Is the world awakening to the heated tobacco smokescreen?

In late July, Philip Morris International (PMI) delayed the U.S. test launch of its IQOS heated-tobacco device to the end of the year without a clear explanation. Initially slated for a second quarter unveiling in Austin, Texas, the pilot faced strong opposition from anti-tobacco and public health activists, who accuse PMI of exaggerating the number of smokers who quit using IQOS in addition to misrepresenting the US Food and Drug Administration's (FDA) regulatory decisions to facilitate heated tobacco marketing and sales in other countries.

Adding to the headwinds against PMI is the EU's flavoured, heated tobacco ban, a pillar of the bloc's 'Europe's Beating Cancer Plan,' which entered into force last October and whose higher than anticipated impact has prompted PMI to lower its annual growth forecast for this product category. Moving forward, public health leaders and policymakers must build on rising international momentum and well-established research to place heated tobacco products on the same regulatory footing as traditional tobacco, protecting the global anti-tobacco effort from the industry's machinations.

Walls Closing In on Big Tobacco

In a June 27 letter addressed to the FDA, six major health organisations, including the American Heart Association and the American Cancer Society, boldly challenge PMI's claims on heated tobacco's smoking reduction benefits. The letter's authors notably cite recent independent studies on IQOS conducted in other countries, which "fail to show a population-wide public health benefit," while highlighting PMI's habit of making "misleading and deceptive statements wrongly suggesting that the FDA has found that IQOS reduces the risk of disease."

Concerningly, PMI has applied for FDA approval to reintroduce IQOS as a "modified risk product," which would subject it to more lenient marketing regulations, a vital commercial objective as Big Tobacco sees heated tobacco as the future amid long-term projected declines in cigarette sales in former stronghold markets like the U.S. and Europe. Amid tightening regulations and falling smoking rates, PMI has invested over $12.5 billion in the expansion of its non-combustible cigarette portfolio, with the lion's share going into the development of IQOS.

PMI aims for IQOS, already the global market leader in heated tobacco devices, to seize a 10% chunk of the U.S. industry within five years. With PMI estimating the U.S. profit pool for heated tobacco at roughly $20 billion, regulators and health advocates should prepare for the company to double down on its aggressive campaign of deception to minimise scrutiny and secure its future commercial success.

French Court Raising the Alarm

Encouragingly, the emerging public health uprising in the U.S. is being mirrored on the other side of the Atlantic, with this mounting international pushback against heated tobacco devices coming at a critical juncture. In late June, the Paris Court of Appeal slapped Philip Morris France (PMF) and Philip Morris Products (PMP) with a €900,000 fine for illegal tobacco advertising related to IQOS. Initiated by France's National Committee Against Smoking (CNCT), the case targeted PMI's advertising campaigns since the product's launch in the country, notably with the Ministry of Health's backing.

In a massive blow to PMI, the French court has confirmed that IQOS is "indissociable from a tobacco product," given it cannot function without HEETS tobacco inserts, meaning it is subject to the same advertising regulation as traditional tobacco products. Crucially, the Paris Court of Appeal's ruling aligns with the World Health Organisation's (WHO) position, which last year reminded national authorities that a "separate marketing regulation" of heated tobacco products "as a non-tobacco product is...not warranted." By extension, governments in every WHO country should place wide-ranging regulatory constraints on IQOS and all heated tobacco products to match those imposed on combustible cigarettes, from robust excise tax regimes and public smoking prohibitions to bans on sales to minors and industry-independent traceability to tackle the illicit tobacco trade.

More broadly, the French judges have highlighted how the promotion of IQOS has pulled from PMI's traditional playbook of deception, presenting the product as a healthy alternative for smokers and a key driver of a "smoke-free world"—a knowingly illegal marketing strategy deployed globally that the Court notes has contributed to an undeniable rise in tobacco consumption.

Landmark Ruling Set to Shape Legal Norms

Looking at the broader picture, the CNCT views Paris' ruling as a fundamental step forward, potentially setting a precedent for other countries where PMI is relentlessly promoting IQOS at the expense of national smoking reduction and public health efforts.

Spain has equally taken a strong stand in this space, with its government recently implementing stricter regulations on heated tobacco products to put them on par with traditional cigarettes by banning additional flavours and requiring packaging health warnings. Yet, despite the promise embodied by this Paris-Madrid tandem, heated tobacco consumption in these countries remains considerably lower than in countries outside of Europe with significantly more permissive regulatory environments.

For example, a study published earlier this year found that 13% of adults in Pakistan regularly use heated tobacco products, underscoring how the fight against PMI's misleading charm offensive must be deployed rapidly and globally. Moving forward, this international effort is likely to accelerate further as information trickles out about the cynical tactics employed by PMI and its fellow Big Tobacco giants to get consumers hooked on heated tobacco products.

Time to Ramp Up Global Defences

Proving that PMI is certainly not alone, Italy's national competition authority, the AGCM, fined British American Tobacco (BAT) and Amazon €7 million last February for their misleading advertising of heated tobacco products as "simple electronic devices" while failing to inform consumers about nicotine content and health risks.

Meanwhile, in July, the Bureau of Investigative Journalism (TBIJ) exposed PMI for secretly funding heated tobacco research at prestigious universities in a bid to boost IQOS sales in Japan through six-figure payments made via a web of intermediaries. This damning revelation came from whistleblower Shiro Konuma, a former senior official at Philip Morris Japan. The same month, a new study revealed the stark, ethnicity-based differences in the way IQOS is portrayed in Israeli media, with outlets targeted at the country's Arab population often providing misleadingly positive information about its safety and benefits, heavily relying on PMI's narratives.

With researchers increasingly sounding the alarm on PMI for "manipulating science for profit"—notably based on leaked internal documents revealing a covert IQOS marketing strategy—governments, public health professionals, and NGOs around the world must come together urgently to thwart Big Tobacco's powerplay and protect citizens from the industry's latest assault on public health.