Heated Tobacco Products: Philip Morris International

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Image 1: PMI’s IQOS and HEETS tobacco sticks (Source: Screengrab from uk.iqos.com, 15 June 2021)

PMI’s flagship heated tobacco product (HTP), called IQOS, was first trialled in Milan (Italy), and then Nagoya (Japan) in 2014.1

What is IQOS?

IQOS uses a battery-operated device that heats tobacco sticks called HEETS, which are available in several flavours. The sticks are also sold under cigarette brands Marlboro and Parliament in some countries.]2 IQOS heats the tobacco up to 350°C, compared to 600 °C in cigarettes, and therefore, according to PMI there is no “combustion, fire, ash, or smoke” and “the levels of harmful chemicals are significantly reduced compared to cigarette smoke”.3 A subsequent peer reviewed study, using PMI’s clinical data, concluded that IQOS was “not detectably different” from cigarettes, in terms of potential harmful effects.45 PMI publishes its own evidence on IQOS on its PMI Science website.

PMI also sells an e-cigarette under the IQOS brand, called IQOS Mesh. For information see E-Cigarettes: Philip Morris International

Product Innovation

In 2019, PMI launched brand extensions IQOS Multi and IQOS Duo (see image 1).2

PMI has a second HTP product under development, called TEEPS, which uses a carbon heat source to heat the tobacco sticks.6 The company has alleged that this product is closer to the look and feel of a conventional cigarette than IQOS. 7  PMI conducted a “small scale city test” of TEEPS in the Dominican Republic in December 2017, and intended to “consumer test” the product in late 2020.89 As of June 2021, TEEPS did not yet appear to be on the market.6

In February 2021, PMI announced to investors that it planned to launch another device later in the year called IQOS ILUMA.210

Markets and Launches

After first launching in 2014, by 2016 IQOS accounted for 99% of the global HTP market, according to Euromonitor data.11 Although competition increased in subsequent years, IQOS continued to hold by far the largest share.41112

Image of a list of IQOS launch markets by year 2014 to 2019, organised by world bank income level

Image 2: IQOS launches by year (Source: STOP report February 2020)4

Market authorisation in the US

By the end of 2019 IQOS was available in at least 47 markets, including the United States (US).4 This followed authorisation from the US Food and Drug Administration (FDA) to launch the product on the US market, which PMI had applied for in 2017.13 14 PMI launched IQOS in the US in 2019, initially in Atlanta, Georgia.15 In July 2020, it was reported that Altria was also selling IQOS in Richmond (Virginia) and Charlotte (North Carolina), with plans to roll out to four more US cities in the following 18 months.16 For more information on global market shares see Heated Tobacco Products.

Marketed in lower income countries

PMI has mainly sold IQOS in high income countries. However, it is also increasingly marketing its products in lower income countries (see Image 2). Although not officially launched, there is evidence that IQOS was available in 2018 in Vietnam, Indonesia and the Philippines, described by PMI as “key markets”. 41718 PMI indicated that it intended to formally launch IQOS in the Philippines in the second quarter of 2020, subject to meeting “some regulatory and legal requirements”.18

On 17 February 2020, PMI launched the product in Lebanon.19 IQOS had been sold previously in airport duty free stores in both Lebanon and Saudi Arabia.20

Marketing during Covid-19 pandemic

During 2020, at the height of the Covid-19 pandemic, PMI’s IQOS launches continued. In July 2020, it launched in Georgia.21 In the Philippines, the product first went on sale online and in some independent retail outlets in April 2020, with IQOS stores opening in Manila in September and October.222324 In October, PMI also announced that it had launched in Jordan, although the precise timing and nature of the launch was unclear.2225 In 2020, Jordan had the world’s highest smoking rates, and was reported to have experienced a large amount of tobacco industry interference, including by PMI.26 For more information see the Eastern Mediterranean Region page.

PMI formally launched IQOS in Costa Rica in October.27 PMI said that this took their total number of IQOS markets to 61, “of which half are outside the OECD”.22 IQOS was already available in Mexico, although, after considerable lobbying, the company failed to get the Mexican government to approve its import or promotion there.2829

The Australian government also continued to reject the product, as well as e-cigarettes. For more information see Heated Tobacco Products

According to PMI, by the end of 2020, IQOS was “commercialised” in 64 markets.230IQOS is not yet on sale in Indonesia, PMI’s largest market for cigarettes.20222

Closed IQOS Stores In the UK

In the UK, where the overall market for HTPs is small, Philip Morris Ltd (PML) opened specialist IQOS stores in London, Bristol, Manchester and Cardiff.20 However by June 2021, most of them were permanently closed, likely due to the impact of the Covid-19 pandemic.231 PML appeared to shift its retail focus to independent grocery retailers and other potential stockists, reportedly doubling the size of its UK sales force.3233

IQOS users

PMI releases frequently updated estimates of the number of smokers who it says have stopped smoking and switched to IQOS.3435 However, it is not clear how it arrives at these estimates, as PMI does not release all of its data, and so they can not be independently verified. PMI conducted some user studies (which it submitted to the FDA),36 but these were run over periods of only 4-6 weeks which limits the ability to generalise the findings as a reflection of sustained behavioural change. The FDA’s 2020 decision on IQOS (see below) states that PMI must conduct post market surveillance studies in the US, which may provide a more accurate picture of conversion rates.36

PMI also estimates the number of users in the process of “conversion” to using IQOS.3435. However, these are based on a seven day assessment only,34 which limits the ability to generalise the findings as a reflection of sustained behavioural change. It is likely that the number of people who use IQOS exclusively is lower than PMI’s estimates.437

In 2020, PMI claimed that over 10 million smokers had “switched” to IQOS, with another 4 million “in conversion”.3538 In its 2020 Annual Report the switching figure had risen to 12.7 million.2 It states that its “aspiration” is for the number of smokers switching to IQOS to exceed 40 million by 2025.39

For definitions of ‘cessation’, more details on PMI’s user estimates, the evidence on dual use, and its attempts to promote IQOS as a cessation tool, see PMI’s IQOS: Use, “Quitting” and “Switching”.

Promoting IQOS and “Smoke-Free”

Although it does not disclose its marketing spend, PMI has allocated a large amount to advertising and promoting IQOS.344 As well as retail websites and distribution deals, it has established dedicated ‘concept’ stores around the world to promote its products direct to its customers, with multiple stores in some cities.20 It has developed sophisticated, multi-platform advertising campaigns, using traditional and social media. (For examples see images from Stanford University’s research into the impact of tobacco advertising and work by the Campaign for Tobacco Free Kids). It has also promoted its products at music festivals and cultural events in glamourous locations around the world.42040 PMI has been accused of marketing IQOS and other NGPs to youth, including through the use of paid social media influencers.420404142

PMI’s promotion of IQOS is inextricably linked to its “Smoke-Free” public relations strategy, and campaigns such as “Hold My Light” and “UnSmoke Your World”. Research published in February 2020 by Stanford University shows how PMI’s promotional activities not only replicate advertising strategies used in the past to promote cigarettes, but also help to “normalize” the company and its heated tobacco products in the eyes of the consumer.44043 This normalization increases pressure on policy makers to regulate these products in ways that benefit the industry, particularly in lower income countries.

Submitted Modified Risk Application to FDA

In December 2016 PMI submitted an application to the FDA to approve IQOS as a “Modified Risk Tobacco Product” (MRTP).4445 In 2018, the US Tobacco Products Advisory Committee (TPSAC) recommended against approving PMI’s application to market IQOS as a reduced risk product.46

On 7 July 2020, the FDA partially authorised PMI’s MRTP application. While it concluded that the data PMI submitted showed that IQOS may reduce exposure to harmful substances, it did not agree that IQOS reduces the risk of disease and death, compared to smoking cigarettes, and so had failed to meet the higher standard of “risk modification”. PMI used the US-specific MRTP order granted by the FDA to further promote IQOS and push for its approval, or deregulation, in multiple countries around the world. For more background see Heated Tobacco Products. For details and examples see PMI Promotion of IQOS Using FDA MRTP Order.

PMI submitted a new MRTP for IQOS 3 in 2021.47

For information on all PMI’s NGPs, its collaborations, and how it uses its products to undermine public health, see Next Generation Products: Philip Morris International.

TobaccoTactics Resources

Relevant links

TCRG Research

References

  1. Philip Morris Japan Limited, Country: Japan, PMI website, undated, accessed December 2019
  2. abcdefgPhilip Morris International, 2020 Annual Report, accessed June 2021
  3. Philip Morris S.A., IQOS explained, PMI website, undated, accessed December 2019
  4. abcdefghijStopping Tobacco Organizations and Products, Addiction At Any Cost: The Truth About Philip Morris International, STOP report, 20 February 2020
  5. Glantz, S.A., PMI’s own in vivo clinical data on biomarkers of potential harm in Americans show that IQOS is not detectably different from conventional cigarettes, Tobacco Control, 2018; 27;9-12
  6. abPhilip Morris S.A., Carbon heated tobacco product TEEPS, PMI website, undated, accessed December 2019
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  14. PMI Submits Pre-Market Application for Heat-Not-Burn, Convenience Store News, 31 March 2017, accessed December 2019
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  20. abcdefM. Davies, B. Stockton, M. Chapman, T. Cave, The ‘UnSmoke’ Screen: The Truth Behind PMI’s Cigarette-Free Future, The Bureau of Investigative Journalism, 24 February 2020, accessed February 2020
  21. Philip Morris Georgia Launches IQOS in Georgia, Forbes Georgia, 24 July 2020, accessed October 2020
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  27. Philip Morris Costa Rica anunció la llegada de su dispositivo electrónico IQOS  (Philip Morris Costa Rica announced the arrival of its electronic device IQOS), Revista Summa, 12 October 2020, accessed October 2020
  28. FCTC Secretariat, Mexico prohibits the import of electronic cigarettes and heated tobacco products, 19 February 2020, accessed October 2020
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  36. abFood and Drug Administration, Scientific Review of Modified Risk Tobacco Product Application (MRTPA), 30 June 2020
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  38. Philip Morris International, Science, Data, and Facts Should Unite Decision-Making, Says PMI CEO in Speech at Concordia Summit, Business Wire, 24 September 2020, accessed September 2020
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