舉增加對加熱但不燃燒產品銷售的投入。

目前菲利普-莫里斯和高特利尚未具體說明其增長目標。高特利將亞特蘭大稱為試點市場，包含HeatStick的IQOS產品由臨時銷售團隊負責推廣，范圍是500家“零售合作門店”，而且主要是便利店。入門級套裝包括一個IQOS和200支煙彈，售價80美元。奧爾科扎克在健康問題上很小心，并沒有過多地作出承諾。他說：“我可沒有說IQOS是零風險產品，我的意思是它比目前市面上的產品好。”實際上，法律甚至不允許菲利普-莫里斯在美國使用這樣的說法。是否開這個綠燈則要取決于美國食品與藥品管理局。

For a man whose job is selling smokeless tobacco devices, Jacek Olczak makes buying smokeless tobacco devices sound like a huge hassle.

Olczak is the chief operating officer of PMI, and the device he’s pitching is the IQOS (“EYE-cose”), a heat-not-burn device. Such devices deliver nicotine using a pellet made up of finely ground and reconstituted tobacco. (PMI calls its version a HeatStick.) After users place a stick into the stylus device, a small internal blade heats the tobacco to a temperature hot enough to release a nicotine-laden vapor but not hot enough to set the tobacco on fire. As with a vaping device, there’s no combustion, so there’s no ash or smoke.

The IQOS, which looks like what would result if Apple’s Jony Ive designed a ballpoint pen, made its U.S. debut in early October at a minimalist IQOS-branded store in an upscale mall in Atlanta. But obtaining one, as Olczak describes it, is no casual affair. You can order it online, Olczak says, but you have to pick it up at a store. You’ll have to prove you’re 21. You’ll also have to testify that you’re an active smoker trying to quit. You could lie about that, but PMI says customers will be asked about how long they’ve smoked, how often, and which brands they purchase—to test their bona fides.

“I started smoking when I was about 22,” says Olczak, a native of Poland. “I want to target adult smokers.” He also wants to build a smokeless customer base. PMI hopes to derive about 40% of net revenue from smoke-free products by 2025, up from 13.8% last year. And responsible adult use is key to the IQOS pitch: The idea is to serve up nicotine in a package that’s less prone to abuse, or to ultra-intensive use, than vaping devices have turned out to be.

Outside the U.S., the IQOS has found an audience. The device, made its debut at the end of 2014. As of last year, PMI says, there were 9.6 million users in 44 countries, with Russia and Japan among its biggest markets. The FDA cleared the device for sale in the U.S. last spring, and Altria is handling marketing and distribution in the U.S. Unlike vape rivals that have been available in candy-like flavors, the IQOS is regulated like a cigarette, and thus can sell no flavors other than regular tobacco and two menthol variants. (Mint is sold in some markets outside the U.S.) And Olczak insists most of its users are adults. “Underage use of IQOS is 0.2%, maybe 0.3%,” he says.

It can take several minutes to recharge an IQOS device between uses—which can make the smoking experience less like lighting a cigarette and more like boiling water for tea. But cumbersome as the process seems, it has its loyalists. “Outside the U.S., people switch from cigarettes to IQOS 60% to 70% to 80% of the time,” says Lavery, the Piper Jaffray analyst. PMI says it shipped 11.5 billion HeatSticks in its fiscal first quarter this year. PMI doesn’t break out revenue, but the product could prove to be a lucrative seller—one not yet tainted by the public-health concerns over e-cigarettes.

Wall Street certainly sees an opportunity. In a recent analyst note, Wells Fargo argued that the retrenchment in the e-cigarette market should incentivize Altria to aggressively double down on heat-not-burn sales.

For now, PMI and Altria aren’t being specific about their growth goals. Atlanta is the test market, Altria says, with devices and HeatSticks rolling out through pop-up sales teams and in 500 “retail trade partner stores,” mostly convenience stores. Smokers can buy a starter pack—an IQOS and a carton of 200 sticks—for $80. Olczak is careful not to overpromise on the health front. “I’m not saying IQOS is a zero-risk product,” he says. “What I’m saying is, it’s better than what’s available right now.” And even that claim, it turns out, isn’t one that PMI is legally allowed to make in the U.S. Whether it will someday do so is in the hands of the FDA.

美國食品與藥品管理局在電子煙領域的監督工作一直大起大落，既有監管方面的彌補，也有曖昧的司法操作。2009年，美國食品與藥品管理局先是打算將電子煙作為醫藥設備進行監管，但生產廠家成功地阻止了這個計劃。《家庭吸煙預防和煙草控制法》獲得通過并在2009年6月由總統貝拉克·奧巴馬簽字生效，從而讓美國食品與藥品管理局首次獲得監管煙草產品的權力。但由于花了幾年時間和國會議員以及游說團體進行辯論，所有的新電子煙法規都被耽誤了。奧巴馬政府推出首批規定已經是2016年5月以后的事了，其中包括禁止向未成年人銷售電子煙以及制造商必須披露產品成分。

更重要的是，這些新規讓電子煙更接近全面監管，它們要求制造商證明其產品利大于弊，否則就不能在市場上銷售。2017年，美國食品與藥品管理局的新任局長斯科特·戈特利布——一位電子煙取代可燃香煙的倡導者決定暫緩出臺這些規定，并將廠商提交所謂營銷申請的時間推遲到了2022年8月。但醫生群體、公共健康倡導團體以及反煙草組織已經就美國食品與藥品管理局暫不頒布這些規定提起訴訟，理由是現在就需要更嚴格的監管，而不是將來。

今年7月，聯邦法官裁定原告勝訴。電子煙廠商必須在2020年5月以前提交公共健康審核報告。隨后，監管部門可以再用一年時間來判斷其產品是否適于消費者使用。但電子煙行業已經時間緊迫，如果生產商無法證明其產品不會損害公眾健康，它們的產品銷售就可能受到更嚴格的控制，甚至被徹底封殺。

戈特利布于今年4月卸任，他的代表尚未就《財富》雜志的置評請求做出回應。美國食品與藥品管理局則告訴《財富》雜志可以查看今年7月該局的公告，代理局長內德·夏普萊斯在其中表示：“美國食品與藥品管理局已經準備加快對電子煙和其他新型煙草產品的審核。”

菲利普-莫里斯和高特利可能支持官方審核。它們一直想讓美國食品與藥品管理局確認IQOS等產品對人的危害絕對小于可燃香煙，因為這可能是個開展營銷的機會。這項工作涉及名為“修正風險的煙草產品”程序，而目前還沒有電子煙通過這項評定。但有些投資者認為IQOS可能符合要求。萊弗里說：“我們認為科學支持他們申請美國食品與藥品管理局做出修正風險評價。”

The FDA’s oversight of e-cigarette products has been a roller coaster of regulatory catch-up and murky legal maneuvers. The agency first attempted to regulate them as drug devices, in 2009, but manufacturers successfully blocked that effort. The passage of the Family Smoking Prevention and Tobacco Control Act, which President Barack Obama signed in June 2009, gave the FDA the power to regulate tobacco products for the first time, but years of wrangling among lawmakers and lobbyists delayed any new e-cig rules. It was May of 2016 before the Obama administration instituted the first regulations, including a ban on sales to minors and a requirement that manufacturers disclose ingredient lists.

More significant, those new rules pushed e-cigarettes closer to full regulation, requiring manufacturers to prove that their products did more good than harm in order to keep them on the market. In 2017, new FDA commissioner Scott Gottlieb, an advocate of e-cigarettes as an alternative to combustible ones, delayed those requirements, giving manufacturers until August 2022 to submit so-called marketing applications. But a cohort of doctors, public-health advocacy groups, and anti-tobacco organizations sued to block that extension, arguing that tighter oversight was needed now, not later.

This July, a federal judge ruled for the plaintiffs. Companies must now submit public-health reviews by May 2020. After that, regulators could take another year to determine if the devices are kosher for consumers, but the industry will face a ticking clock: If manufacturers can’t prove that their products don’t make the public any worse off, they could face more strict control of sales, or even an outright ban.

Representatives for Gottlieb, who stepped down this April, did not respond to Fortune’s requests for comment. The FDA directed Fortune to an agency statement from July wherein acting commissioner Ned Sharpless said, “FDA stands ready to accelerate the review of e-cigarettes and other new tobacco products.”

PMI and Altria may be rooting for a review. They’ve been trying to get the FDA to classify the IQOS and other products as definitively less harmful than combustible cigarettes—a potential marketing bonanza. This process involves something called the “Modified Risk Tobacco Product” protocol, and it’s a bar that current e-cigarettes haven’t cleared. But some investors think the IQOS could qualify. “We believe the science supports the application for a modified risk claim,” says Lavery.

盡管最近出現了爭議，但今后幾年蒸汽型電子煙繼續留在市場上的可能性非常高，而且有可能和加熱但不燃燒產品同時存在。如果目前的疾病流行最終只和非法THC及尼古丁產品掛鉤，主流電子煙廠商就有可能躲過進一步的限制。適當改造其產品可能提高出現這種局面的幾率。比如，制造商或許能在產品中采用新的模式，從而提高改變和交換使用煙彈的難度。

但一些批評人士指出，電子煙和加熱但不燃燒產品的危險根源埋藏的較深。二者的一個共同點是它們都把丙二醇和蔬菜甘油作為其他成分的“保濕劑”。蒸汽煙彈和IQOS的煙桿都含有這些成分，所以使用者會不可避免地將其吸入體內。

食品中的二醇類物質和甘油被視為安全成本，但初步研究顯示，吸入此類物質的情況與食用不同。貝勒醫學院的研究人員在今年9月公布的一份研究報告探討了電子煙蒸汽對老鼠的影響。該研究發現，將老鼠暴露在含有丙二醇和蔬菜甘油的蒸汽中會導致其肺部損傷，而且會造成肺部脂質（也就是脂肪）積累，從而有可能影響肺的功能。一些科學家懷疑，脂質積累在目前由蒸汽型電子煙引發的流行疾病中有一定的作用，只是還有其他許多誘因。如果進一步研究表明這些物質和肺部損失有更明確的聯系，加熱但不燃燒產品的處境就不妙了。加州大學舊金山分校的教授斯坦頓·格蘭茨指出：“IQOS的二醇類物質含量遠高于傳統香煙。”

菲利普-莫里斯表聲明稱，IQOS“釋放的有害物質的種類和水平要低得多”，而且不會像傳統香煙那樣釋放任何碳煙顆粒物。該公司指出：“不存在零風險的煙草產品或者含尼古丁的產品。”

換句話說就是，新的無煙產品可能不會給人們帶來什么好處，而且危害可能更大。這也許就是煙草巨頭的勝利宣言，甚至是在目前的爭議給它們帶來考驗的情況下。煙草行業早已經歷過這樣的考驗。畢竟，可燃香煙對人的危害無可置疑，但想買煙的人仍然可以買到它，也許大家還沒有注意到這一點。（財富中文網)

本文另一版本登載于《財富》雜志2019年11月刊，標題為《隨煙而上》。

譯者：Charlie

審校：夏林

Despite the recent controversies, there’s a strong possibility that vaping-style e-cigarettes will stay on the market for years—perhaps alongside heat-not-burn. If the current spate of illnesses is eventually tied exclusively to illicit THC and nicotine products, mainstream e-cig makers may escape further restrictions. Modest adaptations could increase their odds: For instance, manufacturers may be able to create new models that make it harder to modify and interchange pods.

But some critics say the fundamental hazards of both e-cigs and heat-not-burn products run deeper. One thing both systems share is the use of propylene glycol and vegetable glycerins as “humectants” that keep other ingredients moist. Both vape pods and the heat sticks in an IQOS contain these compounds, and users inevitably inhale them.

Glycols and glycerins are recognized as safe in food, but early research suggests that inhalation is a different story. One study by Baylor College of Medicine researchers, published in September, examined the impact of e-cigarette vapor in mice. It found that exposing mice to vapors that contained propylene glycol and vegetable glycerin led to lung damage and the buildup of certain lipids, or fats, in the lungs that could disrupt their function. Some scientists have speculated that lipid buildup is playing a role in the current vaping-illness epidemic, although there are many other factors in play. If further studies strengthen a link between these substances and lung damage, it won’t bode well for heat-not-burn. “IQOS has much, much higher levels of glycols than a regular cigarette,” says Stanton Glantz, a professor at the University of California, San Francisco.

In a statement, PMI says that the IQOS “emits significantly lower number and levels” of the harmful compounds and none of the ?carbon-based solid particles found in traditional cigarettes. “No tobacco- or nicotine-containing product is risk-free,” the company notes.

Put another way: The new smokeless cigarettes may not be good for you, but they could be worse. That may be Big Tobacco’s winning argument, even as today’s controversies test it. The industry has survived such tests before. After all, combustible cigarettes are undeniably bad for you—and in case you haven’t noticed, you can still buy them if you want them.?

A version of this article appears in the November 2019 issue of Fortune with the headline “Up in Smoke?”