“Clearly, the best thing somebody can do is to quit nicotine and tobacco altogether,” says Moira Gilchrist, a spokesperson for Philip Morris International, which developed the Iqos. Short of quitting, though, Gilchrist says the Iqos is a “better alternative.”
In April, the FDA allowed the product to go on sale in the US through a process called pre-market authorization. After reviewing the device and reams of data presented by Philip Morris, the agency decided that although Iqos isn’t risk-free, it was “appropriate for the protection of the public health,” because the devices had “fewer or lower levels of some toxins.” The authorization doesn’t mean the FDA approves of the device or thinks it’s safe, it just means the FDA believes Iqos isn’t more dangerous than regular cigarettes.
But scientists say the FDA’s logic is flawed, in part because Iqos may present unique dangers that aren’t measured in traditional toxicity tests. “Because it has glycerin that’s been heated it’s actually putting stuff out that no cigarette ever put out and that hasn’t really been studied very well,” says Robert Jackler, a tobacco researcher at Stanford.
What’s more, other research suggests the devices do present many of the same risks as regular cigarettes. Stanton Glantz, a professor at the University of California San Francisco’s Center for Tobacco Control Research and Education, analyzed Philip Morris’s data and concluded that Iqos’s toxicity is “indistinguishable from a cigarette.” An independent study from researchers at the University of Bern in Switzerland found that Iqos contains the “same harmful constituents of conventional tobacco cigarette smoke.” Another study suggested the devices could cause more damage to the liver than regular cigarettes.
Glantz is troubled by the FDA’s interpretation of the product as “appropriate for the protection of the public health.” Few legal items are more dangerous for your health than cigarettes, he says, so the agency should apply a higher standard to such products. DeSaulnier says his proposed legislation is just a first step, and agrees the FDA’s standards are not adequate. “I want to look at how the FDA process is being implemented,” he says. “It’s not stringent enough.”
The FDA did not comment for this story but in a press release, the agency explained that one reason it authorized Iqos sales is because the agency determined the product was unlikely to attract kids or people who don’t already smoke.
Iqos is more complicated to use than an e-cigarette. It has to be cleaned and users have to charge both the sticks and the heating device. But it comes with mint and menthol options, which are among the most popular e-cigarette flavors with kids. And the devices’ design mimics the trendy tech that teenagers gravitate to. “They’re selling you an iPhone of tobacco products,” says Sward. According to SEC filings, the product was even initially spelled iQOS. (The company ultimately opted for all-capital letters.) Iqos’s Lenox Square store has a glass front wall, long, rectangular display tables, and intricate packaging that call to mind Apple stores and iPhone boxes.
Kids can’t get into the stores—you need a government-issued ID proving you’re 21 or older—but that doesn’t mean teens won’t be attracted to the products. “Any high-tech gadget is going to have interest on the part of young people,” says Jackler, who put together a comprehensive report on how e-cigarette marketing campaigns appeal to teenagers. Iqos ran similar social media campaigns in Japan and Italy, where the device has been on the market since 2015. Thousands of posts under hashtags like #iqos and #iqosfriends show young, attractive people posing with their devices.