Revolution or redux? Assessing IQOS through a precursor product

Abstract

Background Philip Morris International (PMI) currently claims that its heated tobacco product, IQOS, reduces health risk by reducing users’ exposure to harmful and potentially harmful constituents present in tobacco smoke. Given the tobacco industry’s long history of misrepresenting and obfuscating research, independent assessment of PMI’s claims is important. Analysis of Accord, a failed but strikingly similar precursor to IQOS, may help contextualise PMI’s claims in its Modified Risk Tobacco Product (MRTP) application. Methods We analysed previously secret internal Philip Morris (PM) and PMI documents, public communications and MRTP application. Results PM marketed Accord as a ‘cleaner’ tobacco product in an attempt to address smokers’ growing health concerns without making explicit health claims. While PM communications asserted that Accord reduced users’ exposure to harmful constituents, company scientists and executives consistently stressed to both regulators and the public that such reductions did not render Accord safer. IQOS’s design and marketing are similar to Accord’s. On the basis of aerosol chemistry data, IQOS reduces user exposure to some compounds compared with Accord but raises them for others. Discussion IQOS appears to be a variant of Accord without consistent improvements in exposure to aerosol toxic compounds. In contrast to PM’s past claims for Accord, PMI now claims in its MRTP application that IQOS reduces health risk. This shift in stance is likelynot the result of any toxicological difference between Accord and IQOS, but rather a change in the social and regulatory landscape permitting these claims.

Heated tobacco products: another tobacco industry global strategy to slow progress in tobacco control

“…The launching of the latest incarnation of HTPs is a reprise 55 of similar efforts in the past to use similar products to undermine tobacco control, particularly efforts that present the tobacco industry as a harm reduction partner.…”

“…A few of these products, such as RJ Reynolds (now Reynolds America, part of BAT) Premier and Eclipse and Philip Morris’ Accord and HeatBar were marketed but received poor ratings from customers, were commercial failures and were withdrawn 55 . It is possible the companies were not more aggressive in making ‘reduced harm’ claims on new products because of legal concerns: Claiming that the new products were safer would amount to an admission that cigarettes were dangerous, opening the door for litigation and political difficulties for the tobacco industry, including FDA regulation of new products and cigarettes in the USA 56 – 58 .…”

“…All these factors laid the foundation for the wave of HTP reduced risk claims in several countries that accompanied new HTP products starting around 2014. The introduction of these new products may also have been a response to the growing popularity of e-cigarettes beginning around 2007 after independent companies introduced them before the major multinational tobacco companies entered the e-cigarettes market 55 , 57 . Furthermore, the global decline of cigarette consumption and decrease in adult smoking prevalence (from 24% in 2007 to 21% in 2015), combined with the success of tobacco control, including implementation of the FCTC, 59 – 62 may also have lead the tobacco companies to consider alternative products to protect their profits and political interests.…”

Tobacco company strategies to identify and promote the benefits of nicotine

“…In response to consumers moving away from cigarettes, ageing and becoming more multicultural, RJR expanded its portfolio from cigarettes only in 2004 to include moist snuff in 2006, snus and dissolvables in 2009, nicotine replacement therapy/Zonnic gum in 2012, the electronic cigarette Vuse in 2013 and next generation heat-not-burn products in 2014 101 102. We did not find documents describing company strategies to use purported benefits of nicotine to promote their newer products, perhaps because RJR entered these markets after companies became aware that documents could be made public until 2021) 103. Nevertheless, nicotine-friendly messages, similar to those promoted by the tobacco industry in the 1980s and 1990s, continue to appear in popular media in the 2000s and include references to cognitive benefits14–20 104; some of these messages can be traced to individuals with industry ties or to industry-funded studies 18–20 104.…”

Lethal news: The dexterous infiltration of news media by the tobacco industry agenda

“…Second, PMI has ridiculously called its new product IQOS (for “I quit ordinary smoking”). Multiple independent scientific assessments suggest that IQOS can be very harmful and the device is so new that its harm has not been fully uncovered/experienced. Yet PMI is trying to curb regulatory defences.…”