Heated Tobacco Products

This page was last edited on at

As the harms from conventional products have become better understood, and tobacco control measures have been put in place, the cigarette market – from which tobacco companies make most of their profits – has started to shrink. To secure the industry’s longer-term future, transnational tobacco companies (TTCs) have invested in, developed and marketed various newer nicotine and tobacco products.1

Since the early 2000s TTCs have developed interests in e-cigarettes (also known as electronic delivery systems, or ENDS), heated tobacco products (HTPs), snus and nicotine pouches.  Companies have referred to these types of product as ‘next generation products’ (NGPs) although terminology changes over time.

This 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. It does not include all research updates on the potential health benefits/risks of HTPs but does refer to some key and emerging independent analyses. It primarily looks at how the tobacco industry uses its own scientific studies, and the concept of harm reduction, to further its business goals.

Background

Unlike e-cigarettes, HTPs contain tobacco.2 The World Health Organization (WHO) describes the tobacco in these products as being “heated without reaching ignition to produce an emission containing nicotine and other chemicals”.3 According to tobacco companies, by heating the tobacco, rather than burning like conventional cigarettes, the formation of harmful substances created at high temperature associated with combustion is significantly reduced.4 This tobacco industry reduced-risk claim has yet to be fully supported by independent scientific evidence, as discussed below. IQOS, produced by Philip Morris International (PMI) is the most widely available HTP, with by far the biggest share of the heated tobacco market, but the other big three transnational tobacco companies (TTCs) all now have HTPs, Imperial Brands being the last to launch a product in 2019 (see below). South Korean tobacco company KT&G also has a growing share of the HTP market and, in 2020, a new partnership with PMI to commercialise KT&G’s range of Lil HTPs and e-cigarettes.56 China National Tobacco also has an HTP called Mok.78 This page focuses on the four main transnational tobacco companies and their interests in HTPs.

In 2017, the British Government classified HTPs into three categories:9

  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.[referred to here as HTP ‘hybrids’]

In its 2020 briefing the WHO identified the same three types, with the addition of new carbon tipped devices.3

The images below shows examples of tobacco companies’ HTPs. The images are screenshots from the manufacturers’ websites taken in June 2017, with the exception of Imperial’s Pulze (2019).10

Image 1. PMI’s IQOS

Image 2. BAT’s iFuse

Image 3. JTI’s PloomTech

Image 4. BAT’s glo

Image 5: Imperial’s Pulze

Despite significant media attention on the tobacco industry’s HTP pursuits,111213 and the technology being initially marketed as “a real game changer”,14 in 2019 HTPs still represented less than 2% of the retail value of the global tobacco market, according to market research company Euromonitor International.15 Conventional tobacco products (mainly cigarettes) continued to dominate the market.

Heated Tobacco Product Technology Pioneered in 1980s

Image 7: Accord Advertisement by Starcom Media Services16

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, the American tobacco company RJ Reynolds (RJR) launched the first HTP, Premier, in several American cities.1718 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”.17 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 2014.24

In 1998, Philip Morris launched its first HTP, called Accord, under the slogan “the time is right” (Image 7).25 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.1626 Accord remained on the market until 2006, when it was discontinued due to poor sales.27 Consumers allegedly complained that the product was not as satisfying as conventional cigarettes.27 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.28

It appears as though none of the early HTPs gained commercial success, and none were marketed as potentially less harmful. A 2016 study by Dutra et al.29 concluded that the tobacco industry’s early HTP pursuits were primarily driven by non-health related reasons: 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 (by then owned by British American Tobacco) launched Revo (allegedly a revamped version of Eclipse) under the banner “an unconventional cigarette”,30 PMI introduced IQOS (allegedly a revamped version of Accord)31 under the banner “this changes everything”,32 and BAT launched iFuse in 2015.33

By early 2018, all transnational tobacco companies except Imperial Tobacco had included 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.343536 In 2019, Imperial Tobacco (now Imperial Brands) also launched an HTP.37

By 2019, BAT and PMI were testing devices using a carbon tip as the heat source (details below).

Japan Tobacco International

In 2010, JTI acquired a 27% share in San Francisco-based entrepreneurial company Ploom Inc., signing an agreement to commercialise Ploom Inc.’s HTP outside the US.38 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.40 These HTPs heat small pods of tobacco, through a capsule of e-liquid, and so are referred to on TobaccoTactics as HTP ‘hybrids’.  By 2019, the company had multiple Ploom products in its portfolio, with  pods sold under the Winston and Mevius brands.4142 In the US, PloomTech is marketed as Logic Vapeleaf.43

Philip Morris International

PMI first launched IQOS 44 in the second half of 2014 in Italy, and later trialled the product in Japan.45 It was reported at the time that IQOS  stood for I Quit Ordinary Smoking. However, this claim has been denied by PMI, and tobacco control researchers warn against the use of this misleading term.46

The electronic device heats tobacco sticks, called HEETS. According to PMI, in February 2018 IQOS was available in around 30 countries.47 By 2021 PMI stated that IQOS was on sale in 64 markets.48 Its 2021 report stated that “As of year-end, our smoke-free products were available in 71 markets, of which 30 are classified as low- and middle-income markets.” (Note that this may have included some markets where only its e-cigarette Veev was available).49

Altria has an agreement with PMI to distribute and market its HTPs and e-cigarettes  in the US.  PMI also has a distribution deal with South Korean tobacco company KT&G for its  ‘lil’ products.

PMI applied to have IQOS classified as a Modified Risk Tobacco Product (MRTP) by the US Food and Drug Administration (FDA) in December 2016.5051 On 7th July 2020, PMI was granted an exposure modification order for IQOS, but denied a risk modification order.5253

PMI has been testing a carbon tip device, called TEEPS 5455 This is likely to be similar to BAT’s Neocore device (see below). As of June 2022, TEEPS did not appear to be on the market 56 Both companies have stated that these products resemble traditional cigarettes.545557

British American Tobacco

BAT initially focused its newer product 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, which creates a vapour which is passed through a tobacco pod (similar to JTI’s PloomTech).58 In 2016, BAT launched Glo, which the company claimed was “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).59]60 According to BAT, glo is a simpler and more practical alternative to IQOS.61 In 2017, the product was sold in five countries.62 By 2019, glo was sold mainly in the large markets of Japan and South Korea, and the product was being rolled out in other countries, including in Eastern Europe, Russia and Canada,6364 although it was discontinued in Canada in 2019 in favour of BAT’s e-cigarette Vype.65 By June 2022, BAT stated that glo was available in 25 markets, with 20 were listed on the glo website.6667

The company was also developing a carbon tip device, under the name NeoCore.57 This appeared to be a version of an earlier Reynolds product Revo, renamed Eclipse (BAT acquired Reynolds in 2017).57 Although Neocore was cleared for sale by the FDA, and BAT were reported to be testing the product with consumers in 2018,68 it did not appear on the market and by July 2020 was no longer on BAT’s website.576769

Imperial Brands

At the end of 2017, Imperial Brands (previously Imperial Tobacco) was the only transnational tobacco company not selling HTPs. The company’s newer product 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’”.70 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.71

However in early 2018, apparently under pressure from shareholders, Imperial announced that it was after all developing and trialling HTPs.72737475 In May 2019, Imperial’s HTP Pulze was launched in Fukuako, Japan.767778 As of 2022, Imperial’s HTP appeared to be undergoing consumer testing in Greece and the Czech Republic.79

Global HTP Market

Rapid growth

Since 2014, the HTP market has grown rapidly, and remains dominated by PMI (see below). According to Euromonitor International, in 2014, 100,000 devices and just over 15 million HTP sticks were sold worldwide. In 2021, this had increased to nearly 30 million devices and over 125 billion sticks.80 In the same period, the global retail value of HTPs (devices and sticks) nearly doubled from around US$15.6 million to US$28.7 billion (Figure 1).15 (All figures rounded)

Figure 1: Relative retail value of tobacco products, in $US, 2014-2021. NB graph shows values above US$600,000 million. (Source: Euromonitor International)

Devices vs sticks

The composition of retail sales changed over this period. In 2014, HTP sticks accounted for around one third of the total by value, and devices for the remaining two thirds. By 2020, the sticks made up over 90%.80 This is likely due to the high initial uptake and purchase of devices.

Company shares

In terms of company market shares, slightly different pictures emerge for devices and sticks. The devices, which do not contain any tobacco, are bought separately and less frequently than the sticks. Thus, the market share for HTP sticks should be considered comparable to the cigarette market. In 2016, PMI held 75% of the device market and nearly 90% of the HTP stick market.80 Over the next few years, JTI and BAT began to challenge this dominance, with Ploom and glo devices respectively. Since 2018, PMI’s share of the market for HTP devices has fluctuated between 50% and 70%, and as of 2021 stood at 61%.80 KT&G’s share increased to around 5%, prior to its distribution deal with PMI in 2020.15 Although PMI’s share of the HTP stick market has also been challenged by BAT and JTI, in 2021(as summarised in the table below) it continued to dominate:80

Key markets

The key regional markets for HTPs are in South East Asia, which accounted for over half the total global value by 2020. Japan remains by far the biggest single country market for HTPs.  The table below shows the markets with the highest number of sales of HT sticks in 2021.80 (All figures rounded)

The WHO stated in 2020, that HTPs may still be available in markets where they are in theory banned from sale.81 See below for more on the regulation of HTPs.

Still a Small Part of the Global Tobacco Business

According to Euromonitor data, in 2021, HTPs represented 3% of the global retail value of all tobacco products (Figure 4). this represents a doubling in value since 2018, and now appears to have overtaken that of e-cigarettes. Smokeless tobacco accounts for a smaller share, around 1%. (Note that Euromonitor does not include nicotine pouches, which do not contain tobacco leaf, in its smokeless tobacco data).80

Figure 2: Relative value of tobacco products, global, 2021 (Source: Euromonitor International)

Cigarettes and other conventional tobacco products still represent the bulk of the market and are likely to do so for the foreseeable future.

HTP Adoption Rates

Japan and South Korea

BAT, PMI and JTI have used Japan, and to a lesser degree South Korea, as trial markets for their HTPs. Both tobacco markets are dominated by companies which were former state monopolies, Japan Tobacco and Korea Tomorrow & Global Corporation (KT&G), with PMI in second place in both cases.  Both had very high smoking rates and a preference for low tar brands, which may make alternatives more appealing.82

Preliminary sales reports by the tobacco companies and industry analysts showed strong adoption rates of HTPs. According to PMI, by March 2017 the tobacco company had sold three million IQOS devices in Japan, saying that “demand continues to outstrip supply”.83 In 2018, BAT’s market research, conducted by Kantar estimated the prevalence of HTP use was much higher at around 5%.84 However, the sample was drawn from three urban areas, and therefore was not representative of the whole population. This study did not identify brand preferences.

Independent academic analysis of data from the 2018 International Tobacco Control (ITC) Japan Survey, a nationally representative web survey,  found that the overall prevalence of HTP use was 2.7% , equivalent to nearly 4.4 million people if applied to the whole population of Japan.85 The researchers found that over 60% of HTP users reported using IQOS devices (representing approximately 2.6 million people).85 IQOS was preferred by younger people and daily users, while JTI’s Ploom TECH was more popular among older people and less regular users.85. In contrast to PMI’s claims, the researchers found that most users of HTPs also smoked combustible cigarettes.85

It has been suggested that the success of HTPs in Japan might be connected to restrictive e-cigarettes being banned in the region.8685 E-cigarettes containing nicotine liquid are covered by pharmaceutical regulation, and as of 2020 have not been approved for sale in Japan.87 Japanese consumers being more receptive to innovative products,62 and cultural values prevalent in Japan which do not necessarily apply to other markets.8889

Researchers have raised concerns that as IQOS was marketed in Japan as a high tech, aspirational product it might appeal more to youth and young adults.8589 A study based on 2017 data found that HTPs were being used by Japanese adolescents, although still at lower rates than combustibles and e-cigarettes.90

Philip Morris used a similar marketing approach when it launched IQOS in South Korea in June 2017.91 Research conducted three months later found that “Awareness, experience and use of IQOS among young Korean adults were relatively higher than among their Japanese counterparts”.92 Subsequent studies found high poly use of products (HTPs, e-cigarettes and conventional cigarettes) among young people in South Korea.9394

Europe and North America

A recent survey of over 40,000 US adults found that over 8% were aware of HTPs, but only 0.5% reported ever using them (all figures rounded). The data also showed adult use of HTPs was higher amongst current users of other nicotine and tobacco products, like cigarettes and e-cigarettes.95

Research in the US has shown HTPs were likely to appeal to adolescents and young adults.9697 A national survey found 0.7% of middle and high school students reported using a HTP in the past 30 days.98

HTP use is markedly higher across Europe, and rising. A 2017-18 survey found 1.8% of participants from 11 European countries had ever used a HTP (the highest figure in Greece) and 0.1% were current users.99 2020 data from 28 European countries found 6.5% had ever used a HTP (the highest being nearly 15% in Czech Republic) and 1.3% were current users.100 Both these studies also noted HTP use was more common among younger people, and former and current smokers.

A study across Canada, England and the US found that, on average, in 2017, 7% of 16- to19-year-olds reported awareness of IQOS with the highest figure in the US. The same study found that around 40% expressed an interest in trying IQOS.101

Take up supported by favourable taxation?

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 (50% lower than conventional cigarettes, and at the same level as e-cigarettes) as well as more lenient packaging and marketing regulations.102103104 Research from Italy indicated that PMI’s annual sales of IQOS grew from 11 tonnes in 2015, to 83 tonnes in 2016, and 519 tonnes in 2017.103 In contrast, in July 2017, BAT Chief Executive Nicandro Durante reported that BAT had seen “no success whatsoever” with glo in European markets like Italy and Switzerland.30 By 2019, BAT appeared to have had a little more success Italy, having gained around 15% of the market by value, but PMI continued to dominate.15

The FCTC requires that HTPs are taxed as tobacco products, but they are taxed more favourably than cigarettes in a number of countries (see The Campaign for Tobacco Free Kid’s web pages on global tobacco taxation). It is not clear if this always results in lower prices for the consumer, and how this relates to consumption and adoption rates. A research study in 2018 concluded that: “The tax advantages being given to HTPs may instead of providing a price signal to a consumer looking to switch, be providing a profit signal to tobacco companies to switch over to selling more HTPs and fewer combusted cigarettes”.105

In 2020, the European Commission announced a review of tax rates for HTPs and e-cigarettes, with a view to achieving harmonisation of product definitions and taxation. The consultation phase was announced on 2 June, and intense lobbying for the tobacco industry was anticipated.106107108 The US based Tax Foundation, a think tank with tobacco industry links, published an article the next day detailing existing tax rates in Europe and outlining proposals for change.109

Harm Reduction: A Tobacco Solution to a Tobacco Problem?

Tobacco companies frame HTPs as less harmful alternatives to cigarettes, while the WHO continues to urge caution, stating that independent scientific evidence does not bear out these claims.

Research on heated tobacco products (HTPs) is less developed than that relating to e-cigarettes.110111 However, the general independent scientific consensus is that when smokers switch fully from conventional cigarettes to HTPs, they are exposed to reduced levels of some harmful substances.112   However, HTP users are also exposed to higher levels of other potentially harmful substances and the subsequent risks of harm, especially after long-term use, remain unknown.112 113 There is also no reliable evidence that they help people stop smoking cigarettes.112

The UK Cochrane review, published in January 2022, noted that to date all randomised control trials (RCTs) assessing the safety of HTPs had been funded by tobacco companies. Of the eleven trials eight were “at unclear risk of bias and three at high risk”.112 The Cochrane reviewers concluded that: “Independently funded research on the effectiveness and safety of HTPs is needed.”112

The Industry Narrative

RJ Reynolds’s executive Steven Alderman testified in an American court in 2016 that there is no such thing as a ‘safe’ tobacco product.114 Yet, some tobacco manufacturers have marketed HTPs with direct and indirect claims that they are less toxic or less harmful than conventional cigarettes.115116117

BAT and PMI have set up dedicated websites (bat-science.com, pmiscience.com) to showcase their harm reduction efforts, and have published some of their findings in scientific journals.11811984120121

In December 2016, PMI submitted a ‘modified risk tobacco product’ (MRTP) IQOS application to the US Food and Drug Administration (FDA), which if successful, would allow PMI to market IQOS in the US as with specific reduced risk claims.122 In line with the Tobacco Products Advisory Committee 2018 recommendation in 2018123

On 7 July 2020, the FDA partially approved PMI’s 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”.113 Nevertheless, immediately after the FDA’s decision, PMI launched an international PR campaign, calling it a “public health milestone” (see below).113124 PMI stated that they intended to pursue full approval, and that the FDA had “left the door open to continue the dialog with them on precisely the next level”.125

Although BAT indicated that it would undertake similar regulatory steps with glo, as of June 2022 BAT had not submitted an application to the FDA.30

Emerging Independent Evidence

Public health advocates have cautioned that the short and long-term health effects of HTPs remain unclear, and that due to the tobacco industry’s long history of deceit over the health risks of smoking,126 there is an urgent need for independent evidence.127128129

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.2

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”.130 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, incomplete combustion (a chemical process known as ‘pyrolysis’) can also produce cancer-causing chemicals. Importantly, the authors demonstrate that pyrolysis occurs in IOQS.130 PMI acknowledges this in its own research.131

In line with this, a 2022 review by independent researchers found that emissions from IQOS could be defined as both aerosol and smoke, and that smoke can arise without combustion. Further, the existing evidence confirms that IQOS releases potentially harmful chemicals, albeit at lower levels than cigarettes on a per stick basis. However, the researchers go on to explain that PMI’s studies may underestimate the yields of harmful chemicals in IQOS emissions. When comparing levels based on tobacco mass in each product, IQOS emits roughly twice as much tar and nicotine compared to cigarettes.132

In December 2017, following concerns raised by former PMI employees and contractors  over “a number of irregularities” involving clinical trials that underpin PMI’s application to the FDA.133 Reuters conducted an independent investigation. They found 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 a second investigator had submitted urine samples exceeding human levels, 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”.133 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”.133

In 2018, researchers at the Center for Tobacco Control Research and Education at the University of California San Francisco (UCSF) published their research into PMI’s HTPs.31  They reviewed leaked internal industry documents relating to the IQOS “precursor” Accord as well as contemporary company documents and communications, and PMI’s MRTP application. They found that:

“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.”31  

Their research showed that the design of IQOS (and its marketing statements) were similar to those for Accord, and therefore IQOS was a new product variant, but “without consistent improvements in exposure to aerosol toxic compounds”.31 They concluded that:

“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 likely not the result of any toxicological difference between Accord and IQOS, but rather a change in the social and regulatory landscape permitting these claims.”31 

An analysis of IQOS commissioned by the Italian Government also concluded that PMI’s reduced risk claims did not hold up. An investigation in 2020 by the Organized Crime and Corruption Reporting Project (OCCRP) and Italian broadcaster Radiotelevisione Italiana (RAI) found that Italy’s National Health Institute had conducted analysis on HTPs, after being approached by PMI.134135136  The Institute reported its findings to the Italian government after a reduction in tax on HTPs (to 50% of that of combustible cigarettes) had been approved by parliament.135137

In early June 2020, Italy’s Health Ministry released a summary of this research which concluded that:

 “The scientific data presented … is not enough to establish that [IQOS] reduces the risk of the product compared to combustion products with the same conditions of use” (translated by OCCRP from Italian).135

PMI itself stated in its MRTP application to the FDA that:

“It has not been demonstrated that switching to the IQOS system reduces the risk of developing tobacco-related diseases compared to smoking cigarettes”.113138

The 2020 TCRG/STOP briefing provides a more detailed, but accessible, explanation and critique of the FDA’s authorization of IQOS as an MRTP.113

A Cochrane review published in January 2022, found very limited data on the effectiveness of HTPs as smoking cessation aids and thus concluded their use to help smokers quit remains uncertain. The authors did identify two time-series studies, which showed an accelerated decline in cigarette sales following the introduction of HTPs to the Japanese market. However the authors went on to explain “[t]his evidence was of very low‐certainty as there was risk of bias, including possible confounding, and cigarette sales are an indirect measure of smoking prevalence.”112

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,139 “in pursuit of profit rather than public health”,140 and should be subjected to the same policy and regulatory measures applied to all tobacco products, in line with the FCTC.139

Regulation of HTPs

At the FCT Conference of the Parties in 2018 (COP 8), the parties agreed to regulate HTPs as tobacco products under the FCTC Articles and guidelines.141 In March 2019, the Secretariat of the WHO FCTC issued an information note, which compiled all Conference of the Parties (COP) decisions related to novel tobacco products, including HTPs.142

Individual countries are at different stages in their regulation of HTPs; some have banned them outright, while some in Europe have allowed their sale under certain regulatory conditions.143144145 For more information see the Global Tobacco Control website.

There were some significant changes to regulation in the late 2019 and early 2020. In December 2019, India passed a law banning HTPs, e-cigarettes and all similar devices.146 In February 2020, Mexico banned the import of HTPs and e-cigarettes by Presidential Decree.147 In June 2020, the Australian government’s Therapeutic Goods Administration (TGA) made an interim judgement rejecting the sale of HTPs, which became final in August 2020, in the face of considerable lobbying from PMI to allow the sale of IOQS in Australia.148149150151  The TGA concluded in its final judgement that:

“maintaining the current scheduling for HTPs is necessary to protect public health from the risks associated with introducing a new nicotine product for non-therapeutic use.”149

In September 2019, the FCA Secretariat released a statement urging governments to remain vigilant towards emerging nicotine and tobacco products.152 Tobacco control researchers have pointed out “there is nothing in US law or the FCTC that prevents authorities from prohibiting HTPs”.51

PMI Promotion of HTPs

Even before the FDA granted IQOS “modified exposure” status, there was evidence of PMI promoting their HTP as a reduced risk product outside the US, where regulations on marketing are less stringent.117143153154 The TCRG/STOP briefing identifies the potential for misrepresentation of the partial approval applying to the marketing of IQOS in the US.113 Research from the US in 2020 anticipated PMI’s promotional tactics, concluding that “reduced exposure claims as well as reduced risk claims on PMI’s IQOS product packaging are likely to mislead consumers, especially youth, and thereby endanger public health.”97

On 27 July 2020, the WHO issued a statement reminding parties that “Heated tobacco products are tobacco products” and that, while the US is not a signatory, where countries are signed up to the FCTC, it fully applies to HTPs.155 In relation to health impacts, it stated:

“WHO reiterates that reducing exposure to harmful chemicals in Heated Tobacco Products (HTPs) does not render them harmless, nor does it translate to reduced risk to human health. Indeed, some toxins are present at higher levels in HTP aerosols than in conventional cigarette smoke, and there are some additional toxins present in HTP aerosols that are not present in conventional cigarette smoke. The health implications of exposure to these are unknown.(…) Given that health may be affected by exposure to additional toxins when using HTPs, claims that HTPS reduce exposure to harmful chemicals relative to conventional cigarettes may be misleading.155

The WHO also drew attention to the FDA’s specific conditions requiring monitoring of youth use and exposure, and that PMI must not use the FDA decision to mislead consumers:

“Even with this action, these products are not safe nor “FDA approved.” The exposure modification orders also do not permit the company to make any other modified risk claims or any express or implied statements that convey or could mislead consumers into believing that the products are endorsed or approved by the FDA, or that the FDA deems the products to be safe for use by consumers.”155156

In 2020 PMI began quoting the FDA decision in its press releases and media interviews around the world, pushing for a greater acceptance of IQOS, more favourable regulation of HTPs, and to allow their introduction in countries where they are currently, or soon to be, banned. For example, in Hong Kong, various media outlets have published articles in which the FDA decision has been used to advocate against a proposed ban on newer products.157158

On 1 September 2020 the Mexican Ministry of Health made a public statement referring to PMI’s “aggressive” campaign for IQOS in Mexico, including its misleading use of the FDA decision.159 This statement reiterated the ban on the import of HTPs, and made clear that the Mexican government had not granted IQOS any form of reduced risk status, and that it did not support its use as a tool to stop smoking. It also confirmed that, while the product was already being marketed in Mexico, doing so remained illegal. The Ministry of Health reaffirmed the WHO position; that HTPs are tobacco product, and should be regulated as such, and that any interference in public health by the tobacco industry should be resisted.159

Bath TCRG researchers, in an editorial published in the British Medical Journal (BMJ) in September 2020, warned that the FDA’s decision was likely to lead to “regulatory confusion” in respect of HTPs.160 They reiterated the WHO recommendation to regulate HTPs as tobacco products, and urged the FDA to “make its terminology clearer to ensure products which meet only reduced exposure criteria cannot be misrepresented as reduced harm”.160

PMI has made a number of attempts to promote IQOS to governments as a cessation tool, supported by its own estimates of IQOS use. It downplays the evidence on dual use with cigarettes and the potential for uptake by non-smokers including youth.

Patent Challenges

In 2020, BAT and PMI had active legal claims against each other, in relation to patents for the tobacco heating technology in IQOS and glo.161 A court ruling in 2021 limited Altria’s distribution of PMI’s IOQS in the US.162 In September that year, the US International Trade Commission banned the import of IQOS into the US, to take effect in November.163164165166 According to Bloomberg news PMI said it would ask the U.S. Trade Representative to veto the import ban and appeal the decision.164 As of June 2022 the legal cases were ongoing.

Relevant Links

TobaccoTactics Resources

TCRG Research

References

  1. STOP, Addiction At Any Cost: The Truth About Philip Morris International, 20 February 2020, accessed January 2021
  2. abWorld Health Organization Tobacco Free Initiative, Heated tobacco products (HTPs) information sheet], WHO website, 2018, accessed July 2019
  3. abWorld Health Organization, Heated Tobacco Products: A brief, 2020
  4. Philip Morris International, Heat-Not-Burn, undated, accessed October 2017
  5. J. Lee J, S. Lee, Korean-made heated tobacco product, ‘lil’Tobacco Control, 2019;28:e156-e157, doi:10.1136/tobaccocontrol-2018-054430
  6. Philip Morris International Inc. Announces Agreement with KT&G to Accelerate the Achievement of a Smoke-Free FutureBusiness Wire, 28 January 2020, accessed August 2020
  7. New HNB from China Tobacco, Tobacco Asia, 30 May 2019, accessed August 2020
  8. MOK HNB device review – The leader of heat not burn products, vape.hk, website, 12 November 2019, accessed August 2020
  9. HM Treasury, Tax treatment of heated tobacco products, Closed consultation published 20 March 2017, accessed June 2017
  10. Imperial Brands, Annual Report and Accounts, 2019, 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. abBAT Sheds Light on Glo, CPS Daily News, 27 March 2017, accessed July 2017
  15. abcdEuromonitor International, World Tobacco data, accessed June 2020
  16. abStarcom Media Services, Media Plan Recommendation Launch I Revised 980603, 3 June 1998, Truth Tobacco industry Documents, Bates no: 2071224804-2071224832, accessed July 2017
  17. abUnknown, 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. 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. Tobacco Vapour Electronic Cigarette Association, Reynolds pursues another restart with revamped heat-not-burn cigarette Eclipse, TVECA website, 2 November 2017, accessed December 2019
  25. Advertisements Regarding Accord Cigarettes, Truth Tobacco Industry Documents, 1999, Bates no:3990051443-3990051454, original source unknown, accessed February 2018
  26. Unknown, Marketing, 1990, Truth Tobacco Industry Documents, Bates no:2080923084-2080923118, accessed July 2017
  27. abOntario Tobacco Research Unit, OTRU Update: Heat-Not-Burn Tobacco products: Claims and Science, November 2016, accessed September 2017
  28. PMI Heatbar, Vape Museum, undated, accessed July 2020
  29. 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
  30. abcS.Chaudhuri, BAT to submit FDA application to sell Glo in U.S., MarketWatch, 27 July 2017, accessed September 2017
  31. abcdeJ. Elias, L.M. Dutra, G. St. Helen et al, Revolution or redux? Assessing IQOS through a precursor product, Tobacco Control, 2018;27:s102-s110
  32. Philip Morris International, This Changes Everything: Annual Report 2016, 2017, accessed January 2020
  33. British American Tobacco, E-cigarettes and other Next Generation Products, undated, accessed October 2017
  34. Philip Morris Products S.A., How long will PMI be in the cigarette business?, PMI website, undated, accessed December 2019
  35. British American Tobacco, British American Tobacco underlines commitment to transforming tobacco in latest Group reports, press release, 18 March 2018, archived 20 March 2018, accessed February 2020
  36. British American Tobacco, Annual Report and Form 20-F 2018, BAT website, accessed November 2019
  37. L.Du and G.Huang, Imperial Brands jumps into Japan’s crowded heated-Tobacco Market, Bloomberg Technology, 25 April 2019, accessed May 2019
  38. Japan Tobacco International, Innovative partnership for Ploom and Japan Tobacco International JTI to take minority share in Ploom, News Release 8 December 2011, accessed June 2017
  39. Japan Tobacco International, JTI acquires “Ploom” Intellectual Property Rights from Ploom, Inc., 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. Japan Tobacco, JT launches a new flavor of tobacco sticks for Ploom S: “MEVIUS Menthol Purple for Ploom S”, JT press release, 6 December 2019, accessed February 2020
  42. Japan Tobacco, JT launches two new tobacco stick products for Ploom S: Camel Regular and Camel MentholPress Wire, 6 December 2019, accessed February 2020
  43. FAQs: What is Logic Vapeleaf, logicvapes.us, website, undated, accessed August 2020
  44. L. Rapaport, ‘Heat-not-burn’ cigarettes still release cancer-causing chemicals, Reuters, 26 May 2017, accessed February 2018
  45. Euromonitor International. Global Tobacco: Key Findings Part 2: Vapour Products. August 2016
  46. A. Seidenberg, B. Freeman, IQOS is not an acronym: a call to researchers and journals, Tobacco Control, Special Communication, 16 April 2020, doi:10.1136/tobaccocontrol-2019-055571
  47. Philip Morris International, Where is IQOS available?, PMI website, undated, accessed February 2018
  48. Philip Morris International, 2020 Annual Report, accessed June 2021
  49. Philip Morris International, 2021 Annual Report: Next Level Forward, 2022, available from pmi.com
  50. L. Wheeler, Tobacco giant asks the FDA to approve ‘less risky’ cigarette, thehill.com, 23 August 2017, accessed August 2020
  51. abL.K. Lempert, S. Glantz, Heated tobacco product regulation under US law and the FCTC, Tobacco Control, 2018;27(Suppl 1):s118-s125, doi:10.1136/tobaccocontrol-2018-054560
  52. US Food & Drug Administration, IQOS System Holder and Charger Modified Risk Order Decision Summary, 2020
  53. Philip Morris International, FDA Authorizes Marketing of IQOS as a Modified Risk Tobacco Product, press release, 7 July 2020, accessed July 2020
  54. abPhilip Morris International, Glossary: TEEPS, undated, accessed September 2017
  55. abPhilip Morris S.A., Carbon heated tobacco product TEEPS, PMI website, undated, accessed December 2019
  56. Philip Morris International, Frequently asked questions about smoke-free products, undated, accessed June 2022
  57. abcdBritish American Tobacco, Tobacco Heating Products, BAT website, undated, accessed February 2020
  58. Vapor from novel hybrid tobacco heating product produces little or no effect on human cells, news-medical.net, 5 June 2017, accessed July 2017
  59. Euromonitor International, HTP (Heated Tobacco Products)- Hot Prospect? Briefing 24 April 2017
  60. G. Salmon, British American Tobacco – Drawn to the glo, Hargreaves Lansdown, 27 July 2017, accessed September 2017
  61. D. Caruana, BAT launches Glo in South Korea, Vapingpost.com, 15 August 2017, accessed September 2017
  62. abNikkei Asian Review, BAT’s entry an opening salvo in smokeless-tobacco war in Japan, 31 May, accessed July 2017
  63. N. Durante, Analyst Briefing, British American Tobacco, 16 October 2018, accessed November 2019
  64. Home page, discoverglo.com, website, undated, archived 19 May 2019, accessed July 2020
  65. GLO Discontinued in Canada, heat180.com, 3 March 2020, updated 24 May 2020, accessed July 2020
  66. Home page, discoverglo.com, website, undated, accessed July 2020
  67. abBritish American Tobacco, Tobacco Heating Products, BAT website, undated, accessed June 2022
  68. S. Chambers, BAT Gets Leg Up on Marlboro in U.S. Heated-Tobacco Race, Bloomberg.com, 26 July 2018, accessed July 2020
  69. British American Tobacco, Tobacco Heating Products, BAT website, undated, accessed February 2020
  70. M. Geller, Imperial shuns “heating products” pushed by Big Tobacco rivals, Reuters, 6 May 2015, accessed June 2017
  71. G. O’Connell , P. Wilkinson, K.M. Burseg, et al. Heated tobacco products create side-stream emissions: implications for regulation, International Journal of Environmental and Analytical Chemistry 2015;2:2380–91, doi:10.4172/2380-2391.1000163
  72. T. Boles, Imperial Brands is expected to reassure the market with new next generation products, cityam.com, 5 November 2017, accessed February 2018
  73. Imperial Brands, AGM Update, 7 February 2018, accessed February 2018
  74. M. Williamson, Presentation at Imperial Brands Annual General Meeting 2018 , script, 7 February 2018, accessed August 2020
  75. 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
  76. L.Du and G.Huang, Imperial Brands jumps into Japan’s crowded heated-Tobacco Market, Bloomberg Technology, 25 April 2019, accessed May 2019
  77. Pulze Heated Tobacco Makes Global Debut in Fukuoka, Fukuoka Now, 13 June 2019, accessed February 2020
  78. Imperial Brands, Next Generation Products: Heated Tobacco, website, undated, accessed July 2020
  79. Imperial Brands, Next Generation Products, website, undated, accessed June 2022
  80. abcdefgEuromonitor International, World Tobacco data to 2021, accessed June 2022
  81. World Health Organization, Heated tobacco products: information sheet – 2nd edition, WHO website, July 2020
  82. M. Horne, Philip Morris takes cigarette alternative to South Korea, Asia Nikkei Review, 17 May 2017, accessed August 2020 (paywall)
  83. T. Uranaka, Philip Morris says it has doubled supply of IQOS tobacco device in Japan, Reuters, 1 March 2017, accessed July 2020
  84. abJ. Adamson, C. Kanitscheider, K. Prasad et al, Results from a 2018 cross-sectional survey in Tokyo, Osaka and Sendai to assess tobacco and nicotine product usage after the introduction of heated tobacco products (HTPs) in Japan, Harm Reduction Journal, 17: 32, 26 May 2020 doi:10.1186/s12954-020-00374-3
  85. abcdefE. Sutanto, C. Miller, D.M. Smith et al, Prevalence, Use Behaviors, and Preferences among Users of Heated Tobacco Products: Findings from the 2018 ITC Japan SurveyInternational Journal of Environmental Research and Public Health, November 2019, 16, 4630 doi: 10.3390/ijerph16234630
  86. BAT says strong demand for ‘glo’ smokeless tobacco, Reuters, 17 March 2017, accessed July 2020
  87. Global Tobacco Control: E-cigarette Policy Scan, Japan, website, accessed July 2020
  88. B. Elder, Imperial sighs after broker waves away vaping scepticism, Financial Times, 21 August 2017 (paywall)
  89. abE.C. Hair, M. Bennett, E. Sheen et al, Examining perceptions about IQOS heated tobacco product: consumer studies in Japan and Switzerland, Tobacco Control, published online 15 May 2018, 27:s70-s73
  90. Y. Kuwabara, A. Kinjo, M. Fujii et al, Heat-not-burn tobacco, electronic cigarettes, and combustible cigarette use among Japanese adolescents: a nationwide population survey 2017BMC Public Health, 2020;20:741, doi:10.1186/s12889-020-08916-x
  91. M. Kim, Philip Morris International introduces new heat-not-burn product, IQOS, in South Korea, Tobacco Control, 2018;27:e76-e78
  92. J. Kim, H. Yu, S.Lee S et al, Awareness, experience and prevalence of heated tobacco product, IQOS, among young Korean adults, Tobacco Control, 2018;27:s74-s77
  93. J. Kim, H. Yu, S.Lee S et al, Awareness, experience and prevalence of heated tobacco product, IQOS, among young Korean adults, Tobacco Control, 22 October 2018;27:s74-s77
  94. H. Kang, S. Cho, Heated tobacco product use among Korean adolescents, Tobacco Control, 2020;29:466-468
  95. S. Azagaba, L. Shan, Heated Tobacco Products: Awareness and Ever Use Among U.S. Adults, American Journal of Preventative Medicine, Vol 60:5, May 2021, doi:10.1016/j.amepre.2020.11.011
  96. K. McKelvey, L. Popova, M. Kim  et al, Heated tobacco products likely appeal to adolescents and young adults, Tobacco Control, 2018;27:s41-s47
  97. abK. McKelvey, M. Baiocchi, B. Halpern-Felsher, PMI’s heated tobacco products marketing claims of reduced risk and reduced exposure may entice youth to try and continue using these products, Tobacco Control, Online First: 06 February 2020, doi: 10.1136/tobaccocontrol-2019-055318
  98. Gentzke AS, Wang TW, Cornelius M, et al. Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021,  MMWR Surveillance Summaries, 2022;71(No. SS-5):1–29, doi: 10.15585/mmwr.ss7105a1
  99. S. Gallus, A. Lugo, X. Liu, et al, TackSHS Project Investigators, Use and Awareness of Heated Tobacco Products in Europe, Journal of Epidemiology, 2022 Mar 5;32(3):139-144, doi:10.2188/jea.JE20200248
  100. A.A. Laverty, C.I. Vardavas, F.T. Filippidis, Prevalence and reasons for use of Heated Tobacco Products (HTP) in Europe: an analysis of Eurobarometer data in 28 countries, The Lancet Regional Health – Europe, Vol 8, 2021,100159,doi:10.1016/j.lanepe.2021.100159
  101. C.D. Czoli, C.M. White, J.L. Reid et al, Awareness and interest in IQOS heated tobacco products among youth in Canada, England and the USA, Tobacco Control, Jan2020;29(1):89-95, doi: 10.1136/tobaccocontrol-2018-054654
  102. Euromonitor International. Global Tobacco: Key Findings Part 3- Vapour Products. November 2015
  103. abX. Liu, A. Lugo, S. Spizzichino et al, Heat-Not-Burn Tobacco Products Are Getting Hot in Italy, Journal of Epidemiology, Letter to the Editor, 2018;28(5):274-275, doi:10.2188/jea.JE20180040
  104. X. Liu, A. Lugo, L. Spizzichino et al, Heat-not-burn tobacco products: concerns from the Italian experience, Research Letter, Tobacco Control, 2019;28:113-114, doi: 10.1136/tobaccocontrol-2017-054054
  105. A.C. Liber, Heated tobacco products and combusted cigarettes: comparing global prices and taxes, Tobacco Control, 2019;28:689-691
  106. Council of the European Union, Taxation: Council approves conclusions on future administrative cooperation and excise duty on tobacco, 2 June 2020, accessed July 2020
  107. L.Auge, MEP Cristian Bușoi establishes tobacco working group ahead of #Tobacco Products Directive revision, EU Reporter, 21 October 2019, accessed August 2020
  108. Corporate Europe Observatory, Smoke and Mirrors: Weak EU Transparency Rules Allow Tobacco Industry Lobbyists to Avoid Scrutiny, website, 2 July 2020, accessed August 2020
  109. U. Bosen, EU Member States Pushing EU-wide Vapor Tax, 3 June 2020, accessed July 2020
  110. M. Jankowski, G.M. Brożek, J. Lawson et al, New ideas, old problems? Heated tobacco products – A systematic review, International Journal of Occupational Medicine and Environmental Health, 2019;32(5):595-634. doi:10.13075/ijomeh.1896.01433
  111. E. Simonavicius, A. McNeill, L. Shahab, L.S. Brose, Heat-not-burn tobacco products: a systematic literature review, Tobacco Control, 2019;28(5):582-94. doi:10.13075/ijomeh.1896.01433
  112. abcdefH. Tatton-Birch, J. Hartmann-Boyce, L. Koch et al, Heated tobacco products for smoking cessation and reducing smoking prevalence, Cochrane Review, January 2022, doi:10.1002/14651858.CD013790.pub2
  113. abcdefS. Braznell, A.B. Gilmore, A. Rowell, FDA does not rule that IQOS reduces tobacco-related harm, yet PMI still claims victory, STOP briefing, August 2020
  114. 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
  115. 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
  116. British American Tobacco, The health risks of our products: Tobacco Heating Products, undated, accessed October 2017
  117. abL.J. Rosen, S. Kislev, IQOS campaign in Israel, Tobacco Control, 2018;27:s78-s81
  118. 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, doi: 10.1093/toxsci/kfv244
  119. 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;19(2):168-175, doi: 0.1093/ntr/ntw164
  120. M.C. Bentley, M. Almstetter, D. Arndt et al., Comprehensive chemical characterization of the aerosol generated by a heated tobacco product by untargeted screening, Analytical and Bioanalytical Chemistry, 2020;412:2675–2685, doi:10.1007/s00216-020-02502-1
  121. J. Sozstak, B. Titz, W. Shlage et al., Structural, functional, and molecular impact on the cardiovascular system in ApoE-/- mice exposed to aerosol from candidate modified risk tobacco products, Carbon Heated Tobacco Product 1.2 and Tobacco Heating System 2.2, compared with cigarette smoke, Chemico-Biological Interactions, online 2019, doi:10.1016/j.cbi.2019.108887
  122. L. Wheeler, Tobacco giant asks the FDA to approve ‘less risky’ cigarette, thehill.com, 23 August 2017, accessed September 2017
  123. Y. Abutaleb, U.S. senators ask FDA to reject Philip Morris’ IQOS application, Reuters, 7 February 2018, accessed February 2018
  124. Philip Morris International, FDA Authorizes Marketing of IQOS as a Modified Risk Tobacco Product, press release, 7 July 2020, accessed July 2020
  125. E. Babeau, Philip Morris International Inc (PM) Q2 2020 Earnings Call of 30 June 2020: Transcript (in response to a question from Bonnie Herzog), Motley Fool, 21 July 2020, accessed July 2020
  126. R. Proctor, Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition, 2012: University of California Press
  127. Action on Smoking and Health, ASH reaction to new Philip Morris IQOS ‘heat not burn’ product, 30 November 2016, accessed October 2017
  128. ASH Scotland, New tobacco products: heat-not-burn ASH Scotland Viewpoint, December 2016, accessed October 2017
  129. ASH Wales Cymru, Heat not burn products, undated, accessed October 2017
  130. abR. Auer, N. Concha-Lozano, I. Jacot-Sadowski et al., Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name, JAMA Internal Medicine, 2017;177(7):1050-1052
  131. V. Cozzani, F. Barontini, T. McGrath, B. Mahler, M. Nordlund et al., An experimental investigation into the operation of an electrically heated tobacco system, Thermochimica Acta, 2020;684:178475, doi:10.1016/j.tca.2019.178475
  132. C.N. Uguna, C.E. Snape, Should IQOS Emissions Be Considered as Smoke and Harmful to Health? A Review of the Chemical Evidence, ACS Omega Article ASAP, June 2022, doi:10.1021/acsomega.2c01527
  133. abcT. 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
  134. Organized Crime and Corruption Reporting Project, Unsmoking for Health, 25 May 2020, accessed June 2020
  135. abcOrganized Crime and Corruption Reporting Project, Italy Releases Confidential Study on Philip Morris’ IQOS, 1 June 2020, accessed June 2020
  136. Radiotelevisione Italiana, La Cortina de Fumo, 25 May 2020, accessed June 2020
  137. X. Liu, A. Lugo, L. Spizzichino et al, Heat-not-burn tobacco products: concerns from the Italian experience, Tobacco Control, 2019;28:113-114, doi: 10.1136/tobaccocontrol-2017-054054
  138. Philip Morris International, MRTPA Section 2.7 Executive Summary: U.S. Food and Drug Administration, 2017
  139. abWorld Health Organization Tobacco Free Initiative, Heat-Not-Burn tobacco products information sheets, September 2017, accessed February 2018
  140. 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, 19 September 2017, accessed February 2018
  141. World Health Organisation, Conference of the Parties to the WHO Framework Convention on Tobacco Control, DECISION FCTC/COP8(22) Novel and emerging tobacco products,  Geneva, Switzerland, 6 October 2018, accessed July 2020
  142. Secretariat of the WHO FCTC, Information Note on classification of novel and emerging tobacco products, 15 March 2019, accessed July 2020
  143. abS.A. Bialous, S.A. Glantz, Heated tobacco products: another tobacco industry global strategy to slow progress in tobacco control, Tobacco Control, 2018;27:s111-s117
  144. Campaign for Tobacco Free Kids,  Heated Tobacco Products: Global Regulation, briefing, May 2020
  145. Institute for Global Tobacco Control, Countries That Regulate Heated Tobacco, globaltobaccocontrol.org, accessed July 2020
  146. FCTC Secretariat, India adopts ban on electronic cigarettes and heated tobacco products, 2020, accessed July 2020
  147. FCTC Secretariat, Mexico prohibits the import of electronic cigarettes and heated tobacco products, 19 February 2020, accessed July 2020
  148. Australian Regulator Rejects Tobacco Heating Products, Tobacco Reporter, 12 June 2020, accessed July 2020
  149. abTherapeutic Goods Administration, Australian Department for Health, Notice of final decisions to amend (or not amend) the current Poisons Standard, 24 August 2020, accessed August 2020
  150. S.Bedo, Heated tobacco Australia: TGA rejects application from Philip Morris, Courier Mail, 24 August 2020, accessed August 2020
  151. C. Watts, S. Burton, B. Freeman, Creating a market for IQOS: analysis of Philip Morris’ strategy to introduce heated tobacco products to the Australian consumer market, Tobacco Control, Published Online First: 15 November 2020, doi:10.1136/tobaccocontrol-2020-056057
  152. 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 July 2020
  153. S.A. Glantz, Heated tobacco products: the example of IQOS, Tobacco Control, 2018;27:s1-s6, doi:10.1136/tobaccocontrol-2018-054601
  154. The Philip Morris Files,  Reuters, 2017
  155. abcWorld Health Organization, WHO statement on heated tobacco products and the US FDA decision regarding IQOS, 27 July 2020, accessed July 2020
  156. Food and Drug Administration, FDA Authorizes Marketing of IQOS Tobacco Heating System with ‘Reduced Exposure’ Information, 7 July 2020
  157. T. Chow, FDA statement on IQOS may prevent ban on alternative smoking products in Hong Kong, Harbour Times, 20 July 2020, accessed July 2020
  158. M. Zheng, Vaping easing historic moment for public health, The Standard, 14 July 2020, accessed July 2020
  159. abGovernment of Mexico, Ministry of Health Statement [in Spanish], COFEPRIS website, 1 September 2020, accessed September 2020
  160. abA.B. Gilmore, S. Braznell, US regulator adds to confusion around heated tobacco productsBMJ, 2020;370:m3528, doi:10.1136/bmj.m3528
  161. BAT Sues PMI over IQOS Patents, Tobacco Asia, 12 April 2020, accessed July 2020
  162. Altria Halts IQOS Expansion After British American Tobacco Wins Patent Infringement Ruling, Motley Fool, 4 August 2021, accessed September 2021
  163. Jones Day, R.J. Reynolds wins major patent dispute at ITC involving tobacco heating and vaping products, website, May 2021, accessed September 2021
  164. abS. Decker, C. Gretler, Philip Morris IQOS Imports Barred in Reynolds Tobacco Fight, Bloomberg, 30 September 2021, accessed September 2021 (behind paywall)
  165. J. Maloney, U.S. Trade Body Rules Against Import of IQOS Heat-Not-Burn Tobacco Devices, The Wall Street Journal, 30 September 2021, accessed September 2021 (behind paywall)
  166. A. Lucas, Philip Morris, Altria banned from importing or selling Iqos tobacco device in the U.S., CNBC, 30 September 2021, accessed September 2021
Go to Homepage