The global market has increasingly included heated tobacco products (HTPs). Philip Morris International (PMI) submitted
a Premarket Tobacco Application for IQOS, the global HTP leader, and is pursuing Modified Risk Tobacco Product
categorization for this product. Given the impending introduction of IQOS into the US market, it is critical to leverage
marketing data from other contexts to inform and advance regulatory efforts regarding IQOS. This proposal leverages a
scientific premise and a conceptual framework based on a Socioecological Framework, indicating the importance of
regulatory contexts and implications for marketing, and Diffusion of Innovation Theory, accounting for marketing
strategies and channels, as well as impact on consumer behavior and perceptions. At the policy level, while there are
several countries in which IQOS has a presence in the market, Israel is unique in that it represents 3 distinct regulatory
contexts: 1) during IQOS’s initial emergence in Israel, it was not categorized as a tobacco product (Dec 2016-Apr 2017);
2) it was classified as a tobacco product in a relatively weak regulatory context (Apr 2017- 2019); and 3) it will be
regulated as a tobacco product within new progressive legislation (going into effect beginning 2019). Our study team has
been collecting and analyzing IQOS marketing data in Israel since 2016; thus, we are strategically positioned to compare
real-world marketing strategies used by PMI in these different regulatory contexts and to examine consumer reactions to
this marketing content in both Israel and the US. PMI’s IQOS website suggests targeting at least 4 consumer market
segments (business & current events; art, culture & fashion; nature & hiking; innovation & technology). Thus, their
marketing content and distribution channels likely reflect these groups. However, these segments may be differentially
prioritized by PMI marketing and may be distinct in their likely IQOS use and perceptions. In summary, the Israeli
regulatory context and our prior research offers an opportunity to advance US readiness to regulate IQOS marketing. This
will be critical, given that independent research is needed, particularly using real-world marketing and borrowing from the
industry’s own methods, in order to truly estimate population impact of such products and their marketing. The overall
goal of this line of work is to inform tobacco regulatory efforts to minimize population harm of tobacco use. To this end,
the immediate objective is to examine IQOS marketing strategies used in Israel during 3 regulatory periods and examine
their impact on segments of the Israel and US population. We propose 2 inter-related specific aims: 1) examine IQOS
marketing strategies in Israel from its emergence in the Israel market; and 2) examine market segments of Israeli and US
adults in relation to IQOS use and/or likelihood of future use. This proposal is responsive to RFA-OD-18-002, focusing
on marketing influences and behavior, and involves innovative applications of rigorous methodology. By examining
PMI’s IQOS marketing strategies used in the 3 different regulatory periods in Israel and understanding the impact of
these strategies on different segments of consumers and the extent to which they generalize to US consumers, findings
will provide information to better estimate the potential impact of IQOS and its marketing in the US.
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