The Japanese Tobacco Miracle the World is Overlooking

Smokers in Japan consumed 92.4 billion cigarettes in 2023 -- less than half as many as they did in 2014.  Since vapor products are illegal there, the impressive decline is likely due to the introduction of heat-not-burn tobacco products, which didn’t exist in 2014, but accounted for 38% of the Japanese tobacco market in 2023.  Notably, this progress occurred in an overall declining tobacco market. 

UK tobacco harm reduction advocate Clive Bates previously opined: “The only mystery is why the skies over Tokyo are not dark with chartered planes bringing officials from WHO, FDA, Truth Initiative, the Campaign for Tobacco-Free Kids, the European Commission and others on an emergency mission to learn about this most extraordinary shift.  What is the secret they would find? ‘Do nothing, stay out of the way....’  There was very little involvement from tobacco control – the demise of cigarettes in Japan has been driven by the market and consumer preference.”

Those officials should also be landing in Stockholm, the capital of the only country that has had comparatively minuscule smoking rates among men and is close to being officially smoke-free.

Instead, the WHO and its nicotine/tobacco prohibitionist allies persist in meddling with the natural demise of smoking that will result from the proliferation of vastly safer and satisfying cigarette substitutes.

One positive development to note: The U.S. FDA authorized the IQOS heat-not-burn system as a reduced exposure alternative to cigarettes on July 7, 2020, greenlighting these claims:

“AVAILABLE EVIDENCE TO DATE:

• The IQOS system heats tobacco but does not burn it.
• This significantly reduces the production of harmful and potentially harmful chemicals.
• Scientific studies have shown that switching completely from conventional cigarettes to the IQOS system significantly reduces your body’s exposure to harmful or potentially harmful chemicals.”

The FDA advised that its approval “is expected to benefit the health of the population as a whole.”

Unfortunately, a patent dispute in 2021 blocked U.S. IQOS sales, but there is still hope for American smokers for re-introduction of the brand in 2024.

Back in 1995, I wrote (here), “It is not surprising to find that Swedish lung cancer mortality rates have been the lowest in Europe over the past 40 years.  These large scale vital statistics from Sweden…strongly support the suggestion that if tobacco is to be used, it should be in the form of [smokeless tobacco, ST] and not cigarettes. The population that uses ST in lieu of smoking is, in effect, protected from lung cancer and other major smoking-related diseases and suffers little or no increased risk of oral cancer.”  Seven years later I spent six months conducting research in Sweden and publishing a series of real-world tobacco harm reduction articles (here). 

The Japanese and Swedish miracles weren’t the result of government programs or anti-tobacco campaigns.  They arose organically, as tobacco users in those countries made rational choices to use smoke-free substitutes instead of cigarettes.

 

 

IQOS Continued to Drive Down Japan Cigarette Sales in 2020; U.S. Cigarette Sales Steady

 

Japan is experiencing an unprecedented decline in cigarette consumption.  Japan Tobacco International reports (here) that cigarette sales dropped 8% in 2020, largely due to sales of reduced-risk products.  The dominant such product in Japan is Philip Morris International’s IQOS heat-not-burn HeatSticks.

U.K. veteran tobacco harm reduction advocate Clive Bates opined: “The only mystery is why the skies over Tokyo are not dark with chartered planes bringing officials from WHO, FDA, Truth Initiative, the Campaign for Tobacco-Free Kids, the European Commission and others on an emergency mission to learn about this most extraordinary shift.  What is the secret they would find? ‘Do nothing, stay out of the way....’  There was very little involvement from tobacco control – the demise of cigarettes in Japan has been driven by the market and consumer preference.” 

Meanwhile, the U.S. FDA finally authorized IQOS as a reduced exposure alternative to cigarettes on July 7, 2020, greenlighting these claims:

“AVAILABLE EVIDENCE TO DATE:

• The IQOS system heats tobacco but does not burn it.
• This significantly reduces the production of harmful and potentially harmful chemicals.
• Scientific studies have shown that switching completely from conventional cigarettes to the IQOS system significantly reduces your body’s exposure to harmful or potentially harmful chemicals.”

The FDA advised that its approval “is expected to benefit the health of the population as a whole.”

The Covid-19 pandemic is hurting U.S. IQOS marketing and sales.  PMI’s retail program requires smokers to visit an IQOS store to get educated about the system and purchase the hardware.  After that, smokers can buy the heat sticks in convenience stores and other outlets.  PMI’s program aims to suppress teen adoption, but the added inconvenience has slowed adoption by adult smokers.  The Wall Street Journal reports that the decades-long decline of cigarette sales has ended. One hopes the trend line will improve again as the pandemic comes under control and smokers make the effort to learn about this new smoke-free alternative.

 

IQOS Heat-Not-Burn Products Are Drawing Smokers Away from Cigarettes

Tobacco prohibitionists offer a plethora of reasons why harm reduction won’t work for smokers.  One last-gasp argument is that tobacco companies will never sacrifice cigarette sales by selling less harmful substitutes.  A recent report from Philip Morris International (PMI), however, provides substantial evidence that a transition from combustibles to smoke-free products is already happening across the globe.

The PMI chart at left shows that its iQOS heat-not-burn products accounted for 19% (about $5.6 billion) of the company’s 2019 revenues.  As recently as 2015, iQOS revenue was essentially zero.

PMI reports that IQOS is now available in 52 markets worldwide.  The company estimates that there are 13.6 million users, 71% of whom have stopped smoking completely, as seen in the following chart. 

 

The next chart shows that IQOS market share in key cities around the world varied considerably, from 3-4% in Zurich and Munich, to 14% in Moscow and Kiev, 21% in Tokyo, and 29% in Vilnius, Lithuania.

 

Although the FDA approved IQOS sales last year, the agency has still not determined whether it is a reduced risk product, two years after an FDA committee unanimously endorsed PMI’s claim that switching reduces smokers’ exposure to toxins.

PMI’s international sales suggest that IQOS will succeed in the U.S., although the product is currently available only in Atlanta and Richmond.

Note regarding use of company estimates: PMI marketing claims concerning IQOS are strictly regulated by the FDA, meaning they must be fully substantiated.  That is a considerable deterrence to inaccurate reporting, a control that does not apply to anti-tobacco activists in government or elsewhere.