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

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s96-s101 ◽  
Author(s):  
Jesse Elias ◽  
Pamela M Ling
Keyword(s):  
Conflicts Of Interest ◽  
Tobacco Product ◽  
Market Potential ◽  
Health Claims ◽  
Third Party ◽  
Tobacco Products ◽  
Health Authorities ◽  
The Usa ◽  
Public Archives ◽  
Future Business

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 Lancetendorsed 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 ofThe Lanceteditorial had previously corresponded with RJR regarding Premier’s health effects and market potential. Internally, RJR regardedThe 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.

FDA’s reduced exposure marketing order for IQOS: why it is not a reliable global model

2021 ◽  
pp. tobaccocontrol-2020-056316
Author(s):  
Lauren Kass Lempert ◽  
Stella Bialous ◽  
Stanton Glantz
Keyword(s):  
Public Relations ◽  
Tobacco Control ◽  
Scientific Evidence ◽  
Tobacco Product ◽  
Tobacco Products ◽  
Sales And Marketing ◽  
Philip Morris ◽  
The Us ◽  
The Usa ◽  
The Difference

The US Food and Drug Administration (FDA) issued orders in July 2020 authorising Philip Morris Products S.A. to market its heated tobacco product (HTP) IQOS inside the USA with claims that it reduces exposure to some dangerous substances. FDA’s ‘reduced-exposure’ orders explicitly prohibit the marketing of IQOS with claims that IQOS will reduce harm or the risk of tobacco-related diseases. Under US law, FDA’s IQOS orders are problematic because FDA disregarded valid scientific evidence that IQOS increases exposure to other dangerous toxins and that Philip Morris Products S.A. failed to demonstrate that consumers understand the difference between reduced-exposure and reduced-harm claims. Unfortunately, both ‘reduced-exposure’ and ‘reduced-harm’ are classified as ‘modified risk tobacco products’ under US law. Exploiting this confusion, Philip Morris International used the FDA decision as the basis for marketing and public relations campaigns outside the USA to press governments to reverse policies that ban or regulate the sales and marketing of HTPs, including IQOS. Parties to the WHO Framework Convention on Tobacco Control should reject tobacco companies’ unsubstantiated explicit or implied claims of reduced harm associated with HTPs and resist Philip Morris International’s and other companies’ calls to relax HTP regulations based on the FDA’s actions. Instead, parties should adopt policies aligned with the Framework Convention on Tobacco Control when dealing with HTPs and other novel tobacco products.

scholarly journals E-cigarette and cigarette purchasing among young adults before and after implementation of California’s tobacco 21 policy

2020 ◽  
pp. tobaccocontrol-2019-055417 ◽  
Author(s):  
Sara Schiff ◽  
Fei Liu ◽  
Tess Boley Cruz ◽  
Jennifer B Unger ◽  
Sam Cwalina ◽  
...  
Keyword(s):  
Population Based ◽  
Tobacco Product ◽  
Cigarette Use ◽  
Limited Data ◽  
Tobacco Products ◽  
Gas Stations ◽  
The Past ◽  
Before And After ◽  
The Usa ◽  
Vape Shops

BackgroundTobacco 21 (T21) laws, which raise the minimum legal age of sale of tobacco products to 21, have been proposed and implemented in states and cities across the USA. However, limited data are available on the effect of T21 laws on youth tobacco purchasing behaviours and access to tobacco products.MethodsParticipants in a population-based prospective cohort in southern California completed questionnaires before (n=1609, age=18–19 y) and after (n=1502, age=19–20 y) T21 was implemented in California (June 2016). We examined the prevalence of past 30-day cigarette and e-cigarette use, and among past 30-day users, purchase location of tobacco products before (pre-) versus after (post-) T21. We also examined whether, post-T21, participants were refused purchase of tobacco products due to their age, and the perceived relative ease of purchasing cigarettes and e-cigarettes (vs pre-T21).ResultsNegligible changes in cigarette and e-cigarette use were observed pre-T21 versus post-T21. At both time points, the majority of past 30-day users purchased cigarettes from gas stations and e-cigarettes from vape shops. Post-T21, the proportion of participants who reported purchasing cigarettes at gas stations decreased. Post-T21, most past 30-day cigarette or e-cigarette users were not refused purchase of cigarettes (65.4%) or e-cigarettes (82.0%) in the past 30 days, despite being under 21; half of the participants felt it was harder to purchase cigarettes (54.3%) and e-cigarettes (43.6%) post-T21.ConclusionPost-T21, few participants were refused purchase of any tobacco product, despite the illegality of such sales. Better enforcement of T21 is needed to improve the efficacy of T21 legislation.

scholarly journals Global review of tobacco product flavour policies

2020 ◽  
pp. tobaccocontrol-2019-055454 ◽  
Author(s):  
Olufemi Erinoso ◽  
Katherine Clegg Smith ◽  
Michael Iacobelli ◽  
Sejal Saraf ◽  
Kevin Welding ◽  
...  
Keyword(s):  
Grey Literature ◽  
Tobacco Product ◽  
Future Research ◽  
Specific Reference ◽  
The European Union ◽  
Tobacco Products ◽  
Product Packaging ◽  
Policy Documents ◽  
Policy Domain ◽  
The Usa

ObjectiveWe determined which countries prohibit flavoured tobacco products and the details of those restrictions in order to identify possible gaps and opportunities for these and other countries to address.MethodsWe reviewed the grey literature, scanned news articles and consulted with key informants and identified 11 countries and the European Union (EU) that ban or restrict tobacco product flavours. We reviewed policy documents for their stated policy rationale, terms and definitions of flavours, tobacco products covered and restrictions on the use of flavour imagery and terms on tobacco product packaging.ResultsCountries with a tobacco product flavour policy include the USA, Canada, Brazil, Ethiopia, Uganda, Senegal, Niger, Mauritania, EU (28 Member States), Moldova, Turkey and Singapore. Most of the countries’ policies provide a rationale of dissuading youth from taking up tobacco use. Ten of the 12 policies use the terms ‘flavours’ (n=6) or ‘characterising flavours’ (n=4). Six policies cover all products made entirely or partly of tobacco leaf. Countries consistently prohibit flavours associated with fruits, vanilla and spices. The USA and Niger make an exception for menthol, while Mauritania and Uganda do not specify the scope of flavours or ingredients covered by their policies. Eight policies make no specific reference to restricting flavour descriptors on tobacco product packaging.ConclusionCountries looking to implement policies restricting flavours in tobacco products can build on existing comprehensive policies. Future research could examine the implementation and impacts of these policies, to inform other countries interested in acting in this policy domain.

scholarly journals Heated tobacco products likely appeal to adolescents and young adults

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s41-s47 ◽  
Author(s):  
Karma McKelvey ◽  
Lucy Popova ◽  
Minji Kim ◽  
Benjamin W Chaffee ◽  
Maya Vijayaraghavan ◽  
...  
Keyword(s):  
Health Risks ◽  
Tobacco Industry ◽  
Tobacco Product ◽  
Adolescent And Young Adult ◽  
Tobacco Products ◽  
Design And Implementation ◽  
Philip Morris ◽  
The Us ◽  
The Usa ◽  
The 1960S

BackgroundBeginning in the 1960s in the USA and globally since 1998, tobacco companies have beenaggressively promoting heated tobacco products (HTP). In 2016, Philip Morris International (PMI) applied to the US Food and Drug Administration (FDA) seeking authorisation to market their IQOS HTP system and flavoured ‘HeatSticks’ in the USA as a modified-risk tobacco product (MRTP).MethodsWe systematically evaluated the publicly available data PMI submitted to FDA in its MRTP application to determine whether PMI’s IQOS product meets the US Tobacco Control Act’s standard for MRTP claims. We examined whether PMI provided sufficient data showing tobacco users will not initiate with IQOS, that youth will not misperceive the MRTP-related claims being made concerning IQOS, and how youth perceive health risks associated with IQOS.ResultsPMI’s own studies failed to provide evidence that youth, including non-users and former users, will not find IQOS appealing, will not initiate use of IQOS and will not perceive these products as risk-free. Further, PMI did not refer to independent studies conducted among adolescents which could influence their conclusions. Finally, their studies suffered from design and implementation flaws and cannot be relied on to support the proffered claims.ConclusionPMI’s own data and available evidence from scientific studies conducted independent of the tobacco industry regarding how novel tobacco products are currently being marketed suggest that introduction of IQOS will result in adolescent and young adult non-users initiating tobacco use with IQOS and could also increase poly-use of IQOS along with other tobacco products.

scholarly journals Awareness, trial and use of heated tobacco products among adult cigarette smokers and e-cigarette users: findings from the 2018 ITC Four Country Smoking and Vaping Survey

2020 ◽  
pp. tobaccocontrol-2020-055985
Author(s):  
Connor R Miller ◽  
Edward Sutanto ◽  
Danielle M Smith ◽  
Sara C Hitchman ◽  
Shannon Gravely ◽  
...  
Keyword(s):  
Tobacco Product ◽  
Regulatory Environment ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
The Usa ◽  
Multivariable Analyses ◽  
Former Smokers ◽  
Use Categories

ObjectiveTo evaluate heated tobacco product (HTP) awareness, trial and current use among adult cigarette smokers and vaping product users in four countries with varying regulations governing HTP sales.DesignData came from Wave 2 of the ITC Four Country Smoking and Vaping Survey, collected from February to July 2018. Respondents were current and former smokers and/or users of vaping products (18 years or older) from Canada (CA; n=3778), England (EN; n=4848), the USA (US; n=2846) and Australia (AU; n=1515). At the time of the survey, only Canada and England permitted the sale of contemporary HTPs (eg, IQOS).ResultsOverall, 30.2% of respondents reported being aware of HTPs (CA=30.4%; EN=31.0%; US=30.2%; AU=27.4%; p=0.346), 2.4% had ever tried HTPs (CA=3.3%; EN=2.4%; US=2.0%; AU=0.9%; p=0.001) and 0.9% currently used HTPs at least monthly (CA=0.8%; EN=1.2%; US=0.7%; AU=0.2%; p<0.001). Trial and current use were higher among those who concurrently smoked and vaped (at least monthly) versus other nicotine use categories (trial: 10.9% v. 1.2%–2.0%, p<0.001; current use: 8.4% v. 0.1%–1.0%, p<0.001). In multivariable analyses, HTP awareness did not differ across countries, whereas odds of trial and current use were lower where HTPs were unavailable. Odds of HTP trial did not differ by regulatory environment when restricting analysis to HTP-aware concurrent smokers–vapers.ConclusionApproximately one third of respondents were aware of HTPs, even in the USA and Australia, where contemporary HTPs were not yet on the market. Trial and use were uncommon, except among concurrent smokers–vapers. Restrictions on availability may have limited HTP use generally, but less so for concurrent smokers–vapers.

scholarly journals Heated tobacco product regulation under US law and the FCTC

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s118-s125 ◽  
Author(s):  
Lauren Kass Lempert ◽  
Stanton A Glantz
Keyword(s):  
Tobacco Control ◽  
Scientific Evidence ◽  
Tobacco Product ◽  
Product Labelling ◽  
Tobacco Products ◽  
Control Laws ◽  
The Public ◽  
Philip Morris ◽  
Product Regulation ◽  
The Usa

Tobacco companies are marketing new ‘heated tobacco products’ (HTPs) composed of battery-powered holders, chargers and tobacco plugs or sticks. The non-tobacco HTP components have escaped effective regulation under many countries’ tobacco control laws because they are packaged and sold separately from the tobacco-containing components. In the USA, HTPs cannot be marketed unless the Food and Drug Administration determines that allowing their sale would be ‘appropriate for the protection of the public health’. Philip Morris International (PMI) is seeking permission to market its IQOS HTP in the USA with ‘modified risk tobacco product’ (MRTP) claims that it reduces exposure to harmful substances and is less harmful than other tobacco products. However, PMI has not submitted adequate scientific evidence required by US law to demonstrate that the product is significantly less harmful to users than other tobacco products, that its labelling would not mislead consumers, or that its marketing—with or without MRTP claims—would benefit the health of the population as a whole. Parties to the WHO Framework Convention on Tobacco Control (FCTC) must take measures to reduce tobacco use and nicotine addiction, and prevent false or misleading tobacco product labelling, advertising and promotions; the introduction of new HTPs must be assessed according to these goals. All components of HTPs should be regulated at least as stringently as existing tobacco products, including restrictions on labelling, advertising, promotion and sponsorship, sales to minors, price and taxation policies and smokefree measures. There is nothing in US law or the FCTC that prevents authorities from prohibiting HTPs.

scholarly journals Awareness, experience and prevalence of heated tobacco product, IQOS, among young Korean adults

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s74-s77 ◽  
Author(s):  
Jinyoung Kim ◽  
Hyunjae Yu ◽  
Sungkyu Lee ◽  
Yu-Jin Paek
Keyword(s):  
Online Survey ◽  
Electronic Cigarettes ◽  
Tobacco Product ◽  
Health Claims ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Korean Adults ◽  
Philip Morris ◽  
The Government ◽  
Korean Market

IntroductionPhilip Morris International introduced ‘IQOS’ to the Korean market in June 2017. To monitor the use of IQOS among young Korean adults, we identified their awareness, experience and current use of IQOS.MethodsThree months after the introduction of IQOS in Korea, we conducted an online survey with 228 general young adults, aged 19–24 years.Results87 participants (38.1%) were aware of IQOS, 13 (5.7%) were IQOS ever users and 8 (3.5%) were current IQOS users. All the current IQOS users were triple users of conventional cigarettes and electronic cigarettes (e-cigarettes). There were no IQOS-only users and one IQOS ever user was a non-cigarette smoker. Among the eight current IQOS users who smoked 9.1 conventional cigarettes a day on average, four smoked 10–20 HEETS sticks a day. The current IQOS users decided to use IQOS because they believed it was less harmful or to stop smoking. The current conventional cigarette smokers were much more likely to be aware of IQOS (OR 4.496; 95% CI 2.185 to 9.250) and to be IQOS ever users (OR 11.649; 95% CI 1.024 to 132.564).ConclusionAwareness, experience and use of IQOS among young Korean adults were relatively higher than among their Japanese counterparts. Current IQOS users were more likely to smoke conventional cigarettes and/or e-cigarettes, which contradicts the tobacco industry’s claims that conventional cigarette smokers will switch to heated tobacco products. Until obtaining robust evidence concerning heated tobacco products, the government should regulate the tobacco industry’s marketing tactics and health claims.

scholarly journals Assessment of industry data on pulmonary and immunosuppressive effects of IQOS

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s20-s25 ◽  
Author(s):  
Farzad Moazed ◽  
Lauren Chun ◽  
Michael A Matthay ◽  
Carolyn S Calfee ◽  
Jeffrey Gotts
Keyword(s):  
Pulmonary Inflammation ◽  
Tobacco Product ◽  
Industry Data ◽  
Dual Use ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Aerosol Exposure ◽  
Philip Morris ◽  
The Us ◽  
The Usa

IntroductionHeated tobacco products are being touted as novel reduced-harm tobacco products by tobacco companies. In the USA, Philip Morris International submitted a modified risk tobacco product (MRTP) application to the US Food and Drug Administration in 2016 in which it purports that its heated tobacco product, I-Quit-Ordinary-Smoking (IQOS), is associated with reduced harm compared with conventional cigarettes.MethodsWe reviewed Philip Morris International’s MRTP application to assess the pulmonary and immune toxicities associated with IQOS use in both animal and human studies.ResultsAmong rats exposed to IQOS, there was evidence of pulmonary inflammation and immunomodulation. In human users, there was no evidence of improvement in pulmonary inflammation or pulmonary function in cigarette smokers who were switched to IQOS.ConclusionIQOS is associated with significant pulmonary and immunomodulatory toxicities with no detectable differences between conventional cigarette smokers and those who were switched to IQOS in Philip Morris International’s studies. Philip Morris International also failed to consider how dual use and secondhand aerosol exposure may further impact, and likely increase, the harms associated with these products.

scholarly journals Sensory analysis of characterising flavours: evaluating tobacco product odours using an expert panel

2018 ◽  
Vol 28 (2) ◽  
pp. 152-160 ◽  
Author(s):  
Erna J Z Krüsemann ◽  
Marlou P Lasschuijt ◽  
C de Graaf ◽  
René A de Wijk ◽  
Pieter H Punter ◽  
...  
Keyword(s):  
Performance Monitoring ◽  
Expert Panel ◽  
Descriptive Analysis ◽  
Principal Component ◽  
Tobacco Product ◽  
Cluster Method ◽  
Tobacco Products ◽  
Quantitative Descriptive Analysis ◽  
Significance Level ◽  
The Usa

ObjectivesTobacco flavours are an important regulatory concept in several jurisdictions, for example in the USA, Canada and Europe. The European Tobacco Products Directive 2014/40/EU prohibits cigarettes and roll-your-own tobacco having a characterising flavour. This directive defines characterising flavour as ‘a clearly noticeable smell or taste other than one of tobacco […]’. To distinguish between products with and without a characterising flavour, we trained an expert panel to identify characterising flavours by smelling.MethodsAn expert panel (n=18) evaluated the smell of 20 tobacco products using self-defined odour attributes, following Quantitative Descriptive Analysis. The panel was trained during 14 attribute training, consensus training and performance monitoring sessions. Products were assessed during six test sessions. Principal component analysis, hierarchical clustering (four and six clusters) and Hotelling’s T-tests (95% and 99% CIs) were used to determine differences and similarities between tobacco products based on odour attributes.ResultsThe final attribute list contained 13 odour descriptors. Panel performance was sufficient after 14 training sessions. Products marketed as unflavoured that formed a cluster were considered reference products. A four-cluster method distinguished cherry-flavoured, vanilla-flavoured and menthol-flavoured products from reference products. Six clusters subdivided reference products into tobacco leaves, roll-your-own and commercial products.ConclusionsAn expert panel was successfully trained to assess characterising odours in cigarettes and roll-your-own tobacco. This method could be applied to other product types such as e-cigarettes. Regulatory decisions on the choice of reference products and significance level are needed which directly influences the products being assessed as having a characterising odour.

Differences in price of flavoured and non-flavoured tobacco products sold in the USA, 2011–2016

2019 ◽  
pp. tobaccocontrol-2019-055111
Author(s):  
Israel T Agaku ◽  
Satomi Odani ◽  
Brian Armour ◽  
Margaret Mahoney ◽  
Bridgette E Garrett ◽  
...  
Keyword(s):  
Tobacco Product ◽  
Scanner Data ◽  
Limited Data ◽  
Joinpoint Regression ◽  
Tobacco Products ◽  
Cigarette Pack ◽  
Moist Snuff ◽  
The Usa ◽  
Price Trends ◽  
Differential Pricing

BackgroundLimited data exist on whether there is differential pricing of flavoured and non-flavoured varieties of the same product type. We assessed price of tobacco products by flavour type.MethodsRetail scanner data from Nielsen were obtained for October 2011 to January 2016. Universal product codes were used to classify tobacco product (cigarettes, roll-your-own cigarettes (RYO), little cigars and moist snuff) flavours as: menthol, flavoured or non-flavoured. Prices were standardised to a cigarette pack (20 cigarette sticks) or cigarette pack equivalent (CPE). Average prices during 2015 were calculated overall and by flavour designation. Joinpoint regression and average monthly percentage change were used to assess trends.ResultsDuring October 2011 to January 2016, price trends increased for menthol (the only flavour allowed in cigarettes) and non-flavoured cigarettes; decreased for menthol, flavoured and non-flavoured RYO; increased for flavoured little cigars, but decreased for non-flavoured and menthol little cigars; and increased for menthol and non-flavoured moist snuff, but decreased for flavoured moist snuff. In 2015, average national prices were US$5.52 and US$5.47 for menthol and non-flavoured cigarettes; US$1.89, US$2.51 and US$4.77 for menthol, non-flavoured and flavoured little cigars; US$1.49, US$1.64 and US$1.78 per CPE for menthol, non-flavoured and flavoured moist snuff; and US$0.93, US$1.03 and $1.64 per CPE flavoured, menthol and non-flavoured RYO, respectively.ConclusionTrends in the price of tobacco products varied across products and flavour types. Menthol little cigars, moist snuff and RYO were less expensive than non-flavoured varieties. Efforts to make flavoured tobacco products less accessible and less affordable could help reduce tobacco product use.

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