Michigan made national news last year when, in an unexpected move, Gov. Gretchen Whitmer banned all flavored nicotine-vaping products — a move she said was intended to protect youth. Other states followed suit.

But vaping enthusiasts and business owners fought the ban, arguing that  e-cigarettes helped reduce risk, enticing smokers from more harmful combustible tobacco. The ban is still tied up in the courts.  

IQOS received a boost in July from the federal government

On July 7, the U.S. Food and Drug Administration announced Philip Morris could market IQOS as a product that exposes users to less harmful chemicals than traditional cigarettes, an order that drew some blowback from the medical community.

Only IQOS and one other tobacco product has been deemed a “modified risk tobacco product,” a legal designation under the 2009 Family Smoking Prevention and Tobacco Control Act. 

The other is a Snus product by Swedish Match USA, Inc. — a small pouch with tobacco that users slip under their lips. Others are seeking the same designation, including R.J. Reynolds Tobacco Co. for its Snus product.

But the July 7 IQOS decision for Philip Morris went even further than the legal designation Swedish Match carries. It allows Philip Morris to promote the product as one that “significantly reduces the production of harmful and potentially harmful chemicals.”

Studies show switching completely from cigarettes to IQOS “significantly reduces the body’s exposure to 15 specific harmful and potentially harmful chemicals,” according to the FDA order, which must be renewed after four years.

Still, the FDA made it clear: The agency has not deemed the product safe, and Philip Morris must stop short of saying that it reduces health “risks.” It also must report to the FDA its “efforts to prevent youth access and exposure.”

Concerns on its appeal to teens 

The FDA decision was little noticed, but could mark a significant shift in keeping tobacco products relevant in a country where public health messaging, social pressure and cost have driven smoking rates to a historical low, according to the U.S. Centers for Disease Control and Prevention. Even so, more than 480,000 people in the U.S. die annually from cigarette smoking (1,300 a day), with millions more suffering from related illnesses, according to the CDC.  

Michigan has the 16th highest adult smoking rate in the country. According to the CDC, 18.9 percent, or nearly 1 in 5, Michigan adults smoke, compared to 25.2 percent, or 1 in 4 adults in West Virginia, the state that lights up most often, and 9 percent, or fewer than 1 in 10 adults, in Utah, which logs the lowest smoking rates in the nation.

The CDC reports that Michigan high school students vape, smoke and use smokeless tobacco at higher rates than the national average. It also warns that too little is known about heated tobacco to make health claims.

All of which puts tobacco opponents are on alert.

Carolyn Chaudhary works with community organizations for the Michigan Department of Health and Human Services, especially those with a youth focus, to drive down tobacco use among youth. For the past year, she’s alerted them about heated tobacco. She and others worry that marketing that depicts the product as “sophisticated, high-tech and aspirational” may appeal to teens and young adults.

She noted that the Truth Initiative, a nonprofit public health organization focused on tobacco prevention, found in interviews with young adults in Japan and Switzerland that heated tobacco products such as IQOS “may appeal to consumers, particularly within cultures that value cleanliness, exclusivity and high tech appearances.”

The devices also sidestep bans on indoor smoking, and it’s not clear to what extent nonusers then may be subjected to toxins released in the heated tobacco, she noted.

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