health & science
Big Tobacco targeting Māori with e-cigarettes
Tobacco company Philip Morris is visiting marae and sports clubs to offer free trials and discounts on its e-cigarette as it targets Māori. Guyon Espiner asks if vaping and e-cigarettes offer smokers a less dangerous habit or give them a new, damaging problem.
Tui sits down against the fence outside Te Wānanga o Aotearoa in Māngere, South Auckland and lights up. This is her reward, a treat which eases her stress but costs her about $130 a week and may kill her one day.
"It's really hard," she says of trying to give up smoking. "Being a working mum, what's my outlet? Seriously? Smoking is my outlet. It keeps me sane."
Colleagues, also following the rules and leaving work grounds to smoke, join her or cross the road to stand in groups outside the Burger King drive-through opposite the wānanga. Mostly Māori. Mostly women.
Māori women have the highest smoking rates in New Zealand - about 37 percent, close to three times the rate of the general population.
"I am gutted at that and my contribution to that statistic," Tui says. "But I can't afford to put that on my plate. I can't afford to feel guilty. I can't afford to think about how much I waste in terms of money. I can't afford to think about the cancers that I potentially am going to get. One day at a time. And today's been good. So I'll reward myself."
Maera Waikato can relate to that. She began smoking when she was 11 years old. Her cousins smoked and Mum smoked too. But Waikato doesn't neatly fit the profile. Firstly, she gave up traditional cigarettes, and, secondly, she works for one of the biggest tobacco companies in the world.
"It is a hard sell," she says of telling Māori she works for Philip Morris. But she says she's doing it for the right reasons - to try to get Māori on to a less harmful product. "It's important to me. It's an obligation as a former smoker who's switched to our new product that I need to share it. I need to share it with Māori women."
The new product is the IQOS. This is not your standard vaping device - it's a hybrid between an e-cigarette and a traditional cigarette, which heats the tobacco rather than burns it. Philip Morris claims the process reduces the harm by about 90 percent, although experts spoken to for this investigation say the harm could eventually prove to be comparable to conventional smoking.
Philip Morris is targeting Māori in its bid to sell IQOS. It is running marketing campaigns at marae and other places with high Māori and Pasifika populations, sending people to promote IQOS and offer discount deals. The company calls them 'community activations' or 'community outreaches'.
Philip Morris NZ general manager James Williams says the company is selling the IQOS device to Māori groups for half price - $50 rather than $100 - because they have what he calls "out-of-pocket issues".
"There are some individuals, some smokers, who don't have credit cards so there's an inability to transact online. So we have to make sure that we engage them in the right way and we don't want to make pricing an inhibiting factor for them."
Shane Kawenata Bradbrook, a long- term advocate for smoke-free Māori communities, describes Philip Morris' tactics as appalling. "Instead of jumping off the tenth floor you are jumping off the sixth floor of a building. It's still harmful," he says of the IQOS product. "It's highly addictive. And that's what they do - they hook people for life. They screw them out of their money. And, let's be honest, Māori are the ones who can least afford that."
At Philip Morris' Auckland central office - a stylish pad with the polished wooden floorboards of a Manhattan-style loft apartment - Gordon Otukolo is dressed in a black, branded IQOS t-shirt. He tilts his shaved head forward, strokes his hipster beard and slips a cigarette into a silver machine that looks like a DJ's deck. An automatic arm slides over, ignites the cigarette and a miniature metal lung sucks the smoke into a tube.
"Okay, so this is a science machine that shows what smoking does to your lungs versus what IQOS does to your lungs," he says running through the demonstration twice for RNZ's camera, with a pitch-perfect presentation each time.
Like any good salesman, Otukolo uses the product himself. He switched from cigarettes to IQOS about two years ago. He hasn't given up smoking and that is not the point of the product he says. "It's not designed to help stop people from smoking. It's designed to be a replacement. So it's more for people that want to continue enjoying tobacco and smoking."
The claim of reduced harm is based on the idea that the tobacco contained in the miniature cigarette users insert into the IQOS device is heated to about 300°C, rather than burned at about 800°C. Philip Morris claims the aerosol inhaled contains fewer toxic chemicals than cigarette smoke - and the harm is reduced by about 90 percent.
"No way," says Dr Sukhwinder Sohal, a researcher at the University of Tasmania. "It's not 90 percent safer, not at all. The figures in our data clearly show that." Sohal was the lead researcher in a study for the European Lung Journal which found that the IQOS 'heat not burn' product was no less toxic to human lung cells than ordinary cigarettes.
Sohal also doesn't buy the claim that, because the tobacco is heated not burned, most of the damage is avoided. "I'm pretty sure some kind of combustion is happening. Otherwise where would the smoke come from?"
IQOS - and indeed all nicotine based e-cigarettes - are banned in Sohal's home country of Australia and he's concerned they are legally sold in New Zealand. "That's very alarming. It took us decades to understand the ill effects of traditional tobacco smoke - do we want that again? Do we want to wait for another decade ... and then say, oh, yes, these were bad as well?"
Not even Philip Morris will claim the product is safe. "It's safer than cigarettes," says James Williams. "It's not 100 percent risk-free at all. But it's definitely safer."
Williams points to the work of the Federal Drug Administration, which authorised the IQOS for sale in the US in April this year. The FDA stressed that "the authorisation of new tobacco products doesn't mean they are safe" but said it was appropriate for public health because it produced "fewer or lower levels of some toxins than combustible cigarettes".
What does that mean in practice? The FDA says levels of formaldehyde are 66 to 91 percent lower than in cigarettes. Or, to look at it the other way round, IQOS users could still get about a third of the amount of formaldehyde they would get by smoking a burning cigarette.
But Williams views the FDA authorisation as a big win for Philip Morris. "They've reviewed upwards of 2.5 million pages of research and done their own independent verification - that's quite a robust system that's probably unparalleled in terms of the world's assessment of these products."
The Centre for Tobacco Research Control and Education at The University of California has also gone through the 2 million pages of Philip Morris material and reached a different conclusion.
"While IQOS may expose users to lower levels of some toxicants than cigarettes, they also expose users to higher levels of other toxicants. Likewise, IQOS likely exposes users to lower risks of some diseases and higher risks of others," it said.
It concluded that Philip Morris' "own data do not support its claims that IQOS is less dangerous than cigarettes".
While the IQOS - and indeed all e-cigarettes containing nicotine - are banned from sale in Australia, Philip Morris can legally sell it in New Zealand after winning a court case against the Ministry of Health last year.
The government is now moving to liberalise the whole of the e-cigarette and vaping market, with legislation to be introduced to Parliament later this year, in its drive to make the country smoke-free by 2025.
A Cabinet paper outlines the government's aim of improving access to "quality vaping and smokeless tobacco products" and claims there is a "scientific consensus that vaping is significantly less harmful than smoking".
Currently there are no mandatory product safety requirements for e-cigarettes in New Zealand, meaning consumers have no way of knowing exactly what is in the vapours they inhale.
The new legislation will allow for safety standards to be introduced and also put vaping and smokeless tobacco products on a similar footing to cigarettes as to where they can be used and how they are advertised.
The Cabinet paper says there are concerns vaping may be a gateway to smoking but that there is "no robust evidence" of this and that most young people who vape are already daily smokers or ex-smokers.
Philip Morris claims that 98 percent of IQOS users smoked cigarettes before taking up the product. It's a figure produced from a Philip Morris study in Japan, where the IQOS has been sold since 2014.
But independent data from Italy, where IQOS was launched the same year, tells a different story. Close to half the 740,000 Italians who tried IQOS were never smokers, according to a study by the Institute for Pharmacological Research in Milan, published in the Tobacco Control journal last year.
The researchers also found that of the 1.2 million Italians who said they were keen to try IQOS in the future, about half were non-smokers, raising fears "IQOS may create new nicotine addicted generations".
The New Zealand government Cabinet paper quotes a British Medical Association study rejecting a gateway effect and notes that in this country smoking has continued to decline while vaping has increased.
Philip Morris likes the direction of travel from the New Zealand government. As regulators try to extinguish its traditional product, vaping could be a new goldmine. Nearly 20 percent of New Zealanders already say they have tried some form of e-cigarette.
Williams says he wants New Zealand to be the first country where Philip Morris stops selling traditional cigarettes altogether. Given 5000 people in New Zealand die every year of smoking-related diseases, wouldn't that be motivation enough to stop selling them right now? "Massive motivation," Williams says. "I don't want to sell any more cigarettes than I have to."
Yet he won't commit to a time frame. "It's difficult to make a move when the industry is not making a move and I think the industry will make a move when the right regulatory treatment is in place."
Back at Te Wānanga o Aotearoa in Māngere, another wave of workers filter out for a cigarette. Gladys is a kaiako at the wānanga and can document her smoking history precisely.
"First time I tried to give up I was 25. I lasted three years and then life happened. And then the second time I tried to give up I was 33. And that lasted for four years. But then life happened again. And then I was 45 with my third try and I lasted another four years. Then life happened again and I haven't stopped."
For Gladys, cigarettes have been a comfort in a stressful life. "Being a single mum having to look after and raise my children on my own, you know, as long as I had my cigarette and coffee I managed." Gladys uses a vape sometimes but still hasn't been able to quit cigarettes.
She and her colleagues across the road are exactly the people Philip Morris are targeting with their IQOS campaign.
It has recently conducted one of its marketing drives at the Māngere East Rugby League Club just around the corner from here.
Two sessions were held, with more than 100 club members attending each time. The league club didn't want to talk to RNZ about the sessions, saying it was too early in the process to be publicly associated with IQOS.
Philip Morris offers IQOS on a free, two-week trial - which is available to all current smokers aged over 18 - and also gives a $30 product voucher to IQOS users who refer others to the device.
Maera Waikato, consumer relations lead for Philip Morris, says she knows many have taken up the product not just because of the initial offers, but because of the "extensive hyper-care" programme Philip Morris runs. "We are continuously following up our consumers making sure that the product is okay, that the stock is available."
How does she respond to those who say this is just Philip Morris trying to make money from Māori who smoke? "Yeah, it's a fair statement to make," she says, but claims attitudes change when she explains the aim is to give them a safer alternative. "They seem to warm up more to that once we share about our vision with going smoke-free."
Tobacco control advocate Shane Kawenata Bradbrook says Philip Morris does not have the interests of indigenous people at heart. "They say it is less harmful but we've also been down that track too with other products that they have put to the market. Everyone remembers light and mild, supposedly they were going to be the savior, IQOS is no different. It's just another tobacco product and it's sad really that they are even allowed in this market."
It's still an addictive product, he points out. And on this point Philip Morris' James Williams agrees. "We're not saying this product's not addictive but I just implore you to speak to smokers and say, 'Would you want to smoke without nicotine?' They would say no. There's a need for people to consume nicotine."