Wednesday, 30 November 2016

The IQOS cometh

Today sees the UK launch of Philip Morris's heat-not-burn product, IQOS, and the Today programme carried an item on it which you can listen to here. Today went to PMI's Geneva headquarters to hear about the science behind it and also interviewed ASH's Deborah Arnott who did her usual moaning about industry but said that if IQOS helps smokers quit that was 'all well and good'.

She made the facile point was made that if PMI wanted to reduce harm they would stop selling cigarettes. The reality is that no harm would be reduced by one tobacco company ceasing production of cigarettes and if even if every tobacco company stopped selling them it is doubtful whether harm would be reduced by driving the market underground. But the more important point is that tobacco companies can only sell cigarettes because people want to buy them.

A more rational way of looking at it is to say that if smokers want to reduce harm, they would stop buying cigarettes. The fact that they don't suggests that they think smoking is worth the risk, or plan to give up at a later date, or have not found a suitable substitute.

That is where e-cigarettes, snus and new nicotine products such as IQOS come in. A couple of striking claims were made by PMI on the Today programme. Firstly, that IQOS delivers 90-95 per cent fewer harmful constituents than conventional smoking and, secondly, that 70 per cent of Japanese smokers who have tried it have switched to IQOS permanently. The other striking figure is that PMI have spent $3 billion on developing IQOS to date. In other words, they are taking this seriously. It is no harm reduction gimmick. 

If the degree of risk reduction can be independently confirmed and if the Japanese experience can be verified and replicated, this could be a significant development. Much depends on whether smokers know the product exists (no easy task given the UK's extreme ban on tobacco marketing) and whether they like it when they try it. As I discussed in Free Market Solutions in Health: The Case of Nicotine, there are unintended consequences from hyper-regulation that work against harm reduction.

We must wait and see, but UK smokers now have a chance to find out. PMI have opened an IQOS store in Soho. I'll be popping up there in a couple of weeks. I've tried the product before and although I switched to e-cigarettes a few years ago, I can see why smokers who have never fully embraced vaping—like my IEA colleague Mark Littlewood—like it.

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