One of the world's largest tobacco companies is rolling out a smokeless cigarette in Canada that it contends is less harmful than conventional combustible products, but some critics call the device merely a ploy to maintain – or even increase – market share in the face of dwindling smoking rates.
Philip Morris International has developed a heat-not-burn product called IQOS, or I-Quit-Ordinary-Smoking, that the tobacco giant says retains a high level of nicotine while reducing carcinogenic components found in the smoke of regular cigarettes.
PMI, along with its Canadian subsidiary Rothmans Benson & Hedges, says it is committed to a smoke-free future – one that eliminates the burning of cigarettes and helps Canada reach its goal of reducing the smoking rate to less than five per cent by 2035.
"Basically if you eliminate the combustion and the smoke in a product that is still satisfying to adult smokers, that's where we'll probably see a true impact of reduction on public health," PMI medical adviser Mikael Franzon said after travelling to Toronto this week from the U.S.
The IQOS product is comprised of a heating blade that's inserted into a cigarette-like stick called a HEETS, which contains ground tobacco. The blade heats the stick to about 350 degrees C., compared to the more than 800 degrees with a combustible cigarette, creating an aerosol instead of smoke.
"Because it is actually heated and not burned, the tobacco rod is intact after you have used it and it lasts six minutes or 14 puffs, whatever comes first," said Franzon, a smoking cessation expert who joined PMI about two years ago.
"But it still gives you the same amount of nicotine as you find in conventional cigarettes," he said, maintaining that testing by PMI scientists has shown there is a more than 90 per cent reduction in harmful components in the aerosol compared with smoke from regular cigarettes.
But Rob Cunningham, senior policy analyst for the Canadian Cancer Society, suggested the company is only blowing smoke when it touts its heat-not-burn technology as a means of reducing Canadians' tobacco use.
"Philip Morris is engaging in double-speak, saying that they want to decrease cigarette sales yet at the same time opposing legislative measures that would reduce cigarette sales, such as plain packaging, a menthol ban and higher (tobacco) taxes," said Cunningham.
"When they say they want to stop selling cigarettes, it is nothing more than a public relations stunt to distract attention from the regulatory measures that would be effective at reducing cigarette sales, measures that they oppose ... and to provide cover as they continue to aggressively sell and market cigarettes."
Given Big Tobacco's long history of denying smoking's link to cancer and other harmful health effects, Franzon said he understands there is skepticism about PMI's intentions.
"But I think also there is a new generation of people working in the tobacco industry, transforming it, and our main mission is to develop and deliver these smokeless products with the potential to reduce smoking-related risks," he said.
The company began selling IQOS in B.C. late last year and has since expanded availability to Alberta, Ontario, and Quebec. The heating unit and holder costs about $125, with a pack of 160 HEETS retailing for about $90, Franzon said.
The product is sold in 20 countries and PMI is seeking approval from the Food and Drug Administration to market IQOS in the U.S. In Canada, companies do not need to seek Health Canada approval to sell new products under the Tobacco Act.
Federal Health Minister Jane Philpott was not available for an interview Tuesday to comment on PMI's assertion that its heat-not-burn cigarettes could help Canada reach its 2035 smoking rate target. The latest estimates from 2015 put that rate at 17 per cent of the population aged 12 and older, or roughly 4.5 million Canadians.
While it's too early to know the specific health effects related to heat-not-burn technology, Philpott said by email that "the harms of tobacco products are indisputable ... New technologies such as vaping products present challenges and opportunities, as do emerging tobacco products reported by industry to be less harmful."
In fact, a study by independent Swiss researchers published in JAMA Internal Medicine in May found IQOS vapour also released carcinogenic chemicals – some of them in much higher concentrations than conventional cigarettes, principal investigator Dr. Reto Auer of the University of Bern reported at the time.
Franzon said PMI has sent a letter to JAMA criticizing the methodology used by the researchers to test its smokeless product against combustible cigarettes.
David Hammond, an expert in tobacco policy at the University of Waterloo, said PMI and other tobacco companies have been making claims about minimizing health risks for decades, going back to the 1950s when filtered cigarettes were introduced.
"If they think combustible cigarettes are killing people and they would rather not sell them, then I would ask them why they continue to sell them?" he said.
Still, Hammond agreed that any nicotine product that doesn't involve smoke inhalation "is almost certainly going to be less harmful than regular smoked cigarettes. That includes e-cigarettes and it probably includes these products."
But that doesn't mean they carry no risk, he said.
"To be clear, smokeless tobacco is less harmful than smoking cigarettes, but that does not mean that it's safe. We definitely know that there's some serious harms."