In Japan, a glimpse at alternatives to cigarettes

Philip Morris International’s CEO Andre Calantzopoulos poses with the new IQOS 3 devices at a news conference in Tokyo October 23, 2018. — Reuters pic
Philip Morris International’s CEO Andre Calantzopoulos poses with the new IQOS 3 devices at a news conference in Tokyo October 23, 2018. — Reuters pic

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COMMENTARY, Oct 26 — Japan has always been a unique country, with a culture that is obsessed with order, cleanliness, discipline but also tinged with some quirkiness not seen anywhere else in the world.

Famously considerate, the way Japan has dealt with the growing global anti-smoking trend is to ban smoking in many places but provide well-ventilated areas away from non-smokers for smokers.

Every shopping centre in Tokyo has a smoking room. In some outdoor spaces, the smoking area is enclosed and separated. Hotels with smoking areas usually equipped with powerful air purifiers are seen everywhere in Japan. Many coffee bars also have separate indoor smoking areas.

The result is that if you take a walk in Tokyo you may be mistaken into thinking no one in Japan smokes anymore.

But tobacco companies are now transforming Japan into a battleground and test-bed for next generation smokeless alternatives to traditional cigarettes.

Companies like Marlboro maker Philip Morris International (PMI) are seen as leaders in the race to effectively end traditional cigarette smoking as we know it.

“I don’t think it’s reasonable to essentially condemn your population to only smoke cigarettes when there are vastly different alternatives,” PMI Chief Executive Officer Andre Calantzopoulos said in an interview with Bloomberg News in Tokyo earlier this week when asked about some countries which effectively ban e-cigarettes and other smokeless alternatives while still allowing the sale of traditional cigarettes.

The Marlboro maker is now betting on a shift to non-cigarette products like its iQOS tobacco-heating device, which gives users a nicotine buzz without combustion. 

Calantzopoulos told Bloomberg he expects regulators will follow Japan, a market where an upsurge in smoking alternatives has also seen a 20 per cent reduction in cigarette consumption in the past three years.

On Tuesday, the company organised a global launch of its iQOS 3, the third generation device for its heat-not-burn tobacco products, where journalists from around the world were given a glimpse of the company’s shiny new device.

The anti-smoking lobby and other critics have slammed Big Tobacco for effectively trying to get smokers hooked on a new type of addiction.

But PMI claims that with iQOS — which heats up tobacco it markets as Heatsticks and provides the user a buzz without the cancer-causing smoke and tar which accompanies traditional cigarettes which relies on combustion—is less harmful.

Critics have challenged the claims and pointed to Big Tobacco’s history of what they say are misleading claims, to substantiate their incredulity over such claims.

At the recent Tokyo launch of iQOS 3, invited guests were allowed to use the devices indoors with no discernible effect on air quality as no smoke was exhaled into the environment.

A man tries Philip Morris' IQOS 3 device after its launching event in Tokyo October 23, 2018. — Reuters pic
A man tries Philip Morris' IQOS 3 device after its launching event in Tokyo October 23, 2018. — Reuters pic

In fact, iQOS users are increasingly being allowed to use the devices indoors in hotels and even in hotel rooms in Japan as the lingering smell and noxious quality of traditional cigarette smoke is absent.

But are smokeless devices like iQOS still harmful to the user? 

At the press conference announcing the new iQOS, Calantzopoulos acknowledged to reporters there was no such thing as zero risk.

“If you don’t make this product available to people who smoke, what is their alternative? They continue smoking,” Calantzopoulos said. “We assume that in an ideal world they will quit, but reality is they don’t.”

“Yes we can dream of a world where everyone should quit, but there are still 1.1 billion people who smoke so if there is a better product why shouldn’t consumers be allowed access?” he said.

In Malaysia, it is unclear if iQOS and its Heatsticks will be available for consumers. PMI has been tight-lipped about its plans as it deals with sensitive regulatory hurdles around the world.

The government plans to tighten further restrictions on where you can smoke.

Anti-smokers tired of being forced to inhale the second-hand smoke are happy with the new rules which bans smoking at all restaurants, including those that are outdoors.

But when it comes to impact on non-smokers, smokeless devices remain in a grey area.

Arguments over tobacco and smoke-related issues are often emotional, but Japan and other countries which have allowed smokeless devices could perhaps provide a model for where this conversation goes.

Besides Japan, other countries like the United Kingdom, South Korea, Germany and Switzerland and Italy have allowed smokeless devices like PMI’s iQOS into their markets as an alternative to cigarettes.

The National Health Service (NHS) in the UK has said that e-cigarettes “aren’t completely risk free, but they carry a small fraction of the risk of cigarettes. E-cigarettes don’t produce tar or carbon monoxide, two of the most harmful elements in tobacco smoke. The liquid and vapour contain some potentially harmful chemicals also found in cigarette smoke but at much lower levels.”

“While nicotine is the addictive substance in cigarettes, it is relatively harmless. Almost all of the harm from smoking comes from the thousands of chemicals contained in tobacco smoke, many of which are toxic. Nicotine replacement therapy has been widely used for many years to help people to stop smoking and is a safe form of treatment.” the NHS says on its website in its help and advice section.

According to Bloomberg, as Philip Morris conducts clinical trials to try to prove iQOS poses fewer health risks than smoking, almost six million people have already switched to the device. 

While e-cigarettes use nicotine-laced liquid, IQOS heats tobacco sticks to a high enough temperature to create a vapour but not smoke.

Philip Morris has applied to US health regulators to have iQOS recognised as having “modified risk” compared with cigarettes.

The relative health benefit of these products was, however, questioned in a study last month, which found that they release chemicals linked to cancer, sometimes in higher concentrations than conventional cigarettes.

British American Tobacco and Japan Tobacco are also selling tobacco-based “vaping” devices, but so far Philip Morris is in the lead, according to Reuters.

The battle in the alternative-device category has centreed on Japan, where more than half of the world’s iQOS users reside. 

In Malaysia, the Health Ministry is rightfully pursuing a policy of clamping down on places where Malaysians can smoke.

But in doing so, it needs to recognise that many Malaysian smokers are also pursuing alternatives to quit smoking by turning to products like iQOS and other smokeless devices.

And it needs to have a conversation with Malaysians — smokers and non-smokers alike — and not just resort to bans as its only policy tool in tackling health issues like cigarette smoking.

* Leslie Lau is Managing Editor, Malay Mail, and a smoker who has now turned to alternatives. This commentary is not in any way meant to promote smoking or any alternatives, or any brand of cigarettes to any individuals or groups. It is meant to start a conversation about the topic of smokeless devices.

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