18B.3 Advertising and promotion of heated tobacco products

Last updated: May 2024           

Suggested citation: Greenhalgh, EM & Hippolyte, D. 18B.3 Advertising and promotion of heated tobacco products. In Greenhalgh EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2024. Available from:  https://www.tobaccoinaustralia.org.au/chapter-18-e-cigarettes/indepth-18b-non-combustible-cigarettes/18b-3-advertising-and-promotion-of-heated-tobacco-products

 

Manufacturers of heated tobacco products have heavily invested in promoting their products to target markets and subgroups.1-4 Heated tobacco products were advertised as reduced-risk tobacco products (i.e., a less harmful alternative to smoking) in their Japanese test market, and such marketing messages has spread to other markets even where such messaging is banned.5 Analyses of marketing strategies consistently note portrayals of the products as a healthier/cleaner alternative to smoking;6-10 though in countries that have introduced more restrictive marketing regulations, the industry has been shown to shift the focus of advertising from product risk to product features such as design and technology,6 or to adapt its content in other ways to circumvent restrictions.2 A survey in Japan in 2018 found substantial exposure to heated tobacco product advertising, including among young people and non-users.4 Researchers have emphasised the importance of comprehensive bans on heated tobacco advertising.2, 4

The design of heated tobacco products is an important selling point for the products. An analysis of marketing strategies in Switzerland and Japan found that Philip Morris International (PMI) promoted the product as sophisticated, exclusive, and aspirational akin to iPhones; strategies that may particularly appeal to youth and young adults.11 PMI’s marketing strategy in New Zealand also highlighted the device’s sleek curves and resemblance of an iPhone or novel fashion accessory.12 Additional design features that have been emphasised in advertising include the products’ high-tech appearance, rapid charging, reduced odour and secondhand smoke, and customisation with colours and limited-edition designs.7 Qualitative interviews have identified less throat discomfort, novel technology, sleek design, appealing packaging, cleanliness, lack of ash and smoke and more social acceptability as key benefits of heated tobacco products.11, 13

The aggressive online marketing of heated tobacco products via social media sites4, 14-17 is concerning because of the medium’s particular appeal to youth. British American Tobacco (BAT) has used young Instagram and Youtube models in advertisements for its glo device,18 and PMI recruited young Instagram influencers as part of its global digital campaign to promote the IQOS via Instagram.19 An analysis of Instagram posts found that posts with models or lifestyle elements (such as a pool or luxury car) had highest user engagement.20 PMI has also used the dating website Tinder to promote its products, touting the IQOS as “A perfect match” for its users, who are disproportionately youth.12 Public health experts have criticised these campaigns as attempts to indoctrinate a new generation of young people into tobacco use.12, 18 Although major social media platforms such as Facebook and Instagram have policies prohibiting the use of paid influencers to promote tobacco products, researchers have noted that such policies are difficult to enforce and widely flouted.16

Additional marketing strategies have also been noted that target particular groups.7 In Poland, despite being prohibited, an observational study found that advertising and promotion of heated tobacco products was rife in nightclubs. This included signs, branded bar accessories, and brand representatives giving out free samples.21 In Japan, ‘transfer discounts’ have been offered by some manufacturers of heated tobacco products; that is, substantial discounts on their products if a competitor’s product is traded in.22 An analysis of print advertisements in the US concluded that IQOS advertisements appear to be particularly targeting women.23 In the UK, a life insurance provider wholly owned by PMI offered premium discounts for people who smoke who switched to IQOS.24 Manufacturers have also sponsored sporting events, art shows, concerts and food and wine festivals.7

IQOS marketing is also common in retail stores.25-27 In the US, one study noted products within full view of all customers including children,25 and research in Israel noted tactics such as product displays and signage that circumvent marketing restrictions.28 An additional marketing strategy is the opening of dedicated retail stores in some countries.7 In Ontario Canada, a study of IQOS boutique stores noted promotional activities including exchanging a pack of cigarettes or lighter for an IQOS device, launch parties, ‘meet and greet’ lunches, and after-hour events.26

In 2016, Philip Morris International (PMI) submitted an application to the FDA seeking authorisation to market IQOS with reduced risk and reduced exposure claims. In its application to the FDA, PMI did not provide any information about its marketing and media plans for the IQOS, which raised concern over potential youth-appealing marketing.29 In 2019, the FDA authorised sale of IQOS in the US through the premarket tobacco product application (PMTA) pathway.30 An analysis of PMI’s marketing in the wake of this authorisation concluded that the company had implied the FDA—a highly trusted governmental agency—approved/endorsed the IQOS, rather than simply authorising it for sale.31 In 2020 the FDA further authorised the marketing of IQOS as modified risk tobacco products. This allows PMI to market the products with the following information: 

 “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.”32

The FDA’s decision was criticised by public health experts, who argue that the products may pose significant health risks33 and that Philip Morris failed to produce adequate evidence of public health benefits of IQOS and therefore failed to meet the rigorous public health standards that are detailed in the law.34 Researchers examined PMI’s FDA application and concluded that PMI’s studies failed to provide evidence that youth, including non-users and former users, will not find IQOS appealing, will not initiate use of IQOS, and will not perceive these products as risk-free.35

Advertising themes noted in the US post-FDA authorisation included switching from traditional cigarettes, same-day/home-delivery, convenience (e.g., use indoors), reduced exposure to some dangerous substances, science/research and distinction from e-cigarettes.9 PMI’s own studies submitted alongside the application showed that adult consumers misperceive reduced exposure claims as reduced risk claims,36 and a range of news outlets similarly reported that the products had been deemed ‘safer’ than cigarettes.37 Independent studies have also found that IQOS ads with modified exposure claims reduce product harm perceptions and/or increased use intentions among consumers and among health professionals.38-40 Research has also shown that descriptions of ‘switching completely’ (from cigarettes to heated tobacco products) are misinterpreted by most smokers as compatible with continued use of cigarettes.41 Mandated health warnings, although frequently noticed by users, do not appear to increase risk perceptions and may instead reassure heated tobacco product users.42

In May 2021, a US International Trade Commission court decision regarding a patent-infringement lawsuit initiated by British American Tobacco against PMI required PMI to discontinue IQOS sales in the US in November 2021. Nonetheless, PMI continued to aggressively market IQOS after the court decision.43 The case was settled in early 2024 with reports stating that under the agreement the parties will request the block on IQOS imports into the US to be rescinded.44  

Relevant news and research

For recent news items and research on this topic, click here. (Last updated May 2024)

References 

1. Khayat A, Levine H, Berg CJ, Shauly-Aharonov M, Manor O, et al. IQOS and cigarette advertising across regulatory periods and population groups in Israel: a longitudinal analysis. Tobacco Control, 2024; 33(e1):e3-e10. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36368887

2. Khayat A, Berg CJ, Levine H, Rodnay M, Abroms L, et al. PMI's IQOS and cigarette ads in Israeli media: a content analysis across regulatory periods and target population subgroups. Tobacco Control, 2024; 33(e1):e54-e61. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36418166

3. Ichikawa M, Hori A, Inada H, and Tabuchi T. Intensified advertising of heated tobacco products in Japan: an apparent shift in marketing strategy. Tobacco Control, 2023; 32(1):130. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34031227

4. Craig LV, Yoshimi I, Fong GT, Meng G, Yan M, et al. Awareness of Marketing of Heated Tobacco Products and Cigarettes and Support for Tobacco Marketing Restrictions in Japan: Findings from the 2018 International Tobacco Control (ITC) Japan Survey. International Journal of Environmental Research and Public Health, 2020; 17(22). Available from: https://www.ncbi.nlm.nih.gov/pubmed/33202995

5. Caputi TL, Leas E, Dredze M, Cohen JE, and Ayers JW. They're heating up: Internet search query trends reveal significant public interest in heat-not-burn tobacco products. PLoS One, 2017; 12(10):e0185735. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29020019

6. Goulette MR, Gravely S, Xu SS, Meng G, Quah ACK, et al. Perceptions of harmfulness of heated tobacco and nicotine vaping products compared to cigarettes, and the association of advertising exposure on harm perceptions among adults who smoke in South Korea: Cross-sectional findings from the 2020 ITC Korea Survey. Tobacco Induced Diseases, 2023; 21:121. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37781238

7. WHO Study Group on Tobacco Product Regulation. Report on the scientific basis of tobacco product regulation: Eighth report of a WHO study group., WHO Technical Report Series, No. 1029.Geneva, Switzerland: WHO, 2021. Available from: https://www.who.int/publications/i/item/9789240022720

8. Braznell S, Branston JR, and Gilmore AB. Corporate communication of the relative health risks of IQOS through a webchat service. Tobacco Control, 2023; 32(e2):e205-e11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35241501

9. Berg CJ, Romm KF, Bar-Zeev Y, Abroms LC, Klinkhammer K, et al. IQOS marketing strategies in the USA before and after US FDA modified risk tobacco product authorisation. Tobacco Control, 2023; 32(4):418-27. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34667105

10. Berg CJ, Bar-Zeev Y, and Levine H. Informing iQOS Regulations in the United States: A Synthesis of What We Know. SAGE Open, 2020; 10(1):2158244019898823. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32719733

11. Hair EC, Bennett M, Sheen E, Cantrell J, Briggs J, et al. Examining perceptions about IQOS heated tobacco product: consumer studies in Japan and Switzerland. Tobacco Control, 2018; 27(Suppl 1):s70-s3. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29764957

12. McKenzie P. Big tobacco’s stake in the NZ dating scene Newsroom,  2019. Available from: https://www.newsroom.co.nz/2019/09/10/798296/big-tobaccos-stake-in-the-nz-dating-scene#

13. Kim M, Watkins SL, Koester KA, Mock J, Kim HC, et al. Unboxed: US Young Adult Tobacco Users' Responses to a New Heated Tobacco Product. International Journal of Environmental Research and Public Health, 2020; 17(21). Available from: https://www.ncbi.nlm.nih.gov/pubmed/33153143

14. Abroms LC, Wysota CN, Tosakoon S, Khayat A, Duan Z, et al. Industry marketing of tobacco products on social media: case study of Philip Morris International's IQOS. Tobacco Control, 2023. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36927516

15. Kostygina G, Tran H, Kim Y, Czaplicki L, Kierstead E, et al. Heating Up: How Early Twitter Marketing Gave Rise to Organic Word-of-Mouth About Heated Tobacco Products. Soc Media Soc, 2022; 8(4). Available from: https://www.ncbi.nlm.nih.gov/pubmed/36908750

16. Gu J, Abroms LC, Broniatowski DA, and Evans WD. An Investigation of Influential Users in the Promotion and Marketing of Heated Tobacco Products on Instagram: A Social Network Analysis. International Journal of Environmental Research and Public Health, 2022; 19(3). Available from: https://www.ncbi.nlm.nih.gov/pubmed/35162709

17. Myers M. Philip Morris Caught Red-Handed Marketing IQOS to Young People on Social Media. Campaign for Tobacco-Free Kids,  2019. Available from: https://www.tobaccofreekids.org/press-releases/2019_05_10_pmi_iqos_socialmedia_marketing

18. Shukman H. British American Tobacco used young Instagram stars in its ads. The Times,  2019. Available from: https://www.thetimes.co.uk/article/british-american-tobacco-used-young-instagram-stars-in-its-ads-hs6wgf5z2

19. Kirkham C. Exclusive: Philip Morris suspends social media campaign after Reuters exposes young 'influencers'. Reuters,  2019. Available from: https://uk.reuters.com/article/us-philipmorris-ecigs-instagram-exclusiv/exclusive-philip-morris-suspends-social-media-campaign-after-reuters-exposes-young-influencers-idUKKCN1SH02K?feedType=RSS&feedName=healthNewsMolt&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+reuters%2FUKHealth+%28News+%2F+UK+%2F+Health+%26+Drugs%29

20. Chen J, Xue S, Xie Z, and Li D. Characterizing Heated Tobacco Products Marketing on Instagram: Observational Study. JMIR Form Res, 2023; 7:e43334. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36920463

21. Nowicka J and Balwicki L. Heated tobacco products and cigarette marketing in nightclubs in Gdansk, Poland: A mixed-methods analysis. Tob Prev Cessat, 2024; 10. Available from: https://www.ncbi.nlm.nih.gov/pubmed/38188060

22. Hirano T. A battle of heated tobacco sales: transfer discount promotions in Japan. Tobacco Control, 2023. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37620138

23. Ganz O, Strasser AA, Giovenco DP, Audrain-McGovern J, Cappella JN, et al. IQOS print magazine advertising characteristics and reach before and after FDA authorisation as a modified risk tobacco product. Tobacco Control, 2023. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36958825

24. Prochaska JJ and Henriksen L. PMI reduced-risk claims and upselling of IQOS via Reviti life insurance. Tobacco Control, 2020; 29(e1):e136-e7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31366704

25. Henderson KC, Van Do V, Wang Y, Duan Z, Popova L, et al. Brief report on IQOS point-of-sale marketing, promotion and pricing in IQOS retail partner stores in Atlanta, Georgia, USA. Tobacco Control, 2023; 32(e2):e260-e4. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35918133

26. Mathers A, Schwartz R, O'Connor S, Fung M, and Diemert L. Marketing IQOS in a dark market. Tobacco Control, 2019; 28(2):237-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29724866

27. Bar-Zeev Y, Levine H, Rubinstein G, Khateb I, and Berg CJ. IQOS point-of-sale marketing strategies in Israel: a pilot study. Isr J Health Policy Res, 2019; 8(1):11. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30642383

28. Bar-Zeev Y, Berg CJ, Khayat A, Romm KF, Wysota CN, et al. IQOS marketing strategies at point-of-sales: a cross-sectional survey with retailers. Tobacco Control, 2023; 32(e2):e198-e204. Available from: https://www.ncbi.nlm.nih.gov/pubmed/35140170

29. No authors listed. 4 big concerns about selling IQOS heat-not-burn cigarettes in the US. Truth Initiative,  2018. Available from: https://truthinitiative.org/news/4-big-concerns-about-selling-iqos-heat-not-burn-cigarettes-us

30. Food and Drug Administration (FDA). FDA permits sale of IQOS Tobacco Heating System through premarket tobacco product application pathway.  2019. Available from: https://www.fda.gov/news-events/press-announcements/fda-permits-sale-iqos-tobacco-heating-system-through-premarket-tobacco-product-application-pathway.

31. Leas EC, Cohen JE, and Ayers JW. A Philip Morris advertisement for its heated tobacco product IQOS sets a troubling precedent. Tobacco Control, 2020; 29(e1):e168-e70. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32019894

32. US Food and Drug Administration. FDA Authorizes Marketing of IQOS Tobacco Heating System with ‘Reduced Exposure’ Information.  2020. Available from: https://www.fda.gov/news-events/press-announcements/fda-authorizes-marketing-iqos-tobacco-heating-system-reduced-exposure-information.

33. Kaplan S. F.D.A. permits the sale of IQOS, a new tobacco device. NY Times,  2019. Available from: https://www.nytimes.com/2019/04/30/health/iqos-tobacco-device-fda.html

34. Glantz S. FDA sets exceptionally low bar when authorizing IQOS, a new tobacco products Center for Tobacco Control Research and Education,  2019. Available from: https://tobacco.ucsf.edu/fda-sets-exceptionally-low-bar-when-authorizing-iqos-new-tobacco-products

35. Glantz S. PMI’s MRTP Application for IQOS Does Not Consider IQOS’s Appeal to Youth or Adolescents. UCSF Center for Tobacco Control, Research and Education,  2017. Available from: https://tobacco.ucsf.edu/pmi%E2%80%99s-mrtp-application-iqos-does-not-consider-iqos%E2%80%99s-appeal-youth-or-adolescents

36. Popova L, Lempert LK, and Glantz SA. Light and mild redux: heated tobacco products' reduced exposure claims are likely to be misunderstood as reduced risk claims. Tobacco Control, 2018; 27(Suppl 1):s87-s95. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30209208

37. No authors listed. PMI Promotion of IQOS Using FDA MRTP Order. Tobacco Tactics,  2020. Available from: https://tobaccotactics.org/wiki/pmi-iqos-fda-mrtp-order/

38. Wackowski OA, Steinberg MB, and Delnevo CD. Impact of IQOS modified risk messaging on physicians' product perceptions and recommendations. Tobacco Control, 2023. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37280064

39. Mays D, Johnson AC, Glasser A, Mercincavage M, and Strasser AA. Effects of IQOS health warnings and modified risk claims among young adult cigarette smokers and non-smokers. Tobacco Control, 2023; 32(4):505-8. Available from: https://www.ncbi.nlm.nih.gov/pubmed/34716283

40. McKelvey K, Baiocchi M, and Halpern-Felsher B. PMI's heated tobacco products marketing claims of reduced risk and reduced exposure may entice youth to try and continue using these products. Tobacco Control, 2020; 29(e1):e18-e24. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32029537

41. Yang B, Massey ZB, and Popova L. Effects of modified risk tobacco product claims on consumer comprehension and risk perceptions of IQOS. Tobacco Control, 2022; 31(e1):e41-e9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33688084

42. Duan Z, Levine H, Bar-Zeev Y, Cui Y, LoParco CR, et al. Health warning labels on heated tobacco products and their impact on use intentions and risk perceptions: a cross-sectional study of adult tobacco users in the US and Israel. Isr J Health Policy Res, 2023; 12(1):33. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37957696

43. Duan Z, Levine H, Romm KF, Bar-Zeev Y, Abroms LC, et al. IQOS Marketing Strategies and Expenditures in the United States From Market Entrance in 2019 to Withdrawal in 2021. Nicotine & Tobacco Research, 2023; 25(11):1798-803. Available from: https://www.ncbi.nlm.nih.gov/pubmed/37338204

44. Shabong Y and Rumney E. BAT, Philip Morris settle patent disputes over heated tobacco, vapes. Reuters, 2024. Available from: https://www.reuters.com/business/healthcare-pharmaceuticals/bat-philip-morris-settle-all-patent-litigations-relating-heated-tobacco-vapes-2024-02-02/