Light and mild redux: heated tobacco products’ reduced exposure claims are likely to be misunderstood as reduced risk claims

Lucy Popova, Lauren Lempert, and I recently published “Light and mild redux: heated tobacco products’ reduced exposure claims are likely to be misunderstood as reduced risk claims” in Tobacco Control.  This paper is another in the series of papers we have written based on a careful reading of the data that Philip Morris International submitted to the FDA to support its application to market IQOS in the US as a less dangerous product.  We found that the information that PMI provided actually indicates that people are likely to misunderstand reduced exposure (i.e., users are exposed to less bad stuff by an IQOS than a conventional cigarette) as a reduced risk (i.e., IQOS is not as dangerous as a cigarette) claim.

This is important because even if FDA allows reduced exposure claims, they will be complicit in allowing PMI to mislead the public.  Without evidence of reduced risk, claims of lower exposure are inherently misleading because they will be interpreted as reduced risk claims even if they do not explicitly make reduced risk claims.

And, of course, the same things hold for how PMI is marketing IQOS all over the world.

Here is the abstract:

Introduction Heated tobacco products (HTPs) are being marketed in several countries around the world with claims that they are less harmful than combusted cigarettes, based on assertions that they expose users to lower levels of toxicants. In the USA, Philip Morris International (PMI) has submitted an application to the Food and Drug Administration (FDA) in 2016 seeking authorisation to market its HTPs, IQOS, with reduced risk and reduced exposure claims.

Methods We examined the PMI’s Perception and Behavior Assessment Studies evaluating perceptions of reduced risk claims that were submitted to the FDA and made publicly available.

Results Qualitative and quantitative studies conducted by PMI demonstrate that adult consumers in the USA perceive reduced exposure claims as reduced risk claims.

Conclusion The data in the PMI modified risk tobacco product IQOS application do not support reduced risk claims and the reduced exposure claims are perceived as reduced risk claims, which is explicitly prohibited by the FDA. Allowing PMI to promote IQOS as reduced exposure would amount to a legally sanctioned repeat of the ‘light’ and ‘mild’ fraud which, for conventional cigarettes, is prohibited by the US law and the WHO Framework Convention on Tobacco Control.

The citation is:  Popova L, Lempert LK, Glantz SA  Light and mild redux: heated tobacco products’ reduced exposure claims are likely to be misunderstood as reduced risk claims. Tobacco Control Published Online First: 12 September 2018. doi: 10.1136/tobaccocontrol-2018-054324.  It is available for free here.