NZ Health Minister's HTP Advice Lacks Evidence, IQOS Pulled by New Regulations

According to a report by Radio New Zealand on October 3, New Zealand Ministry of Health Associate Minister Casey Costello's "independent advice" on heated tobacco products (HTP) was based on five articles that failed to clearly support her views. The documents discussed various products, some of which were outdated or only provided weak evidence to support their claims.

The five articles include:

• The Royal College of Physicians in the UK released a 190-page report in 2016, which did not specifically mention HTPs. 
• An article in the 2022 International Journal of Environmental Research and Public Health suggests that HTPs may help with smoking cessation, but if HTPs are used as a substitute for less harmful e-cigarettes, their benefits will be reduced. It also warns that this may encourage non-smokers to use tobacco or lead former smokers to relapse. 
• An article in the 2016 International Journal of Environmental Research and Public Health pointed out that another tobacco product called "Snus" seems to help with smoking cessation in Sweden. 
• Another article in the same journal in 2020 about smoking patterns in Japan (where nicotine e-cigarettes are not used) indicated that cigarette sales had decreased after the introduction of HTPs. 
• The final article is a commentary published in The Lancet. In a cabinet document submitted to Health Minister Costello, the Treasury's health analysts cited a review by the Department of Health of the latest research, finding "no convincing evidence that the use of HTPs is beneficial.

The World Health Organization also stated that HTP should not be promoted as a smoking cessation tool.

The analyst also pointed out that the rapid literature review mentioned evidence of potential risks associated with HTP, including dependency, exposure to toxins, cardiovascular effects, chronic respiratory diseases, and developmental impacts.

According to RNZ, officials from the Treasury have informed Costello that Philip Morris International (PMI) will be the biggest beneficiary of tax breaks, despite their products being more harmful than e-cigarettes. PMI's "IQOS" is the only heated tobacco product available in New Zealand.

Initially, Costello refused to be interviewed by RNZ, also declined to reveal the sources of her independent advice, and did not answer specific questions posed to her before the report was published.

Subsequently, Costello stated in an interview with RNZ on Wednesday (2nd) that she never claimed HTPs were safe, but rather believed they were less harmful than smoking. She has repeatedly stated that lowering the consumption tax on HTPs is to reduce smoking rates by providing alternative products for those struggling to quit smoking, claiming that "the risk profile of HTPs is similar to e-cigarettes.

However, the Ministry of Finance suggests that heated tobacco products (HTP) may pose greater health risks than e-cigarettes, and reducing the tax revenue from these products could lead to even more detrimental health consequences. Officials from the Ministry of Health and Finance both emphasize that there is a lack of evidence to prove that HTP can be used as a smoking cessation tool.

According to RNZ, all e-cigarette devices must be equipped with removable batteries and child safety mechanisms by October 1, 2024, due to new regulations. PMI's "IQOS" device has already been forced to be removed from shelves.

Previously, Costello tried to request a two-year delay in the implementation of the regulations, but ultimately only received approval for a six-month delay from the original deadline of March 21. Her reasons included potential regulatory challenges faced by international nicotine industry participants.

Costello did not give a clear response to whether the policy is targeting PMI's "IQOS" device. In her statement to RNZ, she stated that the policy is not biased towards specific suppliers or retailers.