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.

 

New Eurobarometer Report Supports The Swedish Miracle

How can the European Union continue to deny Sweden’s success in tobacco harm reduction?  I have documented how Swedish snus has contributed to that country’s world record low rates of smoking (here and here) and smoking-related deaths – rates that would translate into hundreds of thousands of lives saved if snus were not banned in the rest of Europe (here and here).  The EU’s  European Commission persists in ignoring this American researcher and a growing number of international tobacco research and policy experts (here).  Perhaps a new report by Eurobarometer, the EU’s official survey organization, will force a policy change.

The 200+ page report (available here) analyzes tobacco prevalence and consumption, including cigarettes, snus and e-cigarettes, across all EU countries.  Its findings substantiate the dire consequences of the EU’s misguided ban on snus. 

The following table of reported key smoking indicators clearly demonstrates the effect of the Swedish snus experience.  Sweden has the lowest smoking prevalence, at 11% -- less than half the 26% prevalence throughout the EU and eight points lower than second-place Finland.  Sweden also leads the EU in prevalence of former smoking, at 35%.  It is the only country in the EU with cigarette consumption among smokers of less than 10 per day.  The reason is obvious: half of Swedes have “ever tried…oral tobacco (snus), chewing or nasal tobacco.”

Intriguing numbers are also supplied from Finland.  That nation has the second lowest smoking rate (19%) and the second highest ever use of smokeless tobacco (14%).  It is widely known that snus use remains popular in Finland.  In fact, snus importation increased last year (here), even though the product has been officially prohibited in Finland since it joined the EU in 1995.  Research shows that Finnish smoking rates would have declined even more if snus sales had not been banned (here).

Some suggest that snus would have no appeal outside of Sweden, but the product is clearly popular in Finland and in Denmark. Last year, the EU sued Denmark for permitting snus sales (here).  Also popular among Danes is a chewing tobacco product, Oliver Twist, another effective cigarette substitute and one that is legal in the EU.  The Eurobarometer numbers show that snus could work in Austria, Estonia and several other countries that have populations with smokeless tobacco experience.   

Keep in mind that the differences in snus and smoking rates noted here would have been much even more impressive if Eurobarometer had separately reported men and women’s numbers.  The snus experience has primarily affected smoking rates among Swedish men, although snus use has also been linked to smoking cessation in Swedish women (here).

The EU should take its head out of the sand and dissolve its unhealthy snus ban.

Tobacco Use in Sweden Versus the Rest of the European Union, 2014
EU Country	Current Smoking (%)	Former Smoking (%)	Cigarettes Per Day	Ever Tried Oral, Nasal Tobacco (%)
Sweden	11	35	9.9	50
Finland	19	24	13.5	14
Malta	20	19	14.8	1
Luxembourg	21	22	12.8	7
Italy	21	16	13.2	3
Ireland	21	19	13.9	5
Slovakia	21	16	12.5	4
United Kingdom	22	19	14.3	4
Estonia	22	21	11.5	10
Denmark	23	30	13.3	13
Netherlands	23	31	11.4	4
Belgium	25	19	14.1	5
Portugal	25	12	14.9	2
Czech Republic	25	18	14.3	9
Lithuania	26	18	12.1	5
Austria	26	17	19.8	10
Germany	27	22	15.3	9
Romania	27	13	14.2	1
Poland	28	15	15.6	5
Spain	29	19	13.7	2
Slovenia	30	18	16.5	6
Latvia	30	21	12.7	8
Hungary	30	11	16.1	3
Cyprus	31	15	19.5	2
France	32	22	13.0	4
Croatia	33	16	16.7	3
Bulgaria	35	16	15.6	2
Greece	38	21	19.5	1
EU	26	20	14.4	5

Big Tobacco Advertising and Promotion Do Not Drive Consumption

One of the longstanding fallacies promoted by the anti-tobacco movement is that tobacco use is solely driven by advertising and marketing by large multinational companies, also known as “Big Tobacco.”  

This is a weak claim because there is little independent evidence to validate it.  First, a historical perspective: Tobacco was originally cultivated only in the Western Hemisphere and was used by native Americans for thousands of years (here).  In 1492, Columbus discovered the new world, and tobacco.  In the short space of 100 years, tobacco was being consumed by people in nearly every corner of the globe.  This phenomenal explosion happened at a time when a trans-oceanic voyage took months.  In the 16^th Century Big Tobacco did not exist; consumption was driven then – as consumption is largely driven now – by the human brain’s powerful affinity for tobacco and nicotine.

While it’s true that tobacco has been enjoyed by people all over the world for hundreds of years, does Big Tobacco drive contemporary consumption?  To answer that question we can turn to Federal Trade Commission reports on advertising, promotion and sales of smokeless tobacco products (here) and cigarettes (here) in the U.S.

The chart on the left shows advertising and promotional expenditures for moist snuff and chewing tobacco and the amount sold in the U.S. from 1986 to 2010.  At first glance, it looks like the increase in moist snuff consumption from 36 million pounds in 1986 to 93 million in 2010, is related to the increase in advertising and promotion.  But moist snuff also benefited from a sharp decline in chewing tobacco sales, as I noted in my published study of smokeless tobacco use in 2000 and 2005 (abstract here, discussed in my blog here).    

The second chart on the left shows advertising and promotional expenditures for cigarettes and the number of cigarettes sold in the U.S. from 1975 to 2010.  During that time, cigarette consumption dropped almost continuously from 600 billion per year to 280 billion.  In contrast, cigarette advertising and promotion increased continuously from $490 million in 1975, to a peak of $15.2 billion in 2003; that was followed by a steep decline to $8.05 billion in 2010. 

What do these results show?  Cigarette consumption was declining in spite of substantial increases in advertising and promotion.  In 2004, cigarette manufacturers finally realized that they could not influence this trend, but anti-tobacco forces still refuse to believe it.

If tobacco advertising drives consumption, then Sweden should be nearly tobacco-free because tobacco ads were banned completely in that country in 1994 (here).  The prevalence of tobacco use in Sweden after 18 advertising-free years is similar to that in other developed countries.  The Swedish tobacco harm reduction story is not exemplary because of an advertising ban, but because of the availability and use of vastly safer snus.

The Swedish advertising experience will not be repeated in the U.S., but Americans will continue to adopt Swedish tobacco harm reduction methods.