IQOS is not an acronym: A call to researchers and journals

In 2014, Philip Morris International (PMI) introduced the IQOS heated tobacco product system in Nagoya, Japan.¹ The IQOS design resembles a heated tobacco product previously sold in the United States from 1998–2006.² As of November 2019, sales of IQOS have expanded into over 40 countries.³

It has been widely reported in the media that the IQOS brand name is an acronym for“I quit ordinary smoking.”^4–6 A lesser reported phrase includes “I quit original smoking.”⁷ To our knowledge PMI has never used any acronym to describe IQOS. Furthermore, PMI has repeatedly denied that IQOS is an acronym. For instance, in an interview with Bloomberg, PMI CEO André Calantzopoulos was asked about the meaning of IQOS, with the reporter pointing out that the acronym “I Quit Ordinary Smoking” has appeared on the Internet.⁸ PMI responded through a spokesperson that IQOS “has no meaning in particular - it’s meant to represent quality, technology, electronics, intelligent systems…”⁸ Additionally, PMI was asked whether IQOS was an acronym at the US Food and Drug Administration’s Tobacco Product Scientific Advisory Committee (TPSAC) meeting discussing the company’s modified risk application. PMI’s Dr. Gilchrist responded by stating that “It doesn’t stand for anything.”⁹ Relevant excerpts from the meeting can be found in Table 1. Finally, PMI maintains a webpage where they explain, “Although many have tried to come up with explanations of IQOS, none of these creative ideas are correct. IQOS is not an acronym…”¹⁰

Table 1.

Excerpts from the January 24, 2018 and January 25, 2018 Tobacco Product Scientific Advisory Committee (TPSAC) meetings that discussed the modified risk tobacco product application for IQOS.

Transcription from January 24, 20189:

DR. WEITZMAN [TPSAC member]: “Please don’t laugh, but in looking at all the documents provided by the FDA and the industry, I don’t know what IQOS means, what it stands for.”

DR. GILCHRIST [PMI representative]: “Doesn’t mean anything.”

DR. WEITZMAN: “Doesn’t mean anything.”

DR. GILCHRIST: “No.”

DR. WEITZMAN: “It’s not an acronym?”

DR. GILCHRIST: “No. In this day and age, it’s very difficult to trademark a new word for naming a product, so you essentially end up with some random letters, and that’s where we are. It doesn’t stand for anything.”

Transcription from January 25, 201825:

DR GILCHRIST: It’s been written in the press that it stand for ‘I Quit Ordinary Smoking’ or ‘I Quit or Switched.’ We’ve seen all of those things. These are all - I think the term is backronyms; these are things people have invented following the use of the trademark IQOS. It’s not true.”

Despite these denials from PMI, descriptions of IQOS as an acronym meaning “I quit ordinary smoking”, which is an implicit cessation claim, are also being disseminated through numerous peer-reviewed publications. For instance, articles appearing in the Annual Review of Public Health¹¹, JAMA Internal Medicine¹², Pediatrics¹³, New Zealand Medical Journal¹⁴ and Israeli Journal of Health Policy Research have mentioned the acronym.¹⁵ Moreover, at least five articles have appeared in Tobacco Control assigning IQOS this meaning (Table 2).^16–20 Additionally, at least one registered clinical trial uses the acronym in the trial’s title (i.e., “The Effects of I Quit Ordinary Smoking on the Arterial Wall and Endothelial Glycocalyx Properties of Smokers”).²¹

Table 2.

Examples of peer-reviewed publications describing IQOS as an acronym.

Journal (Year)	Title	Text
Annual Review of Public Health (2018)	The Debate About Electronic Cigarettes: Harm Minimization or the Precautionary Principle	“Their new, rapidly expanding international tobacco product is IQOS (“I quit ordinary smoking”), a sleek electronic device rolled out in trendy flagship stores in Europe and Asia that look much like Apple or Microsoft stores.”11
Environmental Pollution (2018)	Characterization of airborne particles emitted by an electrically heated tobacco smoking system	“Lately, Philips Morris International also entered the alternative smoking market developing a “heat-not-burn” tobacco product with a new device named iQOS (acronym of “I quit ordinary smoking”) which is an electrically heated tobacco system where tobacco sticks are warmed to a temperature high enough to release an aerosol but not able to cause combustion.”26
Israel Journal of Health Policy Research (2019)	IQOS point-of-sale marketing strategies in Israel: a pilot study	“Philip Morris International’s IQOS (“I Quit Ordinary Smoking”) device has increasingly penetrated the global tobacco market.”15
JAMA Internal Medicine (2007)	Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name	“Philip Morris International (PMI) created IQOS (I-Quit-Ordinary-Smoking): disposable tobacco sticks soaked in propylene glycol, which are inserted in a holder in the HNB cigarette.”12
The New Zealand Medical Journal (2017)	New Zealand’s legal action against IQOS postponed, consultation with Big Tobacco follows	“Despite the ban on new forms of tobacco, Philip Morris International launched its HNB tobacco product IQQS (I-Quit-Ordinary-Smoking) on the New Zealand market in December 2016”14
Pediatrics (2018)	Heat-not-Burn Tobacco Products: Tobacco Industry Claims No Substitute for Science	“Philip Morris International created and is heavily marketing their version of these products, called the IQOS (I Quit Ordinary Smoking), which involves disposable tobacco sticks soaked in propylene glycol that are inserted into a holder in the HNB cigarette.”13
Tobacco Control (2018)	Assessment of industry data on pulmonary and immunosuppressive effects of IQOS	“On 5 December 2016, Philip Morris International (PMI) submitted an application to the US Food and Drug Administration (FDA) to market its HTP, I-Quit-Ordinary-Smoking (IQOS), as a ‘modified risk tobacco product’ (MRTP) in the USA.”19
Tobacco Control (2017)	Industry watch: heat-not-burn tobacco products are about to reach their boiling point	“These projections are already coming true; PMI recently introduced ‘iQOS’ (‘I Quit Ordinary Smoking’), an HNB device, in Japan, Italy, Switzerland and South Korea.”16
Tobacco Control (2018)	Possible hepatotoxicity of IQOS	“On 25 January 2018, the Food and Drug Administration (FDA) Tobacco Scientific Advisory Committee unanimously voted (with one abstention) that Phillip Morris International (PMI) could not claim their heated tobacco product (HTP) IQOS (I-Quit-Ordinary-Smoking) would reduce the risk of tobacco-related diseases”18
Tobacco Control (2018)	Flavour capsule heat-sticks for heated tobacco products	“Philip Morris International (PMI) launched its HTP, I Quit Ordinary Smoking (IQOS), in Japan in November 2014.”17
Tobacco Control (2018)	IQOS: examination of Philip Morris International’s claim of reduced exposure	“Philip Morris Products S.A., a subsidiary of Philip Morris International, Inc. (PMI), developed IQOS (‘I Quit Ordinary Smoking’) as an HTP.”20

While the origins of the acronym are undetermined, PMI stands to benefit from the free publicity and associated positive connotations. It is possible that early adopters of IQOS created the acronym on the Internet, which was then organically picked up by reporters, and subsequently by the research community. However, it is also possible that PMI may have surreptitiously helped create and spread the acronym online and through the news media (although we have no evidence of this), eventually landing in peer-reviewed journals. For instance, some tobacco companies have hired social media influencers to promote tobacco products.^22,23

While PMI has not used the acronym in IQOS advertising, the company is using similar messaging in its marketing. For instance, PMI’s website claims that “around 9.7 million” smokers have switched to IQOS.³ While evidence and details for this claim (e.g., complete or partial switching, length of switching) are not described, such a statement is consistent with what the acronym is communicating. Additionally, IQOS has been marketed as way to “break free from smoke”²⁴, which again mimic the meaning of the acronym.

Furthermore, it appears PMI first denied IQOS was an acronym when asked about it by a reporter in 2017, despite the acronym appearing in the media at least as early as 2015.⁶ While it is possible PMI may have been unaware of the acronym’s early usage, it is also possible they chose to remain silent to benefit from IQOS being positioned as a cessation product. PMI’s decision to deny IQOS is an acronym at the TPSAC meeting and to create a webpage stating IQOS is not acronym may be part of a strategy to help it to avoid regulatory action by the FDA (or other government agencies), as FDA authorization is needed to make therapeutic claims.

Regardless of its origin, reporters and researchers should immediately stop describing IQOS as an acronym that promotes cessation claims. PMI has repeatedly denied that IQOS is an acronym, and we are aware of no instance where PMI has used any acronym when describing or marketing IQOS. To our knowledge, no government regulatory agency has authorized PMI to make smoking cessation claims for IQOS. Additionally, we call on journal editors to no longer publish IQOS acronyms, and where practical, correct previous instances of its use. Researchers and journals should not be disseminating Internet myths that promote potentially misleading claims that benefit a tobacco manufacturer.