Economic and Health Policy Research, American Cancer Society, Atlanta, Georgia, USA
Economic and Health Policy Research, American Cancer Society, Atlanta, Georgia, USA.
Tob Control. 2020 Jul;29(4):381-387. doi: 10.1136/tobaccocontrol-2019-054998. Epub 2019 Jun 17.
Philip Morris International, one of the largest transnational cigarette manufacturers, has heavily invested in its new heated tobacco product, IQOS, marketing it aggressively as a less harmful alternative to cigarette smoking. The company's assertions that the product replaces cigarettes in a market have never been independently tested. The objective of this study is to determine whether introduction of IQOS affected cigarette sales in a large economy.
Using 2014 to 2018 monthly retailer panel data from Japan, we analyse whether different dates of IQOS introduction across Japan's regions are reflected in the patterns of cigarette sales in those regions. A series of placebo models are estimated to test if events other than IQOS introduction could have better explained the observed trends in cigarette sales.
Cigarette sales begin to substantially decline at the time of the introduction of IQOS in each of 11 Japanese regions (Chow tests p<0.001). IQOS introduction, which varied across regions, better predicted the timing of cigarette sales decline than any one time applied to all regions simultaneously (a national-level exogenous shock) and than nearly all possible rearrangements of the true IQOS introduction months among the regions (exact permutation test's p value from 0.02 to 0.13, depending on the study approach).
The introduction of IQOS likely reduced cigarette sales in Japan. The net population health impact, however, cannot be assessed without resolving several key uncertainties related to the direct harms of IQOS and the precise patterns of both smoking and IQOS use.
菲利普莫里斯国际公司是最大的跨国卷烟制造商之一，对其新型加热烟草产品 IQOS 进行了大量投资，并积极将其作为卷烟的低危害替代品进行营销。该公司声称该产品在市场上取代了卷烟，但这一说法从未经过独立测试。本研究的目的是确定 IQOS 的推出是否影响了一个大型经济体的卷烟销售。
我们使用了来自日本的 2014 年至 2018 年月度零售商面板数据，分析了 IQOS 在日本不同地区的推出日期是否反映了这些地区的卷烟销售模式。我们还估计了一系列安慰剂模型，以检验除 IQOS 推出之外的事件是否可以更好地解释卷烟销售的观察趋势。
在日本的 11 个地区中，IQOS 推出的每个地区的卷烟销售都开始大幅下降（Chow 检验 p<0.001）。IQOS 推出的时间在各个地区都有所不同，比任何一个同时适用于所有地区的时间（国家层面的外生冲击）更好地预测了卷烟销售下降的时间，也比几乎所有可能的地区 IQOS 推出月份的重新排列（具体的排列检验 p 值从 0.02 到 0.13，具体取决于研究方法）。
IQOS 的推出可能降低了日本的卷烟销售。然而，如果不能解决与 IQOS 的直接危害以及吸烟和 IQOS 使用的精确模式相关的几个关键不确定性，就无法评估其对人口健康的净影响。
