We are searching data for your request:
Upon completion, a link will appear to access the found materials.
I am researching the safety of IQOS (THS2.2) for heat-not-burn cigarettes (HEETS).
I am particularly interested in appraising the impact of IQOS/HEETS on CO emission and inhalation.
Is there evidence of this?
Carbon monoxide levels after inhalation from new generation heated tobacco products
Heated tobacco products (HTPs) are new tech devices that release nicotine and other volatile compounds into an inhalable aerosol by heating the tobacco
. At their operating temperatures, tobacco combustion is unlikely.
The aim of this randomized cross-over study was to measure the exposure levels of the combustion marker, carbon monoxide in the exhaled breath (eCO) of subjects after use of two HTPs and to compare these levels with participants’ own brand of cigarettes.
A total of 12 healthy smokers who reported smoking ≥10 conventional cigarettes per day for at least 5 years took part in the study. Product administration consisted of a first round of 10 puffs, which was followed by an identical second round after a 5 min pause in between rounds. After obtaining a baseline eCO value, this measure was recorded at 5, 10, 15, 30, and 45 min after the first puff of the first round. In contrast to combustible cigarettes, no eCO elevations were observed in the exhaled breath after use of the HTPs under investigation in any of the study participants.
In an effort to accelerate the decline in smoking prevalence and smoking-related population harm, the tobacco harm reduction approach has been increasingly recognised by public health organisations, such as the National Health Service, healthcare professionals and regulators, as a valuable and promising complement to existing tobacco control measures.
Tobacco harm reduction is based on switching adult smokers to markedly less harmful tobacco and nicotine-containing products that deliver significantly reduced levels of toxic and harmful compounds than cigarettes and have the potential to reduce the occurrence of adverse health effects of smoking.
For any smoke-free alternative to be successful in reducing population harm, it has to fulfil two criteria: it must be scientifically proven to be significantly less harmful than cigarettes and it should be satisfying enough for current adult smokers to encourage them to switch, without being appealing to those people below the age of 18 and those who have never smoked. Manufacturers have risen to this challenge by offering smoke-free options, such as nicotine-containing e-cigarette vaping products, with some degree of success. However, a 2019 New England Journal of Medicine study 4 showed that only 18 per cent of smokers who switched to e-cigarettes were still smoke-free after 12 months, while less than 10 per cent of smokers who had switched to NRTs were smoke-free after the same length of time. These figures highlight just how significant relapse can be amongst smokers and underscores the need for a greater range of alternatives that keep smokers away from cigarettes. Additionally, many alternatives to smoking do not enable smokers to successfully switch. The more smoke-free alternatives that are available, which are able to replicate the taste and ritual of tobacco consumption, whilst reducing the harm, the easier it may be for smokers to abandon cigarettes and move to less harmful alternatives.
Does iQOS burn tobacco?
According to Talbot, the tobacco in a Heet is charred when the iQOS heats up. That, she says, leads to a process called pyrolysis, which creates toxins. Her team decided this after looking at a used Heet under a stereomicroscope – but a stereomicroscope isn’t powerful enough to detect pyrolysis. I have one at home they’re designed for looking at insects, coins and electronic components. If the tobacco really was charred, like she claims, a stereomicroscope could detect that, but is charring possible in an iQOS?
No, it isn’t. The heating blade in an iQOS never gets hotter than 350°C, and that temperature was chosen for a reason. In a cigarette the tobacco burns at a temperature of at least 800°C, and there’s no way an iQOS will ever get anywhere close to that. PMI deliberately selected a temperature that was hot enough to create a vapour from the tobacco, but not hot enough to burn or char it.
I’ve dissected used Heets myself, and looked at them under both a stereomicroscope and a high-powered biological microscope. I didn’t see any signs of burning or charring what I did see was some discolouration around where the blade had been. PMI say this is torrefaction, a kind of mild thermal decomposition that takes place around 300-350°C.
PMI also cited Public Health England, the UK Committee on Toxicity and the Netherlands National Institute for Health and Environment, all of which confirm from their own research that iQOS does not burn tobacco – and Talbot is wrong.
What are the main benefits?
Less risk than continuing to smoke
IQOS emits 95% less harmful chemicals compared to cigarettes.*
A smoker that consumes on average 10 cigarettes per day can save £1000 per year when switching to IQOS.
Less impact on you and those around you
With IQOS there is no ash, no smoke or cigarette-like smells and no impact on indoor air quality.
Over £4 billion has been invested over 10 years in research and development, to perfect the technology and design.
*Important information: It does not necessarily equal a 95% reduction risk. IQOS is not risk free.
*Average reductions in levels of a broad range of harmful chemicals (excluding nicotine) compared to the smoke of a reference cigarette (3R4F). It does not necessarily equal a 95% reduction in risk.
**Source: Philip Morris Limited consumer insights data. Based on regular SMS conversion checks (opted-in consumers) during the period 10/11/2018-06/06/2019
IQOS 3 DUO
Our most advanced device to date. The elegant design is also robust and durable with a magnetic lock that keeps the holder safely stored.
IQOS 3 Multi
Our all-in-one pocket size solution IQOS 3 MULTI allows you to have 10 back-to-back uses without recharging in-between.
IQOS 2.4 Plus
With its classic user friendly design, IQOS 2.4 Plus is our more affordable device from the IQOS range.
IQOS emits on average 95% lower levels of harmful chemicals compared to cigarettes*.
*IQOS is not risk-free. It delivers nicotine, which is addictive. Compared to the smoke of a reference cigarette (3R4F). It does not necessarily equal a 95% reduction in risk. These products are not risk-free. Source: Average reductions (95% for IQOS with HEETS and over 95% for IQOS VEEV) in the levels of a range of harmful chemicals (excluding nicotine) compared to the smoke of a reference cigarette.
The ‘Unsmoke’ screen The truth behind Philip Morris’ cigarette-free future
UNITED KINGDOM – The crowd screamed as Calvin Harris began his set at 2019’s Djakarta Warehouse Project, one of Asia’s biggest dance music festivals. The floor pulsed. As each song built, fans jumped up and down, climbed on each other’s shoulders or swayed as they filmed the DJ on their phones.
Opposite the main stage was a sleek building made of solid glass and red lights, with everything a festivalgoer needed to relax: sofas, televisions, Playstations – and cigarettes for sale. The Marlboro Penthouse gave Philip Morris International (PMI), the world’s biggest multinational tobacco company, an opportunity to promote its cigarettes to 90,000 young attendees.
Throughout the festival there were bright Marlboro signs over bars and benches where people sat smoking. There was a Marlboro “Discover Room” with interactive red, blue, and yellow booths, echoing cigarette-pack branding, and an arcade game. The festival’s shops sold only Marlboro-branded cigarettes and the company employed attractive saleswomen to roam around promoting the products.
That heavy promotion was curious, as 3 years earlier, PMI’s chief executive had made a claim so surprising it had made headlines all over the world. He had announced a new ambition for his company: to phase out cigarettes entirely.
In 2017, PMI officially laid out its vision for a “smoke-free” future. André Calantzopoulos, the previously camera-shy chief executive, started giving interviews about his company’s “transformation.” He wanted to switch smokers to PMI’s new range of cigarette alternatives, which he said, would improve public health.
Two years ago PMI said it could stop selling cigarettes by 2030 in the UK. A global campaign called “Unsmoke Your World,” promoting the idea that anyone could become an “Unsmoker,” was released a year later. PMI could be “part of the solution” to smoking, executives said. It hired advertising, PR and lobbying companies to promote a narrative of a new purpose-led, responsible business.
Yet careful scrutiny of its activities and internal documents by the Bureau reveals that much of the campaign is spin rather than substance – just as the recent advertising of Marlboro cigarettes to young Indonesians would suggest.
The Unsmoke mission is a marketing campaign for PMI’s new range of cigarette alternatives and a blatant attempt to rehabilitate the company’s image so it can once again seek to influence policy and regulations. Arguably, it has succeeded: although smoking rates have fallen in the past decade, PMI’s profits and share price have increased.
Some experts fear that if the company’s narrative is taken at face value PMI will continue to sell billions of cigarettes worldwide while promoting itself as “part of the solution” to smoking. It could lure a new generation into addiction with its new products, whose long-term health risks are unknown, and discourage people who might have quit altogether from doing so.
“The multi-billion dollar tobacco industry will do everything they can to stay in business,” said Dr Vinayak Prasad, head of the World Health Organization’s (WHO) tobacco control division. He believes that what they are saying is far from reality.
“If they really want to be a part of the solution, they should go tobacco-free, not smoke-free. If they are genuine about a tobacco-free society, they will readily embrace anything to reduce the demand for all forms of tobacco products.”
Dr Moira Gilchrist, a vice-president of PMI, told the Bureau: “Our vision is that one day smoke-free products will replace cigarettes. The sooner the world transitions away from cigarettes, the sooner we can stop making them.”
The era of Iqos
COLORFUL. IQOS on display. Photo courtesy of Stanford University
Calantzopoulos makes a point of using PMI’s flagship product, a sleek gadget that looks like a cross between an iPhone and an expensive pen. It is called Iqos, which is widely believed to be an acronym for “I Quit Ordinary Smoking” – although this is consistently denied by the company – and is now available in 52 countries worldwide.
It looks like an e-cigarette, or vape, but there is a key difference: it contains tobacco, where e-cigarettes only hold a nicotine solution. PMI has developed sticks of tobacco, called Heatsticks or Heets, which are inserted into the Iqos device and warmed to 350 degrees Celsius (much lower than the 800 degrees of a burning cigarette) until tendrils of aerosol are released. This mimics the rituals of smoking and gives users a satisfying kick of nicotine while inhaling fewer carcinogens.
Calantzopoulos, a Greek electrical engineer who has spent 35 years working for PMI, says he was smoking a pack a day until he switched to Iqos, his personal journey neatly echoing that of his company.
PMI calls Iqos a heated tobacco or “heat-not-burn” device it is part of a new class of products sitting between vapes and traditional cigarettes.
There is a consensus that switching to vaping offers the best health benefits to smokers after quitting or using patches, gum, or prescription drugs that lower cravings. Heated tobacco products release fewer harmful chemicals than cigarette smoke, but more than e-cigarettes do. Neither product has been around long enough for experts to be sure that reducing the levels of toxic chemicals also reduces overall rates of disease.
Some studies have also found that Iqos emits higher levels than cigarettes of other chemicals, but not the ones known to be dangerous. Although these are not toxic in the short term, it is not known if they could have health effects over a longer period of use.
PMI said its testing on Iqos showed the concentrations of these chemicals “are below the level of toxicological concern.”
Some question why, if PMI wants to be “part of the solution” to smoking, it chose to heavily promote a heated tobacco product rather than an e-cigarette, when the potential health benefits of the latter are widely considered greater.
The answer comes down to economics, said Erik Bloomquist, a tobacco industry analyst. PMI could more easily adapt its cigarette manufacturing to make Heatsticks, while the profit margins for many e-cigarettes, especially those where users change the liquids and heating coils themselves, are miniscule.
Iqos was first launched in Japan, where e-cigarettes are banned, and within 4 years, gained nearly 16% of its overall tobacco market. Experts believe its introduction has led to falling cigarette sales. Iqos has also been a hit in South Korea, Russia, and Italy.
PMI says that 10 million smokers have switched to Iqos since it was launched. Calantzopoulos’ new ambition is to switch 40 million smokers from cigarettes to PMI’s alternative products by 2025. He describes the situation as a win-win: better for the smoker, and better for PMI, which can get better profit margins from Iqos if it is subject to lower taxes than cigarettes.
The company’s executives are working hard all around the world trying to persuade governments not to tax Iqos like a cigarette, to the chagrin of the WHO, which has advised against such a concession.
PMI said Iqos helps smokers, who find vapes unappealing, give up cigarettes. “What is most important is that adult smokers have access to a product that they are able to switch to and completely quit smoking cigarettes.” The company said it lobbied governments “because products like e-cigarettes and heated tobacco products should not be banned.”
Calantzopoulos will be wary of the backlash faced by Juul, the maker of America’s most popular e-cigarette, over accusations its early marketing appealed to teenagers. The company denies it ever targeted children but has since faced congressional hearings, federal investigations, and hundreds of lawsuits.
It is against this backdrop that Calantzopoulos maintains he only wants Iqos targeted at the world’s 1.1 billion adult smokers. However, a small Italian study found nearly half of people who had tried the product had never smoked.
PMI appears to have at times recruited occasional or social smokers to promote its devices. “I don’t smoke often, maybe only when I am at a party or having a glass of wine with some friends, but I was interested to find out about this device because it didn’t seem like just another electronic cigarette,” Gabriele Gzimailaite, a London fashion blogger told her readers in November 2017.
Gzimailaite, who has 120,000 Instagram followers, had been flown out to Milan by PMI for an Iqos party, where she posed against an Iqos-branded wall and posted pictures of the device.
Four months later, PMI paid for her stay at the luxurious Rosewood Hotel in London, which has launched Iqos-friendly rooms. Gzimailaite posted a picture of herself posing in a marble bubble bath, drinking a glass of rosé with her black Iqos and a magazine at her side. Another non-smoker has also promoted Iqos.
Calantzopoulos’ promise not to target non-smokers or teenagers is disingenuous, activists say. They argue that if PMI convinced its existing customers to switch to Iqos without attracting new ones, as it claims it wants to do, the company would go out of business within a generation.
“The main purpose is to prevent smokers who could be quitters to stay consumers of their products,” said Pascal Diethelm, president of Oxysuisse, a Swiss NGO dedicated to tobacco prevention. But even that could not sustain the company indefinitely – those smokers will die. PMI needs young people to create a new market, he said.
He points to investor presentations which appear to show PMI using the “theory of diffusion of innovation.” This is where there are “early adopters” of a product, who tend to be richer and more privileged than the rest of the population. As this group adopts the product they serve as influencers on the rest of the market, including young people. Diethelm believes this is why Iqos is being marketed as a luxury, hi-tech, aspirational product.
A visit to an Iqos shop does nothing to dispel this belief. It looks like an Apple store, with big museum table-cases displaying the latest devices. Colorful products are displayed in a rainbow on the wall, and young, hipster shop assistants stand ready to help.
While smoking rates fell in Japan after the introduction of Iqos, public health experts are concerned that not all smokers will switch completely from cigarettes. Independent studies and PMI’s own research show that many people tend to carry on smoking while using the device, negating the health benefits.
“Iqos probably falls halfway in between e-cigarettes and cigarettes on a toxic exposure scale,” said Richard O’Connor, professor of oncology at Roswell Park Comprehensive Cancer Center. “So basically there would be no real benefit to somebody who uses both products at the same time.” PMI did not dispute this.
Behind the smoke screen
Despite the PR push, PMI’s stated aim of phasing out cigarettes is not matched in a number of its business practices.
Its revenues from alternative products shot up from 0.2% in 2015 to almost 20% in 2019, but the vast majority still came from cigarettes. The company sold more than 740 billion cigarettes worldwide in 2018 and is only reducing its production by a few percentage points a year.
Calantzopoulos has also repeatedly reassured investors that PMI wants to remain a leader in cigarettes and will not give up market share to its competitors.
Since it announced its aim to stop selling cigarettes, it has acquired a new cigarette company, launched a new brand, and added enticing new flavors such as Splash Mega Purple and Fusion Summer. It has also launched legal action against anti-smoking policies in countries like the Philippines, and has carried on advertising cigarettes in countries that permit it.
Some pupils in Indonesia can see PMI’s cigarette advertising mere steps from their schools’ gates. Young people attending festivals in Buenos Aires are offered PMI cigarettes in promotions with beer. Children visiting corner shops in Mexico can see Marlboro’s “fusion” cigarettes next to sweets.
INTERNATIONAL. The international spread of Philip Morris. Courtesy of Emily Maguire/The Bureau of Investigative Journalism
“There’s a certain disingenuousness to the whole thing,” said O’Connor, who until recently sat on the US Tobacco Products Scientific Advisory Committee advising the FDA. He believes the company could easily switch many more people away from cigarettes if it wanted to.
“They can stop marketing cigarettes and market the heck out of Iqos and actively encourage people to use it. If you want to shift the market and you control most of that market, you could easily do it. They might lose a few share points on their stock, but I think it would be a much more rigorous demonstration that they really are changing.”
From pariah to ‘part of the solution’
Tobacco is still the leading cause of preventable death around the world, killing 8 million people a year and harming millions more. There is now indisputable evidence that smoking causes multiple types of cancer, heart disease, and respiratory illnesses, killing up to half of those who light up.
In 2006, Judge Gladys Kessler issued an extensive and damning set of findings during a landmark judgment against Philip Morris US, from which PMI later split. She cited evidence of the company’s decades-long campaign to hide the hazardous effects of smoking and secondhand smoke. Philip Morris had lied about the addictiveness of nicotine, manipulated nicotine levels to keep people addicted, misled the public about the health benefits of “low tar” or “light” cigarettes, and marketed cigarettes to teenagers.
Philip Morris had “marketed and sold their lethal product with zeal, with deception, with a single-minded focus on their financial success, and without regard for the human tragedy or social costs that success exacted,” she said.
By the start of the 21st century, PMI and the other tobacco companies were seen as pariahs in most industrialized countries, where social norms around smoking were changing. In 2003 an international WHO treaty was launched and widely adopted, mandating countries to adopt tried-and-tested policies to stop smoking. These included restricting contact with the industry and resisting its attempts to interfere in policy, entrenching tobacco companies’ status as distrusted outsiders.
“I think they [tobacco companies] could just see that the summit of the power and untouchable space that they inhabited for a very long time was not guaranteed for them anymore,” said Professor Johanna Cohen, director of the Institute for Global Tobacco Control at John Hopkins University.
By 2014, when Iqos launched in Japan, PMI knew it needed to change its image. Internal documents uncovered by Reuters in 2017 reveal it feared measures such as litigation and bans on political contributions, charitable donations and tobacco industry market research.
It launched a 10-year plan called “Normalization.” Its new objective was to “establish PMI as a trusted and indispensable partner, leading its sector and bringing solutions to the table.”
To achieve this it would “be ‘for’ something,” establishing a “forward-looking, motivational and credible” purpose statement.
It would also “balance the debate” by exposing the “double standards” of anti-tobacco campaigners and amplifying the voices of people who favored harm reduction – those supportive of offering smokers alternative products.
PMI planned to foster relationships with politicians, international organizations, NGOs, academics, scientists, researchers and the media, to promote its new purpose and products.
In the UK, PMI hired Pagefield, a PR company, to help to launch Iqos. In a blog post, the company describes the work as a good example of “helping distrusted companies gain acceptance.” Pagefield described the success of its strategy: “purpose was put before product and that made for a more captivating story.”
Normalization in action
The normalization strategy appears to be in full swing in the UK. After Iqos was launched, PMI executives appeared on ITV’s Good Morning Britain, BBC Radio 4’s Today program, and BBC Hard Talk describing the company’s transformation. It bought newspaper adverts and paid for events. It even funded a new website by Vice, Change Incorporated, that would publish articles on ending smoking, and sponsored Gay Star News’s health section.
As promised, it also forged relationships with politicians. In July 2018 it hosted a session in Westminster on how the company could work with MPs to “deliver a smoke-free future” with the Scottish MP Ross Thomson. It put up a stand at the Conservative party conference every year from 2017 to 2019, promoting its campaign to British politicians and their teams.
Despite its flagship product not being an e-cigarette, it was a founding member of the UK Vaping Industry Association (UKVIA), which funds an all-party parliamentary group on vaping, giving it access to British politicians.
PMI has always tried to rehabilitate its image, but its move into cigarette alternatives gave it a more persuasive message, said Deborah Arnott, chief executive of the campaigning public health charity Action on Smoking and Health.
“The coal industry spent an awful long time saying it supports green measures when what it was doing in practice was very different, the same is true for PMI,” she said. “We need to continue to protect public health policies. You can’t partner with the industry or allow the industry to determine the policy agenda because commercial vested interests mean shareholders’ needs will always take priority.”
PMI’s PR offensive took place on several different battlegrounds. In 2017 it announced it was setting up an independent organization, the Foundation for a Smoke-Free World, to pay for research on ending the smoking epidemic – and it would hand over $80 million (P4.09 billion) a year for 12 years to this new non-profit. In a massive publicity coup, a former WHO executive, Derek Yach, was hired to lead it.
The WHO itself publicly refused to engage with the foundation, identifying it as an organization that “further[s] the interests of the tobacco industry.” It told governments and the public health community to follow its lead. It was soon being described in some quarters as a front group for PMI.
The Foundation says it “funds research, promotes innovation, and supports collaborative initiatives to accelerate progress in reducing harm and deaths from smoking.” Its health research grants have been largely focused on harm reduction, not ending smoking, in line with PMI’s needs to normalize and legitimize cigarette alternatives like Iqos. Some of the recipients of its grants have links with the tobacco industry.
An analysis by the University of Bath of the Foundation’s latest published tax returns reveals that it spent more on hiring PR and communications agencies than scientific research. The university is a research partner of STOP, the global tobacco control campaign. Tess Legg, co-author of the Bath report, believes that the Foundation is not simply a scientific research organization.
“The Foundation is promoting PMI’s rhetoric on harm reduction, next generation products and the role the tobacco industry wants to play in science and policy-making, but often without the reader or the listener being aware that these messages are funded by the tobacco industry,” she said.
The Foundation said its 2019 tax returns would show it is now spending most of its budget on research. A spokesman added: “There is no tobacco industry influence on the Foundation’s work.”
‘This changes everything’
The April 2019 launch of Iqos in Tirana, Albania, drew a fashionable crowd. Guests walked down a white carpet flanked by palm trees and lit by spotlights until inside an Iqos-branded tunnel they were met by hostesses in futuristic dresses. Hands emerged from velvet curtains to hand them champagne.
TV screens on the wall played videos of erupting flames. “Stop burning, start heating,” the text read as a gold Heatstick slipped smoothly into the Iqos device.
There have been similar launches for Iqos products all around the world, some headlined by Jason Derulo or Jamiroquai. PMI has also sponsored Iqos-branded parties for Playboy magazine in Germany and Cosmopolitan magazine in Russia.
In the UK, where advertising of both the device and Heatsticks is banned, marketing is limited to PMI’s website, Iqos shops, and displays in vape shops. But where regulations are looser, PMI is advertising Iqos far more aggressively.
Its campaign features social media influencers, events, collaborations, glass-fronted shops and an army of brand ambassadors, according to a report compiled by Stanford University. “The advertising tries to portray Iqos as aspirational, high tech, healthy, fashion-conscious, clean, fun and link it with fashion, travel, leisure, and relaxation. Some adverts imply Iqos helps make people more successful in romance by improving their kisses and their teeth, as well as being a good way to show love to family and friends,” Professor Robert Jackler, who led the research, said.
Instagram posts show Iqos with coffee, alcohol, and food. Young, attractive, professional people are shown laughing, socializing, or looking happy with their devices. Some ads show Iqos with surfers and runners, implying it is a product to suit healthy, outdoors-y lifestyles.
Elsewhere, Stanford researchers uncovered examples of explicit health claims, including a post from Iqos’s Instagram page in Japan that promoted it as a way to avoid lung cancer, emphysema, and heart attacks when compared with smoking, which, an expert said, is not backed up by evidence. PMI disputes some of Stanford’s findings.
In the US and UK, PMI cannot legally claim Iqos can help quit smoking or lower the risk of disease. The UK Department of Health wrote to PMI in 2018 to tell the company to stop sending posters advertising the device to convenience stores.
PMI was forced to suspend its own social media influencer campaign when it emerged in May 2019 that the company had hired models who were under 25, against its own internal guidelines. But the Stanford researchers have uncovered an Armenian account that featured attractive young influencers posting about Iqos.
The researchers also found Instagram posts that seemed to target even younger teenagers. Instagram posts from Ukraine and Armenia showed young-looking girls posing with pastel-colored Iqos devices. Others posed the devices against a backdrop of ice creams, palm trees, and seashells.
“It has used the exact same strategy and the exact same images it used to make Marlboro the most popular cigarettes for kids worldwide,” Matt Myers, president of the Campaign for Tobacco Free Kids, said.
“If governments don’t respond strongly and directly, Philip Morris International will use Iqos to renormalize tobacco use and reach a whole generation of young people who otherwise never would have smoked.”
Reto Auer, a doctor and researcher at the universities of Bern and Lausanne, bought an Iqos after seeing adverts that said it did not produce smoke. He smoked it in the office as his colleagues watched, noticing black charring on the Heatstick and that it smelt like burnt tobacco.
Suspicious that the charring suggested incomplete burning, called pyrolysis, his team set up a study to determine whether Iqos produced smoke or not. Their conclusion? It did.
“Basically what the Iqos is, is a portable toaster,” he said. “If you leave your bread long enough, it will become black. At what point do you say your toast is burnt? Is that bread vapor that comes out of your toaster? No, we call it smoke.”
Auer and his team believe PMI is “dancing around” the definition of smoke to avoid indoor smoking bans. In Japan, while smoking is banned indoors, Iqos is not there are “no smoking, Iqos only” signs. “If you have only the Iqos indoors, and all other cigarettes outside, then you have no competitors,” Auer said.
In countries including Japan, Romania, Ukraine, Vietnam, Russia, Czechia, and Spain, PMI has created its own cafés and lounges, where menus pair coffees with particular flavors of Heatstick. It has launched a global network of “Iqos-friendly spaces”: bars, hotels, restaurants or public areas like beaches where people can freely puff on their Iqos.
Mapping Iqos’s launches reveals a pattern. Iqos has mainly been promoted in countries that have introduced smoking or tobacco advertising bans and where cigarette sales were falling, according to Bath’s analysis. “They needed something else to make profit in the future in those countries because people were stopping smoking,” said Karen Evans-Reeves, co-author of the report.
GROWING MARKET. Graphic courtesy of Emily Maguire/The Bureau of Investigative Journalism
Within the UK there are Iqos shops in London, Manchester, Bristol and Cardiff, but none in Hull, Burnley, or Mansfield where PMI’s research shows smoking rates are highest.
Dr Gilchrist, a vice-president of PMI, said: “For PMI, the long-term business opportunity is to convert adult smokers who would otherwise continue to smoke cigarettes to better alternatives.”
“A campaign coordinated by American special interest groups, all of whom are seemingly funded by the same source – Bloomberg Philanthropies – are dedicated to just one mission. Under the guise of promoting public health, they are working to rob adults who smoke of their right to choose scientifically substantiated better alternatives to continued smoking.”
The Bureau’s Smoke Screen project, scrutinizing the tobacco industry which kills millions a year, is funded by a non-governmental organization, Vital Strategies, which is, in turn, funded by Bloomberg Philanthropies. The Bureau is a non-profit predominantly funded by grants from dozens of foundations and fully discloses all of its funders. Neither Vital Strategies nor Bloomberg Philanthropies has any say over the Bureau’s journalism.
Iqos has yet to be launched in Indonesia, PMI’s biggest market for cigarettes. There, more than 2/3 of men and nearly one in 5 teenagers smoke. People in their 30s are dying of heart-related diseases linked to tobacco. Videos of toddlers addicted to cigarettes appear regularly.
Calantzopoulos’ desire to phase out cigarettes may be genuine, but he is hamstrung by an obligation to maximize profit for shareholders, which rules out suspending cigarette advertising or sales.
Perhaps Indonesia’s smokers will eventually all quit or switch to alternatives. Under the neon lights of the Marlboro Penthouse, that day seems a long way off. – Rappler.com
This story is produced in partnership with Dispatches. The Secrets of Big Tobacco: Has Philip Morris International Really Given Up Smoking? Is available on All4.
The science and vision behind IQOS.
IQOS is the combination of science, technology and vision.
We believe in science. We believe it can change the lifestyle of millions of adult smokers who would otherwise continue to smoke. To this effect, we recruited scientists to work on an important idea: developing less harmful products that adult cigarette smokers can switch to if they don’t quit. At PMI’s global research and development centres in Switzerland and Singapore, we have developed and evaluated IQOS, an innovative electronic device that heats and does not burn tobacco. It produces a tobacco vapour that delivers tobacco taste and nicotine.
Switzerland has been central in the development of the technology behind IQOS. It is in our research and development centre on the shores of Lake Neuchâtel that 430 scientists and engineers have been working tirelessly and in close collaboration with more than 100 Swiss start-ups and SMEs from all over the country to develop and scientifically assess IQOS
Why heating is better.
Technology – the world revolves around it. Over the years, it has radically changed our lives for the better. The way we work, the way we communicate, the way we travel. By combining science and technology is how we developed a better alternative to continued smoking.
IQOS is changing for the better the way adult smokers, who would otherwise continue to smoke, can enjoy tobacco.
IQOS heats tobacco instead of burning it for a simple reason: the burning of tobacco emits high amounts of harmful chemicals like carbon monoxide. IQOS HeatControl™ Technology prevents tobacco from burning, which means it significantly reduces the number and level of harmful chemicals emitted compared to cigarette smoke.
When a cigarette is lit, the tobacco burns at temperatures of around 600°C. This burning process generates smoke and ash when a smoker takes a puff, the temperature rises above 800°C at the burning tip.
Cigarette smoke is a complex mixture of over 6,000 chemical substances, around 100 of which have been linked to smoking-related diseases by public health authorities.
IQOS HeatControl™ Technology heats tobacco to a lower temperature (less than 350°C), ensuring that combustion does not occur. Because there is no combustion, IQOS does not produce smoke. It generates a tobacco vapour that brings you a high-quality tobacco taste experience with 95% less* harmful chemicals compared to cigarettes.
Tested to the highest standards.
IQOS has gone through robust scientific assessments, including, to date, 18 non-clinical and 10 clinical studies involving thousands of participants. The totality of evidence available shows that, while IQOS use is not risk-free, switching completely to IQOS presents less risk to your health than continuing to smoke cigarettes.
Additionally, an increasing number of independent studies and government reports have emerged confirming important elements of our research. To date, more than 85 independent studies have been published.
Cigarettes produce tar, IQOS doesn’t.
Burning a cigarette generates smoke and tar. This is not the case with IQOS. Why?
IQOS heats tobacco instead of burning it. It generates a tobacco vapor that is fundamentally different from cigarette smoke with significantly reduced content of harmful chemicals.*
Cigarettes produce high amounts of carbon monoxide, IQOS doesn't.
Burning a cigarette produces smoke that contains a high amount of carbon monoxide. This is not the case with IQOS. Why? IQOS heats tobacco instead of burning it. It generates tobacco vapor that is fundamentally different from cigarette smoke and contains on average 95% less carbon monoxide (CO).*
Indoor air quality.
Indoor air quality (IAQ) refers to the air quality inside buildings, generally based on the principle of ensuring the health and comfort of the occupants. Temperature, humidity and contaminants are some of the factors that can affect the indoor air quality. However, human presence and activities such as cooking, cleaning and smoking have been proven to have a considerable impact.
To enhance our knowledge and understanding of the impact of IQOS on indoor air quality, we conducted studies simulating “real-world” conditions in an environmentally controlled room. Our testing methods are validated and ISO-accredited.
Our study shows that, because IQOS does not burn tobacco and it does not generate smoke, it does not negatively impact indoor air quality in your home. This means that the few compounds we nevertheless detected were found at very low concentrations and far below the maximum exposure levels defined in existing air quality guidelines.
As you probably know, cantons in Switzerland have different regulations with regard to locations where you can smoke or use tobacco products which we recommend you follow.
Is IQOS an e-cigarette?
No. While they are both electronic devices and do not produce smoke like cigarettes, there is one main feature that distinguishes IQOS with HEETS from e-cigarettes: IQOS heats real tobacco, producing tobacco vapor.
Contrary to vaporising an e-liquid, IQOS uses the innovative HEETS tobacco sticks. The tobacco in them is carefully selected and processed to ensure it is evenly heated from the inside, delivering consistent taste and cigarette-like satisfaction. This is why the majority of smokers who switch to IQOS completely quit cigarettes.*
* PMI financials or estimates, IQOS user panels and PMI market research
How retailers are meeting the rising demand of heated tobacco
With IQOS now the UK’s number one product in the smoke-free category , Philip Morris Limited’s head of field force UK and Ireland, Kate O’Dowd, reflects on how it has accelerated the overall growth of the heated tobacco category, and thanks the growing retailer community for the part it continues to play in building a smoke-free future.
For some time now, IQOS has been the world’s number one heated tobacco product  with more than 16 million users in over 60 countries . Where IQOS has launched, impact has followed with 72% of adult smokers who try IQOS abandoning cigarettes and switching completely to IQOS , which emits on average 95% less harmful chemicals compared to cigarettes .
In Japan, for instance, there are now six million IQOS users , with heated tobacco products (HTP) making up about a third of all tobacco sales . This phenomenal rise is matched against a 32% drop in cigarette sales since the introduction of HTPs in 2014 .
IQOS launched in the UK in 2016. As the first heated tobacco product on the market, we worked tirelessly to establish the category through our channels – increasing the understanding of this sophisticated technology to adult smokers who were seeking a cigarette-like alternative  that no other smoke-free alternative was able to deliver. We knew it would take time, but with an unparalleled success rate in helping smokers make the switch from cigarettes, UK customers began to see the benefit.
We ramped up the support we offered our customers through IQOS Care - a comprehensive and increasingly personalised support service. IQOS Care Experts are available seven days a week, with lockdown restrictions not preventing the delivery of remote services through live chat, email and over-the-phone. When restrictions ease on international travel, UK customers can also access IQOS Care support in over 60 countries. This commitment to our customers has led to IQOS Care receiving a Trustpilot rating of 4.4, with more than 1,300 reviews and 77% of customers rating the service as ‘Excellent’ .
St John’s Budgens - an IQOS success story
Sid Sidhu, St John’s Budgens, Kenilworth, Warwickshire
Sid Sidhu at St John’s Budgens in Warwickshire is one of the UK’s leading IQOS and HEETS stockists: “We’ve had an extremely strong couple of months of sales on IQOS and HEETS, including new customers that we’ve converted over since the menthol cigarette ban. We stock seven varieties of HEETS at the RRP of £5 and this is a bonus for us. Shoppers perceive this as good value for money and tend to buy as they would traditional tobacco, one pack at a time. This means we have more footfall into store and generally more basket spend - approximately 60% will go on to buy something else.”
While we served the needs of our customers, retailers nationwide were increasing access to heated tobacco by becoming HEETS and IQOS stockists. Asda, BP, Morrisons, Sainsbury’s, Shell, Tesco, Waitrose and WH Smith High Street, have joined thousands of independent convenience stores in stocking a range of HEETS. The IQOS device can also be purchased at select Sainsbury’s stores and Sainsbury’s online, and from May this year, the opportunity to stock IQOS was extended to thousands of independent retailers.
By working in partnership with our growing retailer community, we have been able to meet customer demand in the heated tobacco category throughout the country. This has resulted in the retail value share of IQOS and HEETS surpassing that for the products of PML’s nearest competitor in the smoke-free category . Importantly for me, however, has been the combined effort to offer adult smokers a better choice – one that could see them quit cigarettes for good. And with our field force expanding, we’ll be able to reach more adult smokers in new regions and cities in 2021.
So, here’s to you – our retail partners. I know it’s been a difficult year but you have made a difference to the lives of thousands of adult smokers. We promise to continue increasing the availability of our products and delivering unrivalled customer support, so that many more benefit.
 Nielsen data as of September 2020, which encapsulates “smoke-free” product categories - e-cigarettes (hardware and consumables) and IQOS (Device and HEETS) specifically - in multiple grocers and General Trade in retail. IQOS and HEETS surpassed the products of PML’s nearest competitor in June, 2020.
 PMI global estimate of total in-market sales of heated tobacco units, as of December 2019 (excluding China and U.S.).
 PMI Third-Quarter Earnings, as of September 30, 2020.
 PMI Third-Quarter Earnings: ‘Over 16 million IQOS users’, as of September 30, 2020.
 Average reductions in levels of a range of harmful chemicals (excluding nicotine) compared to the smoke of a reference cigarette (3R4F). Important information: it does not necessarily equal a 95% reduction in risk. IQOS is not risk-free.
 PMI, Third-Quarter Earnings: ‘grew to an estimate total of 6.0 million’, as of October 20, 2020.
 Burning Issues: Global State of Tobacco Harm Reduction 2020. London: Knowledge-Action-Change, 2020.
 Studies showed that the satisfaction of those who switched completely to IQOS is comparable to those who continued to smoke cigarettes. 3 month clinical studies conducted in US and Japan with 160 adult smokers each under real conditions (ambulatory)
 Trustpilot, IQOS UK (as of Tuesday 10th November, 2020) - https://uk.trustpilot.com/review/uk.iqos.com
 Nielsen data as of September 2020, which encapsulates “smoke-free” product categories - e-cigarettes (hardware and consumables) and IQOS (Device and HEETS) specifically - in multiple grocers and General Trade in retail. IQOS and HEETS surpassed the products of PML’s nearest competitor in June, 2020.
Find out how heated tobacco has replaced vaping
Vaping, by contrast, involves heating a liquid that often contains synthetic nicotine, among other substances, not tobacco itself. Vaping and heated-tobacco devices are both commonly considered “e-cigarettes,” but the difference between the two is especially relevant in the midst of national panic about vaping. Over the summer and fall, reports of several dozen vaping-related deaths surfaced, and autopsies found that the liquids put into some devices contain additives that seem to be the cause of acute inflammatory lung disease. People began to swear off vaping. Some states implemented bans.
In 2020 it was estimated that 11-million men and women smoked cigarettes in South Africa. The World Health Organisation (WHO) estimates that there are 1-billion smokers in the world with this number unlikely to materially change by 2025. While a smokers’ best choice would be to quit, many will not. So what is the alternative?
For centuries people have smoked tobacco and within the last decade, there have been scientific advances in the development of less harmful alternatives like heated tobacco.
Heated tobacco, also known as smoke-free products, although a relatively new category of tobacco product, is an innovative way of enjoying the authentic taste of tobacco without combustion.
Nicotine is one of the reasons that people smoke, along with taste and ritual. While nicotine is not risk-free and is addictive, it is not the primary cause of smoking-related diseases. The burning of tobacco causes the production of the vast majority of harmful chemicals that are the primary cause of smoking-related diseases. By eliminating the burning process, the levels of harmful chemicals generated can be significantly reduced compared with cigarette smoke.
If all those smokers who choose to continue using tobacco would switch completely to smoke-free alternatives, this would dramatically improve their lives and could be the end of cigarette smoking. This is why Philip Morris International has spent the last decade developing scientifically proven products that meet the needs of consumers in providing a better way to enjoy tobacco without burning it.
What are the differences between heated tobacco and cigarettes?
When a cigarette is lit, it burns at a temperature of around 600°C and produces thousands of harmful chemicals, many of which are widely recognised as being associated with the development of smoking-related diseases. Although still addictive and not risk-free, smoke-free alternatives can significantly reduce or eliminate the formation of the harmful chemicals caused by combustion or the burning of tobacco.
IQOS, the first of PMI’s new generation of heated tobacco products, heats specially designed tobacco sticks (branded HEETS) to temperatures no higher than 350°C, well below that required for combustion (around 600°C). As a result, IQOS emits 95% less harmful chemicals compared to the smoke of a reference cigarette. It does not necessarily equal a 95% reduction in risk. IQOS is not risk-free.
By heating the tobacco instead of burning it, the harmful chemicals generated by burning tobacco are significantly reduced, while still delivering nicotine. IQOS produces less smell than cigarettes and does not produce second-hand smoke which can be offensive to smokers or those around them. IQOS is not an e-cigarette or vape and doesn’t use liquids.