IQOS Marketing in the US: The Need to Study the Impact of FDA Modified Exposure Authorization, Marketing Distribution Channels, and Potential Targeting of Consumers

Abstract

IQOS, the leading heated tobacco product globally, recently received 'reduced exposure' authorization from the US Food and Drug Administration. Independent research focusing on IQOS marketing and potential impact on consumers' perceptions and behavior, and ultimately public health, is critical. The literature to date has underscored several concerns. First, Philip Morris's (PM's) marketing distribution requires scrutiny, particularly given its innovative promotional strategies. For example, IQOS is distributed via unique points-of-sale (POS; e.g., specialty and pop-up stores, "corners" in convenience stores) and uses various other opportunities (e.g., social media, sponsored events, direct-to-consumer). Second, although PM claims that IQOS' target market is current combustible tobacco users and not young people, the literature indicates that in some populations, IQOS use is equally prominent among smokers and nonsmokers, and that specific subgroups (e.g., young adults, women) are targeted. Third, the impact of IQOS' use of ad content promoting IQOS health benefits must be studied (e.g., how consumers interpret modified exposure messages). In conclusion, surveillance of IQOS marketing, particularly following reduced exposure authorization, is critical for obtaining valuable data to estimate population impact, particularly among population subgroups (e.g., young adults), and inform future tobacco regulation. These considerations have implications beyond IQOS-to other products and companies.

Keywords: heated tobacco products; marketing; tobacco control; tobacco industry.

Figure 1

Types of IQOS points-of-sale. Notes: (A): Specialty Store, Lenox Mall, Atlanta, Georgia, US, Fall 2019 [37]; (B): Kiosk, Pentagon City Mall, Arlington, Virginia, US, Summer 2021 (photo by authors); (C,D): Specialty Store, Richmond, Virginia, US, Spring 2021 (photo by authors); (E): Corner, Kuala Lumpur, Malaysia, Fall 2019 [49]; (F,G): Pop-up, Thessaloniki, Greece, Summer 2018 [50].

Figure 2

Use of health warning content and FDA MRTP in Israel IQOS ad (translated). Note: Ad from Israel in Spring 2021, purchased from Ifat group [81], initially in Hebrew and translated to English.