A World-Class Case of Corporate Self-Cannibalization May Save Millions of Lives

 

Heat-not-burn (HNB) tobacco products – mainly IQOS from Philip Morris (PMI) – are eroding cigarette sales in Japan, as I recently noted.  Prevalence estimates from the Japanese Health and Nutrition Survey confirm the consumption numbers. 

Because the Japanese survey only began tracking new products in 2018, no trend can yet be discerned, but HNB product use is impressive, as shown in the chart at left.  Depending on how dual users are counted, HNB accounted for 20 to 27 percent of all tobacco use in 2019.   

The highly credible Japanese Health and Nutrition Survey is the world’s oldest nutrition survey, implemented by Allied Forces after World War II.  Participants include adults age 20+ years; questions on smoking and HNB use are included in the lifestyle section. 

The HNB-driven Japanese harm reduction miracle has been ignored by most of the world, but Motley Fool just published an intriguing article, “Is It Time to Stop Thinking of Philip Morris International as a Cigarette Company?”

The answer is a resounding “Yes!”

There are two standout quotes in the article.

“Philip Morris' annual report shows that cigarette shipment volumes last year tumbled over 11%, with its most important brand Marlboro, which accounts for 37% of all cigarette shipments, down by a like amount.”

PMI risked its core cigarette business when the company launched the multi-year, multi-billion-dollar IQOS research and development effort.  Five years ago, it rolled the dice again when it marketed the products in Japan.  Leadership had no guarantee that IQOS would preferentially erode only other companies’ cigarette sales.  This may end up as a world-class example of self-cannibalization that ultimately saves millions of lives that would otherwise be cut short by smoking.  

“Philip Morris generated $6.8 billion in revenue last year from IQOS, or almost 25% of its total $28.7 billion in net revenue. [PMI CEO Andre] Calantzopoulos says if you just look at the three regions where IQOS is most prevalent -- Asia, Eastern Europe, and the European Union -- it represents 35% of the total.”

Naysayers have dismissed the Japanese miracle because there is no e-cigarette/vapor market there.  However, there is no doubt about the success of IQOS across 67 countries around the world.  IQOS might now find similar public health success in the U.S.  As Altria broadens distribution here, tobacco prohibitionists should give smoke-free tobacco products the opportunity to cancel smoking and advance public health.

 

 

 

Bloomberg Tobacco Article Misleads on Nicotine Effects

In an article published on March 4, Bloomberg reporter Tiffany Kary quotes from a February 25 letter sent to the FDA from Paige Magness, tobacco manufacturer Altria’s senior vice president for regulatory affairs. 

Per the article, “Altria asked the FDA to tackle misperceptions about nicotine as part of a proposed $100 million advertising campaign to reduce the harm caused by tobacco…three-fourths of U.S. adults incorrectly believe[e] nicotine causes cancer, Altria said in the communication, citing government research.”

While National Cancer Institute survey data show that only 25% of Americans correctly believe that nicotine does not cause cancer, Bloomberg erroneously asserts “it’s been known for years that nicotine isn’t the direct cause of many of smoking’s ills.”

The article continues, “The drug has even been touted as a way to ease tension and sharpen the mind,” before noting that it is “the ingredient that addicts people to tobacco products, and it has risks, including possibly making people more susceptible to abusing opioids.”

“Tout” is a derogatory term meaning to describe or advertise boastfully.  Given that nicotine conveys many proven benefits (here, here), touting is not required.  Still, Bloomberg irresponsibly and inaccurately paints it as a gateway to hard drugs.

Altria is not wrong to ask the FDA to combat misinformation about nicotine and tobacco, but the agency is unlikely to act on their request.  FDA officials have made their position clear, saying, in essence, “We will continue to tell Americans that all nicotine/tobacco products are dangerous.  Any manufacturers’ claims to the contrary about their products must be approved by us first.”

Bloomberg says the agency “does have the budget and marketing chops to reach the masses through its public education campaigns. But the agency uses much of those resources on targeting the health risks of products made by the likes of Altria. Its recent ‘Real Cost’ ads say oral tobacco can cause mouth cancer [which is not true, according to government research here], tooth loss [totally bogus, here], brown teeth and jaw pain [also caused by coffee and chewing gum], while ‘most vapes contain seriously addictive levels of nicotine.’” 

In addition to filling smokers’ brains with misinformation, the FDA’s “Real Cost” campaign costs taxpayers real money.  In a commentary published last year in the American Journal of Public Health, I commented that “The [second] largest FDA Center for Tobacco Products budget item ($159.5 million, or 22%) supports public education campaigns and communications to ‘reduce tobacco use’ and tell ‘target audiences’ about the ‘harms of tobacco product use.’ (Original Reference 6)  In this category, ‘The Real Cost’ Youth E-Cigarette Prevention Campaign (http://bit.ly/2IWTSWj ) shows e-cigarettes invading adolescent bodies as worms and a magician converting e-cigarettes into combustible cigarettes. The FDA has acknowledged, apparently without concern, that the campaign convinces adult smokers that e-cigarettes are equally or more harmful than cigarettes, thus suppressing quitting. (Reference 7).”

Attempting to lend credence to the story, Bloomberg quotes Eric Lindblom, a lawyer who has worked for the FDA and for the prohibitionist Campaign for Tobacco-Free Kids.  Offering the pseudo-revelation that “Nicotine isn’t benign,” Lindblom opines that nicotine “can interfere with brain development [a documented fallacy] and birth outcomes” and closes with a non sequitur: “It’s an agricultural poison in large doses.”

What is the relevance of large-dose agricultural applications to smokers, dippers and vapers?  Absolutely zero, as with the value of the cited Bloomberg hit piece.

 

 

 

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.