The Pharmaceuticalization of the Tobacco Industry

Hendlin, Yogi Hale; Elias, Jesse; Ling, Pamela M.

doi:10.7326/m17-0759

Cited by 25 publications

(26 citation statements)

References 2 publications

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“…Although the tobacco industry’s diversification of products may appear to be mere attempts to increase profitability and unburden stigmatised smokers, it may in fact be a strategy to rehabilitate the industry’s public image. Heated tobacco products (HTPs), or heat-not-burn tobacco products, are the latest tactic in tobacco renormalisation,1 appealing to non-users, appearing as responsive to public health concerns, and absolving the industry from the responsibility of creating countless smokers and tobacco-related harms 2. If successful, these products will serve as key players in the resurgence of the tobacco epidemic 1…”

Section: Introductionmentioning

confidence: 99%

Heated tobacco product use among Korean adolescents

Kang

Cho

2019

Tob Control

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BackgroundHeated tobacco products (HTPs) may compromise decades-long efforts to marginalise the tobacco industry. Their appeal to adolescents imposes a risk of a new tobacco epidemic. Empirical evidence on the behavioural patterns of HTP use among adolescents is required. We investigated the prevalence of HTP use and the association between use of HTPs and e-cigarettes and attempts to quit smoking cigarettes.MethodsNationally representative cross-sectional survey data of South Korean adolescents aged 12–18 years (mean age: 15 years) were used. The survey was conducted 1 year after the introduction of HTPs in Korea. A total of 59 532 adolescents were identified. Descriptive statistics and multiple logistic regression results are presented.ResultsIn all, 2.8% of South Korean adolescents were ever HTP users. Among these, 75.5% were current cigarette users, 45.6% were current e-cigarette users and 40.3% were concurrent users of cigarettes and e-cigarettes. Unlike ever use of e-cigarettes, which was associated with a higher likelihood of cigarette quit attempts (adjusted OR (aOR)=1.35, 95% CI: 1.16 to 1.58), no difference in cigarette quit attempts was found for ever use of HTPs (aOR=1.07, 95% CI: 0.91 to 1.26).ConclusionConsidering the recent introduction of HTPs to the Korean market and less than 1% prevalence of e-cigarette when first introduced, the prevalence of ever HTP use among Korean adolescents is an important concern. The results showing high polytobacco use and the lack of an association between HTP use and cigarette quit attempts call for a ban on HTP advertisements with modified harm claims.

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Section: Introductionmentioning

confidence: 99%

Heated tobacco product use among Korean adolescents

Kang

Cho

2019

Tob Control

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“…As tobacco companies increasingly expand and diversify their nicotine product portfolio, 1 new heated tobacco products (HTPs), also known as heat-not-burn products, that heat modified cigarettes to produce an aerosol for inhalation have been introduced worldwide, 2–4 including Philip Morris International’s (PMI’s) IQOS. 2 5 As of February 2018, PMI’s marketing in several countries claims that because IQOS heats tobacco sticks, not burns them, it poses lower risks than regular combustible cigarettes.…”

Section: Introductionmentioning

confidence: 99%

IQOS labelling will mislead consumers

et al. 2018

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BackgroundPhilip Morris International (PMI) continually expands and diversifies their nicotine product portfolio, which includes IQOS, a heated tobacco product. In December 2016, PMI filed a modified risk tobacco product (MRTP) application with the US Food and Drug Administration (FDA), seeking authorisation to market IQOS in USA with three claims of reduced harm: ‘switching completely from conventional cigarettes to the IQOS system…’ (1) ‘can reduce the risks of tobacco-related diseases;’ (2) ‘significantly reduce[s] your body’s exposure to harmful or potentially harmful chemicals;’ and (3) ‘presents less risk of harm than continuing to smoke cigarettes.’ Consumers may misunderstand what is meant by ‘switching completely'.MethodsWe critically reviewed study reports submitted to FDA by PMI in support of proposed marketing claims in its MRTP application for IQOS and focused on the statement that switching completely to IQOS reduces risk.ResultsWe found deficiencies with evidence provided by PMI supporting their assertions that: current smokers will understand what is meant by the phrase ‘switching completely'; the proposed claims will not decrease smokers’ intentions to quit; and IQOS users will in fact ‘switch completely’ from smoking cigarettes to using IQOS. The studies and measurement instruments employed by PMI suffer from design flaws and their reporting of associated findings is misleading.ConclusionConsumers will not understand the condition of the claims—that they must quit using cigarettes completely to achieve the inferred health benefits of IQOS. Rather, they are likely to misunderstand the unsupported claims of reduced risks to mean IQOS are harm-free.

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“…Nearly 1000 peer-reviewed papers based on tobacco industry documents, as well as the US District Court’s ruling that the tobacco companies violated the Racketeer Influenced Corrupt Organizations Act 64 demonstrate the folly of partnership with the tobacco industry. August public health organisations, authorities and journals that believe ‘the best science must lead to better lives’ 65 should consider the ethics of endorsing tobacco industry attempts to preserve profits 66 with products claimed to be, but not yet demostrated as reduced risk, 67 while simultaneously continuing to both aggressively promote cigarettes and undermine tobacco control worldwide. 68 Public health practitioners should also bear in mind past experience with industry-backed ‘safer’ cigarettes (eg, filtered and low-tar) that served to undermine and delay tobacco control efforts.…”

Section: Discussionmentioning

confidence: 99%

Invisible smoke: third-party endorsement and the resurrection of heat-not-burn tobacco products

Elias

Ling

2018

Tob Control

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BackgroundTobacco companies are introducing new ‘heat-not-burn’ cigarettes in dozens of countries. Historically, these products failed commercially, and independent researchers contested their health claims. The most prominent early heat-not-burn cigarette was RJ Reynolds’s (RJR’s) Premier, introduced in the USA in 1988. Curiously, The Lancet endorsed Premier as a ‘near-perfect low tar cigarette’ in a 1991 editorial, 2 years after Premier had been removed from the market. We examined the context of this endorsement.MethodsTo ascertain what RJR knew about this endorsement, we systematically searched and analysed previously secret RJR documents in public archives and triangulated the industry document data with other published work.ResultsRJR had a long-standing interest in collaborating with outside scientists to endorse potentially reduced harm cigarettes. The author of The Lancet editorial had previously corresponded with RJR regarding Premier’s health effects and market potential. Internally, RJR regarded The Lancet’s editorial, its stance on novel tobacco products, and its endorsement of Premier as major successes. While the editorial came too late to save Premier, RJR saw future business opportunities for novel products if endorsed by health authorities.ConclusionsEndorsement by high-impact medical journals and health authorities may be critical in helping heat-not-burn’ products succeed where previous attempts have failed. Conflicts of interest influenced these endorsements in the past. Health leaders and academic journals should consider both conflicts of interest and the ethics of endorsing tobacco product substitution, as tobacco companies simultaneously work to promote cigarette smoking and undermine tobacco control globally.

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The Pharmaceuticalization of the Tobacco Industry

Cited by 25 publications

References 2 publications

Heated tobacco product use among Korean adolescents

Heated tobacco product use among Korean adolescents

IQOS labelling will mislead consumers

Invisible smoke: third-party endorsement and the resurrection of heat-not-burn tobacco products

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