IQOS Marketing Strategies and Expenditures in the United States From Market Entrance in 2019 to Withdrawal in 2021

Author:

Duan Zongshuan1ORCID,Levine Hagai2ORCID,Romm Katelyn F34ORCID,Bar-Zeev Yael2ORCID,Abroms Lorien C15,Griffith Lynniah6,Wang Yan15,Khayat Amal2ORCID,Cui Yuxian1,Berg Carla J15ORCID

Affiliation:

1. Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University , Washington, DC , USA

2. Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem and Hadassah Medical Center , Jerusalem , Israel

3. Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, OK , USA

4. TSET Health Promotion Research Center, Stephenson Cancer Center, Univeristy of Oklahoma Health Sciences Center , Oklahoma City, OK , USA

5. George Washington Cancer Center, George Washington University , Washington, DC , USA

6. Wellesley College , Wellesley, M A , USA

Abstract

Abstract Introduction IQOS entered the U.S. market in October 2019, then received the Food and Drug Administration (FDA)’s modified risk tobacco product authorization (MRTPA) allowing use of “reduced exposure” claims in marketing in July 2020. A May 2021 court decision regarding patent infringement required IQOS’ removal from the U.S. market in November 2021. Aims and Methods Using 2019–2021 Numerator marketing data, this study characterized ad occurrences and expenditures—including allocation per ad content (headline theme, imagery) and media type and channel—pre- and post-MRTPA; exploratory analyses characterized the post-court to withdrawal period separately. Results The study period entailed 685 occurrences and $15 451 870 in expenditures. The proportions of occurrences across the three periods (pre-MRTPA, post-MRTPA, and post-court) were 39.3%, 48.8%, and 12.0%, respectively (p < .001); the proportions of expenditures were 8.6%, 30.0%, and 61.5%. Overall, 73.1% of ad occurrences were via online display; 99.6% of expenditures occurred in print. Per occurrences, prominent pre-MRTPA headline themes included “future” (40.2%), “real tobacco” (38.7%), “get IQOS” (35.3%), and “innovation or technology” (20.1%); post-MRTPA, prominent themes included “not burned or heat control” (32.7%), “reduced exposure” (26.4%), and “distinct from e-cigarettes” (20.7%). Visuals mainly depicted the product alone (pre-MRTPA: 86.6%; post-MRTPA: 76.1%), but increasingly featured women (pre-MRTPA: 8.6%; post-MRTPA: 21.5%). The most prominent media channel theme pre-MRTPA was “technology” (19.7%), but post-MRTPA included “women's fashion” (20.4%) and “entertainment or pop culture/gaming” (19.0%). Conclusions IQOS leveraged MRTPA in ads, continued marketing post-court decision, and targeted key consumer groups (ie, women). Marketing surveillance of products granted MRTPA is needed, domestically and in other countries, to assess its use and impact. Implications Philip Morris (PM) leveraged IQOS’ MRTPA from the U.S. FDA, and continued marketing IQOS after its withdrawal from the U.S. market due to a patent-infringement-related court decision. Notably, IQOS marketing increasingly targeted key consumer groups (eg, women). Given IQOS’ potential return to the United States, PM’s use of FDA’s MRTPA to promote IQOS as a risk reduction product in other countries, and FDA’s MRTPA for other products, it is crucial to monitor products receiving MRTPA, their marketing, and their population impact, domestically and in other countries.

Funder

National Cancer Institute

National Institutes of Health

Fogarty International Center

National Institute of Environmental Health Sciences/Fogarty

National Institute on Drug Abuse

Oklahoma Tobacco Settlement Endowment Trust

National Cancer Institute grant awarded to the Stephenson Cancer Center

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health

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