Smokers’ myth -- Herbal does not mean safe - Lifestyle News

You’re trying to quit smoking cigarettes, or at least aiming to cut down on how much you smoke. You may have heard some of your friends and acquaintances talking about herbal cigarettes as a ‘safer’ alternative to the regular ones.

Sure, these products are tobacco free, but they still contain harmful chemicals that can increase your risk of developing cancer or other health problems, say doctors. Tobacco or not, the creeping trend of smoking herbal cigarettes, coupled with them being sold without the same health warnings as regular cigarettes, can be equally dangerous.

“Smoke is invariably harmful, regardless of the source,” says Dr Loveleen Mangla, senior consultant and HOD, respiratory, critical care and sleep medicine, Metro Hospital, Faridabad.

While Dr Mangla agrees that herbal cigarettes are a growing niche, “the idea that they’re healthier than regular cigarettes is mostly a misconception”. “These products are being marketed as part of the nicotine-free lifestyle movement, appealing particularly to younger adults and smokers looking to reduce or quit traditional cigarettes,” she adds.

At a time when smoking causes 7 million deaths per year globally, according to the World Health Organization, any kind of misinformation and ignorance can be especially damaging.

Low safety quotient

Burning any plant matter produces tar, carbon monoxide, particulates, and other toxic compounds — all of which can damage the lungs and raise cancer and heart-disease risks. “Herbal cigarettes without tobacco still generate many of these harmful substances upon combustion,” explains Dr Mangla.

Certain studies have found similar carcinogenic levels in herbal cigarettes, as in tobacco ones, Dr Mangla further explains. “Research has shown that there’s no significant reduction in carcinogen exposure (such as polycyclic aromatic hydrocarbons and nitrosamines) in herbal cigarettes than the tobacco ones. That means people smoking herbal versions may inhale as many harmful chemicals as traditional smokers,” she adds.

Dr Arunachalam M, senior consultant and HOD, pulmonology, Yatharth Super Specialty Hospital, Noida, adds an important point, “The main difference is that there is no nicotine, but the damage to the lungs from smoking is still there. In some cases, herbal cigarettes may even have more tar because people think they are safer and take deeper breaths.”

Just like smoking regular cigarettes, herbal ones also have significant short-term and long-term risks. “Coughing, sore throat, chest tightness, shortness of breath, and worse, asthma or allergies are all short-term risks,” lists Dr Arunachalam. Long-term risks include chronic bronchitis, a lower lung capacity, more respiratory infections, and long-term airway inflammation, he shares, adding, “Repeated exposure to smoke raises the risk of lung damage over time.” With increased risk of lung, throat, and oral cancers, there’s a higher risk of heart disease and stroke, as well as harm in pregnancy and to people exposed to second-hand smoke, he adds.

Heart attack and coronary heart disease risk are threefold higher for those who smoke bidis (a type of herbal cigarette used commonly in certain south Asian countries including India), the Centers for Disease Control and Prevention (CDC), US, says, citing studies done in India, because little research on long-term effects has been done in America. This was stated in a research paper published in the Journal of Chemical Health Risks (JCHR) in 2024, titled ‘Herbal Smoke Deception: Hidden Dangers Among Youth and the Urgent Call for Regulation’.

Stressing on the multiple risks of smoking, including herbal cigarettes, Dr Gajinder Kumar Goyal, programme clinical director, Marengo Asia Hospitals, Faridabad, says, “The smoke released from herbal cigarettes can strike vital physical parameters, potentially having an adverse effect on your heart by decreasing oxygen levels and increasing blood pressure.”

“The smoke of herbal cigarettes can be harmful for other vital organs like liver, kidney and brain too—the liver and kidneys may be burnt out as they find it harder to function, in filtering out the toxic compounds. Over time, people using herbal cigarettes may be suffering from possible memory loss and focus concerns,” Dr Goyal further warns.

Dangers in disguise

Herbal cigarettes often have constituents of ginseng, cherry, vanilla, jasmine, menthol as well as the damiana, shares Dr Goyal. “They often have dried plants in them, like clove, mint, lemongrass, chamomile, rose petals, or other plants. Some of these herbs might be good for you when you drink tea or take medicine, but smoking them and breathing them in takes away any benefits,” adds Dr Arunachalam.

“Growth is also fuelled by flavour diversity, e-commerce availability, and wellness positioning in spa and wellbeing centres,” she opines. She clarifies that the absence of nicotine does not make the smoke safe, rather, it just changes the nature of the addiction.

Dr Arunachalam shares from his experience that he has noted an increase in the adoption of herbal cigarettes, especially among young adults, an opinion that Dr Mangla as well as Dr Goyal echo. “I have seen more patients, especially younger ones, use herbal cigarettes because they think they are safer,” says Dr Arunachalam. “Marketing, social media, and the idea that ‘natural’ products are safe are all driving the growth. Some people use them to avoid getting addicted to nicotine or to get around rules about smoking,” he says, adding that there isn’t enough public knowledge about the risks they pose, which makes the demand even higher.

Herbal cigarettes are crafted to be devoid of both nicotine and tobacco, but they do generate considerable amounts of total particulate matter (TPM, commonly known as ‘tar’) when smoked, says the 2024 JCHR study. Herbal cigarettes contained 30.9 mg of TPM per cigarette, on average, whereas tobacco containing cigarettes generated, on average, 8.9 mg TPM per cigarette. Even the DNA damage caused by smoking HSPs was similar to that of conventional smoking products, which proves their hazardous carcinogenic potential.

Beware the risks

“I start with clarifying the misconception for patients that herbal is synonymous to healthy or safe—and that smoke itself causes lung and heart harm,” shares Dr Mangla. “Alongside acknowledging the patients’ intent to quit smoking, I also explain the risks clearly and recommend safer quitting strategies.”

By ‘safer strategies’, Dr Mangla means nicotine-replacement therapy, prescription aids, counselling, and a structured quit plan. “If they insist on using them, I tell them to minimise the frequency, avoid dual use, or set a clear quit date, and treat them as a temporary step – not as a substitute,” she says.

“Herbal cigarettes are growing mainly because of perception and positioning, not because they’re safer in reality. Natural or herbal, nicotine free, wellness marketing, curiosity and misconception of safety are key drivers,” she says.

A small-scale study done by the Oral Health Sciences Centre in Chandigarh, which surveyed 1,044 records of online marketing websites selling herbal cigarettes in 2021, found that two thirds (67%) of the retail web pages didn’t require any proof of age before purchase, and just 22% stated ‘not to be sold to minors’. According to the study, 43 websites (59%) spelt out health benefits in their product descriptions, of which 41% claimed the benefits to be based on complementary medicine, citing uses such as a smoking cessation aid (40%), a stress reliever (19%), and to ease respiratory symptoms, including Covid-19 (15%).

Dr Arunachalam advocates public awareness campaigns on the subject. “Such campaigns should make it clear that smoke from any source is bad for you. It should be required that herbal cigarette packs have warning labels. Doctors, schools, and the media should be honest about the risks,” he says.

Including herbal cigarettes to talks about tobacco control will also help clear up any confusion. “Getting help from family and healthcare professionals is very important for quitting successfully,” he adds.

BOX – Possible harmful effects