Heated Tobacco Products

From TobaccoTactics
Revision as of 14:08, 24 March 2020 by Editor15 (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigationJump to search

To secure the tobacco industry’s medium to long-term future, in light of growing tobacco regulations and a rapidly shrinking cigarette market (particularly in high income countries), tobacco companies have been looking to develop and market so-called ‘Next Generation Products’ (NGPs), which include snus, e-cigarettes, and Heated Tobacco Products (HTPs).[1][2] This overview page focuses on HTPs. It explains what these products are, summarises tobacco company investments in this product segment, and discusses the main public health debates around these products. This page does not include research updates on the potential health benefits/risks of HTPs.

Background

Unlike e-cigarettes, HTPs contain tobacco.[3] According to tobacco companies, by heating the tobacco, rather than burning like conventional cigarettes, the formation of cancer-causing chemicals created at high temperature associated with combustion is significantly reduced.[4] This tobacco industry reduced-risk claim has yet to be supported by independent scientific evidence, as discussed in the Harm Reduction section below. IQOS, produced by Philip Morris International (PMI) is the most widely available HTP, with by far the biggest share of the market, but the other big three transnational tobacco companies (TTCs) all now have HTP products.[5] In 2017, the British Government classified HTPs into three categories:[6]

1. Processed tobacco heated directly to produce vapour;
2. Processed tobacco designed to be heated in a vaporiser;
3. Devices that produce vapour from non-tobacco sources, where the vapour is then passed over processed tobacco to flavour the vapour.

The image gallery below shows examples of tobacco companies’ HTPs. Unless otherwise stated, images are screenshots from the manufacturers’ websites taken in February 2020.

Despite significant media coverage of the tobacco industry’s HTP pursuits,[11][12][13] and the technology marketed as “a real game changer”,[14] in 2018 HTPs represented only 2% of the value of the global tobacco market, according to market research company Euromonitor. Combustible tobacco (mainly cigarettes) continued to dominate the market with a 93% market share. Smokeless tobacco also had around 2%, and e-cigarettes 3%, of the market.[15][5]

Heated Tobacco Product Technology Pioneered in 1980s

Image 5: Accord Advertisement by Starcom Media Services[16]

HTP technology is not new. It was first developed by tobacco companies in the 1980s to address concerns about second-hand smoke exposure. In 1988, American tobacco company RJ Reynolds (RJR) launched the first HTP, Premier, in several American cities.[17][18] The company’s objective behind developing Premier was to “produce a cigarette which provided the enjoyment and satisfaction of other cigarettes, but without many of the perceived negatives”.[18] Richard Kampe, then President RJR Development, said: “What it all comes down to is a cleaner smoke for smokers and those around them”.[19] Premier was withdrawn from the market in early 1989 reportedly because smokers “did not like Premier’s taste or smell”.[20]

In 1996, RJR started test marketing its second HTP called Eclipse, marketed to smokers under the slogan “imagine the unimaginable”.[21] The company purported that Eclipse was a new cigarette “with nearly 90 percent less second-hand smoke”.[22] This claim was refuted in 2002 by an independent study which found that Eclipse was at least as toxic as conventional cigarettes.[23] The product was on the American market until 2014, apparently reappearing as Revo(see below).

In 1998, Philip Morris launched its first HTP called Accord under the slogan “the time is right”(see Image 5).[24] The company commissioned Starcom Media Service to run a media campaign to create awareness of the product and communicate its perceived benefits, including reduced second-hand smoke, smoke odour and ash.[16][25] Accord remained on the market until 2006, when it was discontinued due to poor sales.[26] Consumers allegedly complained that the product was not as satisfying as conventional cigarettes.[26] In 2007, PMI briefly rebranded Accord to Heatbar and trialled the product on the Swiss and Australian markets. It’s unclear when the product was withdrawn from these markets.

It appears as though none of the first and second generation HTPs gained commercial success, and none were marketed as potentially less harmful. A 2016 study by Dutra et al[27] concluded that the tobacco industry’s early HTP pursuits were primarily driven by non-health related reasons, in particular to evade smoke-free regulations and to complement, rather than compete with, conventional cigarettes.

A New Take on an Old Idea

2014, marked the start of a phase of new HTP launches by tobacco companies. RJR launched Revo (allegedly a revamped version of Eclipse) under the banner “an unconventional cigarette”,[28] PMI introduced IQOS (allegedly a revamped version of Accord) under the banner “this changes everything”,[29] and BAT launched iFuse in 2015.[30]

By early 2018, all transnational tobacco companies except Imperial Tobacco had HTPs in their product portfolio. PMI promoted them as part of its purported goal of a “smoke-free future” and BAT framed them as part of its “Transforming Tobacco” programme.[31][32][33] In 2019, Imperial Tobacco (now Imperial Brands) also launched an HTP.[34]

By 2019 BAT and PMI were testing carbon tip devices. In BAT’s case this appeared to be a version of an earlier Reynolds product (BAT acquired Reynolds in 2017).[35][36] Both companies state that these products resemble traditional cigarettes.[35][36][37]

Japan Tobacco International

In March 2010, JTI acquired a 27% share in San Francisco-based entrepreneurial company Ploom Inc., signing an agreement to commercialise Ploom’s HTP outside the US.[38] Ploom’s HTPs heat small pods of tobacco. In February 2015, JTI and Ploom (later trading under the name ‘Pax Labs’) ended their partnership and JTI acquired the intellectual property rights for Ploom HTPs.[39] One year later JTI launched an upgraded version, called PloomTech, with new products planned.[40] By 2019, the company had three Ploom products in its portfolio.

Philip Morris International

PMI first launched IQOS (reported at the time as standing for I Quit Ordinary Smoking[41]) in the second half of 2014 in Italy, and later trialled the product in Japan.[42] The electronic IQOS device heats tobacco sticks which are called HEETS. In 2018 IQOS was available in over 40 countries including Canada, Columbia, Czech Republic, Denmark, France, Germany, Greece, Guatemala, Italy, Israel, Japan, Kazakhstan, Lithuania, Monaco, Netherlands, New Zealand, Palestine, Poland, Portugal, Romania, Russia, Serbia, Slovak Republic, Slovenia, South Africa, South Korea, Spain, Switzerland, Ukraine and the UK. [43] By the beginning of 2020, PMI reported this number had risen to 52 countries, including the United States.[44] In January 2020, PMI announced a new “collaboration” with South Korean tobacco company KT&G, to commercialize its range of “smoke-free” products globally, alongside IQOS.[45]

PMI has been testing a HTP with a carbon tip device, called TEEPS, which it alleges is much closer to the look and feel of a conventional cigarette than IQOS.[37] This device is likely to be similar to BAT’s Neocore (see below). As of February 2020, TEEPS did not yet appear to be on the market.

British American Tobacco

BAT initially focused its NGP investment on e-cigarettes (for more detail see the page on E-Cigarettes: British American Tobacco). In 2015, BAT entered the HTP market with the launch of iFuse, a product that heats an e-liquid, with creates a vapour which is passed through a tobacco pod (similar to JTI’s PloomTech).[46] In 2016, BAT launched glo which the company has claimed to be “a real game changer for consumers”.[14]glo, like IQOS, uses a battery operated device to heat tobacco sticks (called Neostiks and sold under BAT’s cigarette brand Kent).[47] According to BAT, glo is a simpler and more practical alternative to IQOS.[48] In 2017, the product was sold in five countries, but BAT said that it aimed to launch glo in three times as many the following year.[49] By 2019, glo was sold mainly in the large markets of Japan and South Korea, although the product was being rolled out in other countries, including Eastern Europe, Russia and Canada.[50]

The company has also been developing a carbon tip device, under the name NeoCore.[36] As of February 2020 this product, which seems to be based on Reynolds Revo/Eclipse device, did not yet appear to be on the market.

Imperial Tobacco

At the end of 2017, Imperial Tobacco was the only transnational tobacco company not selling HTPs. The company’s NGP strategy had largely focused on e-cigarettes, and it had publicly dismissed HTP health claims made by its competitors, asserting “there’s no difference really between those products and traditional tobacco products” and “It’s probably better described generically as ‘heat and burn’ rather than ‘heat not burn’”.[51] In 2015, Imperial Tobacco scientists published a study in the Environmental Analytical Chemistry journal that concluded that PMI’s IQOS released tobacco-containing side stream emissions, and as such, the scientists recommended that HTPs should be covered by smoke-free legislation.[52]

However in early 2018, apparently under pressure from shareholders, Imperial announced that it was after all developing and trialling heated tobacco products.[53][54][55][56] In May 2019, Imperial’s HTP Pulze was launched in Fukuako, Japan.[57][58] The company said it was “evaluating other potential market launches for the brand”.[59]

Harm Reduction: A Tobacco Solution to a Tobacco Problem?

RJ Reynolds’s executive Steven Alderman testified in an American court in 2016 that there is no such thing as a ‘safe’ tobacco product.[60] Yet, some tobacco manufacturers have marketed HTPs with direct and indirect claims that they are less toxic or less harmful than conventional cigarettes.[61][62] BAT and PMI have set up dedicated websites (bat-science.com, pmiscience.com) to showcase their harm reduction HTP efforts, and have published their findings in scientific journals. [63][64] In December 2016, PMI submitted a ‘modified risk’ IQOS application with the American Food and Drug Administration (FDA), which if successful, would allow PMI to market IQOS in the US as ‘reduced risk’.[65] BAT has indicated that it will undertake similar regulatory steps with glo.[28] In January 2018, the Tobacco Products Advisory Committee (TPSAC) to the FDA, following careful scrutiny of PMI IQOS data, recommended against approving PMI’s application to market IQOS as ‘reduced risk’. The Committee concluded that the data had shown that IQOS users were exposed to lower levels of harmful chemicals, but had not demonstrated that this would translate into a measurable reduction in death and disease.[66]

Since PMI and BAT launched their science websites, Imperial Brands and Japan Tobacco International have also created sites pointing to their product research and publications on harm reduction (Imperialbrandsscience.com and jt-science.com).

Public health advocates have cautioned that the short and long-term effects on the health of the consumer of HTPs remain unclear, and that due to the tobacco industry’s long history of deceit over the health risks of smoking,[67] there is an urgent need for independent evidence.[68][69][70]

According to the World Health Organization (WHO):

“this generation of HTPs has not been on the market long enough for potential effects to be studied. Conclusions cannot yet be drawn about their ability to assist with quitting smoking (cessation), their potential to attract new youth tobacco users (gateway effect), or the interaction in dual use with other conventional tobacco products and e-cigarettes. Future independent studies should address these effects, as well as the safety and risk of HTPs.”[3]

A new body of evidence is emerging that suggests that HTPs may be more harmful to health than tobacco companies would like us to believe. In May 2017, Auer and colleagues published a research letter in JAMA Internal Medicine which challenged PMI’s claim that IQOS heats tobacco “without combustion fire, ash, or smoke”, and accused the company of “dancing around the definition of smoke to avoid indoor-smoking bans”.[71] According to the authors, PMI has misappropriated the popular, yet scientifically incorrect, perception that combustion releases harmful chemicals and creates smoke. Rather, the authors argue, it’s incomplete combustion (a chemical process known as ‘pyrolysis’) which produces cancer causing chemicals. Importantly, the authors demonstrate that pyrolysis occurs in IOQS.[71]

In addition, in December 2017 a number of former PMI employees and contractors described to Reuters “a number of irregularities” involving clinical trials that underpin PMI’s application to the FDA.[72] Tamara Koval, who worked from PMI from 2012 to 2014 and who was directly involved in these clinical trials, told Reuters that she questioned the quality of the researchers and laboratories contracted to carry out the experiments, and that when she had highlighted an irregularity in one the studies, PMI excluded her from meetings. Reuters’ own investigations found that PMI had dropped one particular experiment because the basic procedure for obtaining informed consent from trial participants had not been followed. Speaking to the investigator in charge of that particular experiment, Reuters was told that he “knew nothing about tobacco”. Reuters also reported that, according to two former employees, a second investigator had submitted urine samples which exceeded what a human is capable of producing, and a third had told Reuters that he “doesn’t hold such company-sponsored clinical trials in high regard, describing them as ‘dirty’ because their purpose is more commercial than scientific”.[72] PMI’s response to the Reuters report was that “all studies were conducted by suitably qualitied and trained Principle Investigators”, and that PMI had “taken steps to address any reported irregularities in our studies”.[72]

HTP Adoption Rates

BAT, PMI and JTI have used Japan, and to a lesser degree South Korea, as a trial market for their HTPs. Initial reports by the tobacco companies and industry analysts showed strong adoption rates in these countries, particularly Japan. According to PMI, by March 2017 the tobacco company sold three million IQOS devices in Japan, and “demand continues to outstrip supply”.[73]

While, by the end of 2019, IQOS had expanded to over 50 markets, the Japanese experience has not been replicated elsewhere. Reuters suggested that HTPs success in Japan might be connected to restrictive e-cigarette legislation, arguing that “e-cigarettes, which use nicotine-laced liquid, are not permitted under the country’s pharmaceutical regulation”. President of BAT Japan, Roberta Palazzetti, described Japan as “the first battleground for heated tobacco products”, explaining that BAT had chosen Japan because “Japan’s consumers are highly receptive to innovation”.[49] In addition, others have suggested that the Japanese success of HTPs may be linked to the Japanese values of discretion and social politeness, which do not necessarily apply to other markets.[74] The market in South Korea is dominated by Korean tobacco company KT&G.[75] It remains to be seen how much PMI’s distribution deal with the South Korean company affects its own market share, and that of its competitors, in South Korea and globally.[45]

In Europe, Italy was at the forefront of HTP developments. PMI chose Milan to trial IOQS reportedly due to beneficial tax treatment of the product by the Italian government.[76] BAT Chief Executive Nicandro Durante reported in July 2017 that BAT had seen “no success whatsoever” with glo in European markets like Italy and Switzerland.[28] However, PMI continues to launch IQOS in Western European markets, as well as expanding into Eastern Europe and Russia.[5]

Threat to Implementation Framework Convention on Tobacco Control

The WHO and the Secretariat to the WHO Framework Convention on Tobacco Control (FCTC) have warned that the tobacco industry’s HTPs are addictive,[77][75] that “all forms of tobacco use are harmful, including HTPs”; [75] and that they should be subjected to the same policy and regulatory measures applied to tobacco products, in line with the FCTC.[77][75] It has also stated that the tobacco industry’s NGP strategy is primarily “in pursuit of profit rather than public health”,[78]

In March 2019, the Secretariat of the WHO FCTC released a statement urging governments to remain vigilant, stating that:

“novel and emerging nicotine and tobacco products…are creating another layer of interference by the tobacco industry and related industries, which is still reported by Parties as the most serious barrier to progress in implementing the WHO FCTC”.[79]

It also reminded Parties of their obligations under Article 5.3 to protect tobacco control policies and activities from all commercial and vested interests.[79]

TobaccoTactics Resources


Relevant Link

TCRG Research

Notes

  1. Euromonitor International. Global Tobacco: Key Findings Part I- Cigarettes, 22 August 2017
  2. G. Salmon, British American Tobacco – Drawn to the glo, Hargreaves Lansdown, 27 July 2017, accessed September 2017
  3. 3.0 3.1 World Health Organization Tobacco Free Initiative, Heated tobacco products (HTPs) information sheet, WHO website, 2018, accessed February 2018
  4. Philip Morris International, Heat-Not-Burn, PMI Science website, undated, accessed October 2017
  5. 5.0 5.1 5.2 Stopping Tobacco Organizations and Products, Addiction At Any Cost: Philip Morris International Uncovered, STOP report, 20 February 2020,accessed February 2020
  6. HM Treasury, Tax treatment of heated tobacco products, Closed consultation published 20 March 2017, accessed June 2017
  7. Philip Morris International, Compare our IQOS products, IQOS website, undated, accessed February 2020
  8. British American Tobacco, Tobacco Heating Products, BAT website, undated, accessed February 2020
  9. Japan Tobacco International, Reduced-Risk Products – our vaping products, JTI website, undated, accessed February 2020
  10. Imperial Brands, https://www.imperialbrandsplc.com/content/dam/imperial-brands/corporate/investors/shareholder-centre/AGM/2020/AGM%202020%20slides.pdf Annual General Meeting 2020: Next Generation Products], Presentation at AGM, 5 February 2020, accessed February 2020
  11. A. LaVito, You may soon see a product that heats tobacco instead of burning it, CNBC News, 25 January 2018, accessed February 2018
  12. O. Waring, New heat-not-burn smoking alternatives ‘may be less harmful than cigarettes’, The Mirror, 11 February 2018, accessed February 2018
  13. Consumer & Society, Could heat-not-burn spell an end to vaping?, 9 February 2018, accessed February 2018
  14. 14.0 14.1 BAT Sheds Light on Glo, CPS Daily News, 27 March 2017, accessed July 2017
  15. Euromonitor International: Global Tobacco data, 2018
  16. 16.0 16.1 Starcom Media Services, Media Plan Recommendation Launch I Revised 980603, 3 June 1998, Truth Tobacco industry Documents, Bates no: 2071224804-2071224832, accessed July 2017
  17. Unknown, Trial testimony of Nicholas George Brookes, June 15 2000 [p.m, Engle v RJ Reynolds Tobacco Co], 15 June 2000, Truth Tobacco Industry Documents, Bates no: brookesn061500pm, accessed June 2017
  18. 18.0 18.1 P.S. Cohen, Marketing Research Report. Comprehensive overview of consumer reactions to Premier, 11 May 1989, Truth Tobacco Industry Documents, Bates no: 506904719-506904746, accessed July 2017
  19. Unknown, Attachment II. Press Release, 4 April 1989, Truth Tobacco Industry Documents, Bates no: 506905454-506905455, accessed July 2017
  20. B. Horovitz, RJR Smokeless Cigarette test is Snuffed Out, Los Angeles Times, 1 March 1989, accessed July 2017
  21. Unknown, I’d like to start my brief presentation today by introducing you to the people who developed eclipse…, 18 April 1996, Truth Tobacco Industry Documents, Bates no: 516860700-516860703, accessed July 2017
  22. Unknown, Press Release. The following press release was issued by R.J. Reynolds Tobacco Company on May 28, 1996 (199606528), 28 May 1996, Truth Tobacco Industry Documents, Bates no: 526348310-526348312, accessed July 2017
  23. J. Slade, G.N. Connolly, D. Lymperis. Eclipse: does it live up to its health claims? Tobacco Control 2002: 11(Suppl 2):ii64-70
  24. Unknown, Advertisements Regarding Accord Cigarettes, Truth Tobacco Industry Documents, 1999, Bates no:3990051443-3990051454, accessed February 2018
  25. Unknown, Marketing, 1990, Truth Tobacco Industry Documents, Bates no:2080923084-2080923118, accessed July 2017
  26. 26.0 26.1 Ontario Tobacco Research Unit, OTRU Update: Heat-Not-Burn Tobacco products: Claims and Science, November 2016, accessed September 2017
  27. L. Dutra, R. Grana, S. Glantz, Philip Morris research on precursors to the modern e-cigarette since 1990. Tobacco Control, published online first 15 November 2016, doi:10.1136/tobaccocontrol-2016-053406
  28. 28.0 28.1 28.2 S.Chaudhuri, BAT to submit FDA application to sell Glo in U.S., MarketWatch’, 27 July 2017, accessed September 2017
  29. Philip Morris International, 2016 Annual Report: IQOS This changes everything, PMI website, 3 March 2017, accessed February 2020
  30. British American Tobacco, E-cigarettes and other Next Generation Products, BAT website, undated, accessed October 2017
  31. Philip Morris Products S.A., Delivering a smoke-free future. How long will PMI be in the cigarette business?, PMI website, undated, accessed December 2019
  32. British American Tobacco, British American Tobacco underlines commitment to transforming tobacco in latest Group reports, BAT website, press release, 18 March 2018, archived 20 March 2018, accessed February 2020
  33. British American Tobacco, Transforming Tobacco. Annual Report and Form 20-F 2018, BAT website, 2019, accessed November 2019
  34. L.Du and G.Huang, Imperial Brands jumps into Japan’s crowded heated-Tobacco Market, Bloomberg Technology, 25 April 2019, accessed May 2019
  35. 35.0 35.1 Philip Morris S.A., Carbon heated tobacco product TEEPS, PMI website, undated, accessed December 2019
  36. 36.0 36.1 36.2 British American Tobacco, Tobacco Heating Products, BAT website , undated, accessed February 2020
  37. 37.0 37.1 Philip Morris International, Glossary: TEEPS, undated, accessed September 2017
  38. Japan Tobacco International, Innovative partnership for Ploom and Japan Tobacco International JTI to take minority share in Ploom, JTI News Release, 8 December 2011, accessed June 2017
  39. Japan Tobacco International, JTI acquires “Ploom” Intellectual Property Rights from Ploom, Inc., JTI website, 16 February 2015, accessed July 2017
  40. T. Urananka, Japan Tobacco to launch new smokeless product this year, Reuters, 6 February 2018, accessed February 2018
  41. L. Rapaport, ‘Heat-not-burn’ cigarettes still release cancer-causing chemicals, Reuters, 26 May 2017, accessed February 2018
  42. Euromonitor International. Global Tobacco: Key Findings Part 2: Vapour Products. August 2016
  43. Philip Morris International, Where is IQOS available?, PMI website, undated, accessed February 2018
  44. Philip Morris International, 2019 Fourth-Quarter and Full-Year Results, PMI website, 6 February 2020, accessed February 2020
  45. 45.0 45.1 Philip Morris International Inc. Announces Agreement with KT&G to Accelerate the Achievement of a Smoke-Free Future, Business Wire, 28 January 2020, accessed January 2020
  46. Vapor from novel hybrid tobacco heating product produces little or no effect on human cells, news-medical.net, 5 June 2017, accessed July 2017
  47. Euromonitor International. HTP (Heated Tobacco Products)- Hot Prospect? Briefing 24 April 2017
  48. D. Caruana, BAT launches Glo in South Korea, Vapingpost.com, 15 August 2017, accessed September 2017
  49. 49.0 49.1 Nikkei Asian Review, BAT’s entry an opening salvo in smokeless-tobacco war in Japan, 31 May, accessed July 2017
  50. N. Durante, Analyst Briefing, BAT website, 16 October 2018, accessed November 2019
  51. M. Geller, Imperial shuns “heating products” pushed by Big Tobacco rivals, Reuters, 6 May 2015, accessed June 2017
  52. G. O'Connell , P. Wilkinson, K.M. Burseg, et al. Heated tobacco products create side-stream emissions: implications for regulation. J Environ Anal Chem 2015;2:2380–91
  53. T. Boles, Imperial Brands is expected to reassure the market with new next generation products, cityam.com, 5 November 2017, accessed February 2018
  54. Imperial Brands, AGM Update, Investis Digital website, 7 February 2018, accessed February 2018
  55. M. Williamson, Presentation at the Annual General Meeting 2018. 7 February 2018. Imperial Brands, Bristol
  56. Imperial Brands, Interim Results for the six months ended 31 March 2018: Delivering our strategy in tobacco and NGP, Imperial Brands website, 9 May 2018, accessed May 2018
  57. L.Du and G.Huang, Imperial Brands jumps into Japan’s crowded heated-Tobacco Market, Bloomberg Technology, 25 April 2019, accessed May 2019
  58. Pulze Heated Tobacco Makes Global Debut in Fukuoka, Fukuoka Now, 13 June 2019, accessed February 2020
  59. Imperial Brands, Annual Report and Accounts, 2019, accessed February 2020
  60. RJ Reynolds, In the Circuit Court of the Seventh Judicial Circuit in Volusia County Florisay. Engle Progeny Cases Tobacco Litigation. Deposition of Steven Alderman PH.D.; In the Matter of: Dickerson V Georgia-Pacific, Et Al. Christopher R. E. Coggins, PH. D. In the State Court of Dekalb County State of Georgia. Martha Dickerson. VS. Georgia-Pacific, LLC. Civil Action File No.:14A50080-1, 23 March 2016 and 12 July 2016, Truth Tobacco Industry Documents, Bates no: 537348052-537348315, accessed October 2017
  61. W. Wan, Big Tobacco’s new cigarette is sleek, smokeless- but is it any better for you?, The Washington Post, 11 August 2017, accessed October 2017
  62. British American Tobacco, The health risks of our products: Tobacco Heating Products, BAT website, undated, accessed October 2017
  63. B. Titz, S. Boué, B. Phillips, et al, Effects of cigarette smoke, cessation, and switching to two heat-not-burn tobacco products on lung lipid metabolism in C57BL/6 and Apoe−/− Mice—an integrative systems toxicology analysis. Toxicological Sciences 2016;149:441–57
  64. F. Lüdicke, G. Baker, J. Magnette, et al. Reduced exposure to harmful and potentially harmful smoke constituents with the tobacco heating system 2.1. Nicotine & Tobacco Research 2017 Feb: 19(2): 168-175
  65. L. Wheeler, Tobacco giant asks the FDA to approve ‘less risky’ cigarette, thehill.com, 23 August 2017, accessed September 2017
  66. Y. Abutaleb, U.S. senators ask FDA to reject Philip Morris’ iQOS application, Reuters, 7 February 2018, accessed February 2018
  67. R. Proctor, Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition. 2012: University of California Press
  68. Action on Smoking and Health, ASH reaction to new Philip Morris IQOS ‘heat not burn’ product, ASH website, 30 November 2016, accessed October 2017
  69. ASH Scotland, New tobacco products: heat-not-burn ASH Scotland Viewpoint, ASH Scotland website, December 2016, accessed October 2017
  70. ASH Wales Cymru, Heat not burn products, ASH Wales website, undated, accessed October 2017
  71. 71.0 71.1 R. Auer, N. Concha-Lozano, I. Jacot-Sadowski et al., Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name, JAMA Internal Medicine, 2017 Jul 1;177(7):1050-1052, accessed February 2018
  72. 72.0 72.1 72.2 T. Lasseter, P. Bansal, T. Wilson et al., Special Report: Scientists describe problems in Philip Morris e-cigarette experiments, Reuters, 20 December 2017, accessed February 2018
  73. T. Uranaka, Philip Morris says it has doubled supply of iQOS tobacco device in Japan, Reuters, 1 March 2017, accessed July 2017
  74. B. Elder, Imperial sighs after broker waves away vaping scepticism. Financial Times, 21 August 2017 (paywall)
  75. 75.0 75.1 75.2 75.3 WHO Tobacco Free Initiative, Heated tobacco products (HTPs) market monitoring information sheet, WHO website, July 2018, accessed February 2020
  76. Euromonitor International. Global Tobacco: Key Findings Part 3- Vapour Products. November 2015
  77. 77.0 77.1 World Health Organization Tobacco Free Initiative, Heat-Not-Burn tobacco products information sheets, WHO website, September 2017, accessed February 2018
  78. Secretariat of the Framework Convention on Tobacco Control, WHO Framework Convention on Tobacco Control Secretariat’s statement on the launch of the Foundation for a Smoke-Free World, WHO website, 19 September 2017, accessed February 2018
  79. 79.0 79.1 World Health Organization, The Convention Secretariat calls Parties to remain vigilant towards novel and emerging nicotine and tobacco products, FCTC press release, 13 September 2019, accessed October 2019