By Wendell Balderas
BANGKOK, Thailand, Jun 14 2019 (IPS)

The U.S. Food and Drug Administration’s (FDA) decision authorizing the sale of Philip Morris International (PMI)’s heated tobacco system, IQOS, in the United States inadvertently puts a foot in the door to increase sales of new tobacco products in the developing world.

In April this year, the FDA authorized the sale of IQOS heated tobacco products in the US. However, it clarified that it has not approved IQOS as a ‘modified risk tobacco product’ (MRTP). But PMI is riding on this ‘US-FDA approved for sale’ of its IQOS as also safer alternative to regular cigarettes to Asian governments.

In Indonesia, PMI’s local subsidiary PT HM Sampoerna signed a Memorandum of Understanding (MOU) with the Ministry of Research, Technology and Higher Education (Kemenristek Dikti) to support IQOS research and capacity building.

Local tobacco control advocates have criticised this collaboration claiming this is an industry tactic to attract new smokers, especially among the younger generation. Meanwhile PMI’s plans to sell even more cigarettes in Indonesia remain on track reflected by its ubiquitous cigarette advertisements.

While Malaysia’s Control of Tobacco Products Regulation requires pictorial warning on all tobacco products, IQOs is being sold as safer alternatives to regular cigarettes without these warnings.

IQOS is marketed via social media and have escaped the arm of regulators. BAT and JTI are now applying pressure on the government to allow sales of their versions of heated tobacco products.

In the Philippines, PMI claims on one-hand that cigarettes are harmful, smokers should quit and children should not buy them, however in the same breath it continues to refute evidence about smoking.

PMI’s lawyer, representing the Philippine Tobacco Institute (PTI), has filed two court cases challenging Balanga City, Bataan which has passed laws to ban smoking in public places and protect its youth from being exposed to cigarette promotions.

Also, the tobacco industry is trying to sneak Heated Tobacco Products (HTPs) into the bills being deliberated in the Philippine Senate and House of Representatives to regulate e-cigarettes (Electronic Nicotine Delivery Systems).

This deception is a typical duplicitous move by the tobacco industry to weaken tobacco product regulation simultaneously deceiving the public to embrace its HTPS as less harmful than regular cigarettes.

In Vietnam, PMI’s President of South and Southeast Asia has met with the Vice Chairman of the National Assembly (NA) promoting its research and development of less harmful product.

PMI’s request to the National Assembly leader was tactical – that they should provide a legal framework to enable its new products to be developed in Vietnam, and on its part, it will provide its own scientific research as well as research from organizations in the United States and Europe.

According to a press report, the Vice Chairman of the National Assembly was ready to create favorable conditions for foreign businesses to invest and expand their business. In investment talks, the emerging evidence on the risks associated with these new tobacco and nicotine products are somewhat lost and even challenged.

Korea’s Ministry of Food and Drug Safety announced in June last year that five cancer-causing substances were found in HTPs including PMI’s IQOS, British American Tobacco’s (BAT) Glo and Lil, with the level of tar detected in some of them far exceeding that of conventional cigarettes.

PMI has filed a lawsuit against the South Korean government to demand the disclosure of detailed information on Seoul’s test results of harmful substances found in electronic cigarettes.

The World Health Organization (WHO) has warned that all forms of tobacco, including heated tobacco products (HTPs), are harmful and that there is no evidence to demonstrate that HTPs are less harmful than conventional tobacco products.

A research paper from the University of California San Francisco also concluded “despite delivering lower levels of some toxins than conventional cigarettes, PMI’s own data fail to show consistently lower risks of harm in humans using its heated tobacco product, IQOS, than conventional cigarettes.”

In April 2019 a Swiss lab found a highly toxic substance, isocyanates, emitted from the filters of IQOS. According to pulmonologist and former vice-president of the Swiss Lung League, Rainer Kaelin, inhaling very small amounts of this toxic substance can cause serious health damage.

Tobacco is inherently toxic and contains carcinogens and toxicants even if not burned. HTPs such as IQOS are not harmless, and the precautionary principle to protect consumer safety must be applied to HTPs.

Around 40 countries already ban the sale of e-cigarettes and emerging tobacco products such as HTPs. Among these are four ASEAN countries: Brunei Darussalam, Cambodia, Singapore and Thailand.

Others include Argentina, Australia, Brazil, East Timor, Kuwait, Taiwan, UAE, and Uruguay. The FDA’s decision should not cause these countries to roll back their ban. These countries have implemented strict tobacco control measures based on the WHO Framework Convention on Tobacco Control (FCTC) and have seen their smoking prevalence decline steadily.

Under the guise of ‘harm reduction’, new and emerging tobacco products such as HTPs pose new threats to society. While continuing to increase sales of cigarettes, transnational tobacco companies are aggressively selling e-cigarettes and HTPs as part of their revamped “smoke-free” image and ironic claims to be part of the solution to the smoking epidemic.

Policy makers should be aware of these veiled attempts of tobacco companies to influence governments to create exemptions for their HTPs and roll back tobacco control policies so as to mislead the public, renormalize tobacco use, increase social acceptability for their products and get more people to be addicted to their products.

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A cigarette vendor in Manila sells a pack of 20 sticks for less than a dollar. Credit: Kara Santos/IPS

By Mary Assunta and Wendell Balderas
BANGKOK, Thailand, Mar 14 2019 (IPS)

International Women’s Day on 8 March recognized and celebrated the progress women are making globally. The day also acknowledged the risks, exploitation and suffering many continue to endure.

The Southeast Asia Tobacco Control Alliance (SEATCA) puts the spotlight on the tobacco industry’s marketing tactics targeting women and girls especially in Asia to market its deadly products.

While smoking prevalence among females remains relatively low in Asia, smoking rates among adolescent girls in the Philippines, Malaysia, and Thailand however are higher than the rate among adult women respectively (9.1% vs 5.8%; 2.4% vs 1.4%; 5.2% vs 1.7%). Despite governments’ efforts to protect public health, tobacco use remains at epidemic proportions.

This is no coincidence. The tobacco industry needs “replacement” customers to maintain and increase its profits, and women and girls are an important market segment which represent the largest product-marketing opportunity the tobacco industry exploits.

Internal tobacco industry documents reveal that the tobacco industry has been notoriously targeting women and girls through their ads and novel products that promote social desirability, independence, sophistication, glamor, romance, and fun.

Women and girls, especially in low and middle-income countries (LMICs), are smoking in greater numbers than ever before. The tobacco industry has been introducing new products framed as “innovation” by refreshing brand marketing devices and imagery to appeal to women and young girls.

Through these product “innovation”, transnational tobacco companies (TTCs) introduce cigarette brands with new characteristics as flavored capsules and flavored filters and packaged and labelled with glitzy promotion.

These so-called innovations are gimmicks on specific product designs including filters, capsules, flavors, shape, color and perceived product’s strength or mildness.

Credit: Bigstock

Some of the tobacco industry’s deceptive tactics which blur the truth about the hazards of tobacco and instead promote smoking in developing countries among women and girls include the following:

• • In Indonesia, Malaysia and Singapore, some cigarettes brands are in “Lipstick” packs. Female-targeted elegant slims or super slim cigarettes are also packaged in slimmer packs and influences beliefs about smoking and weight control – an important predictor of smoking behavior among women.

• • In Malaysia, Cambodia and Vietnam “Less smoke smell (LSS)” technology has been used to promote cigarettes designed to reduce secondhand smoke odor.

• • Kiddie packs (10 to 12 sticks) are also available in Indonesia and the Philippines.

• • Flavor capsules in cigarettes are becoming increasingly popular and increase attractiveness of smoking. Some cigarettes sold in Cambodia, Indonesia, Malaysia, Philippines, Singapore and Vietnam have capsule filters that can be crushed to release additional menthol or other flavoring.

• Colors play an important role to enhance cigarette packaging and labeling to represent flavors and strength within brand families. The brand image is created by attention-grabbing designs and appealing colors to indicate flavors (such as strawberry, orange and apple) and communicate the false impression of lower tar or mild cigarette. Gold and silver convey ‘low-tar’, green for menthol and blue for ‘light’ or icy/cool.

To divert public attention away from the harm and damage caused by the industry, the TTCs have been conducting public relations stunts about employment and gender equity.

Philip Morris International boasted an ‘Equal-Salary certification’ it received, conveniently timed for International Women’s Day. TTCs routinely receive an obscure ‘top employer’ awards while simultaneously fighting smoke-free policies.

According to the US Centers for Disease Control and Prevention (CDC), “a woman’s risk of dying from smoking has more than tripled and is now equal to men’s risk”. This means that women are also at higher risk for heart attacks, strokes, lung cancer, emphysema, and other serious chronic illnesses such as diabetes.

A sudden concern for smoking is the new public rhetoric of the tobacco industry to justify a new range of so-called “less harmful” products such as heated tobacco products, while simultaneously selling regular cigarettes which form the bulk of their profits.

The current sixty-third session of the Commission on the Status of Women (CSW) at the United Nations Headquarters in New York, (11 – 22 March) is expected address women empowerment and their vital roles as agents of development in making progress across all Sustainable Development Goals (SDGs) and targets.

It is timely to discuss the tobacco epidemic among women especially in the LMICs and the concerted effort governments must make to curb this scourge.

Preventing an epidemic of tobacco-related diseases among women in the LMICs is one of the greatest public health opportunities for governments of our time. The global health treaty, WHO Framework Convention on Tobacco Control (FCTC) has been explicitly identified as a means to achieve the SDG health goal.

Steps governments should take to prevent this epidemic include banning tobacco advertising and promotions such as pack displays and applying plain packaging which requires cigarette packs to be sold in a standardized size, shape, and drab brown color, free of any logos or images.

In September 2019, Thailand’s legislation on standardized packaging of tobacco will take effect and Singapore will follow soon. Standardized packaging removes the attractiveness of tobacco products and reduces the ability of tobacco packaging to mislead consumers about its harmful effects.

Other equally important actions in the FCTC include increasing tobacco taxes and making public and work places 100% smoke-free.

*SEATCA is a multi-sectoral non-governmental alliance promoting health and saving lives by assisting ASEAN countries to accelerate and effectively implement the evidence-based tobacco control measures contained in the WHO FCTC. Acknowledged by governments, academic institutions, and civil society for its advancement of tobacco control movements in Southeast Asia, the WHO bestowed on SEATCA the World No Tobacco Day Award in 2004 and the WHO Director-General’s Special Recognition Award in 2014.

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