IQOS marketing to points-of-sale in Israel: a cross-sectional survey with Arab and Jewish retailers

Background and Objectives: IQOS is a heated tobacco product (HTP). it is the global HTP market leader and the only HTP in Israel. Smoking rates, as well as IQOS and/or electronic cigarette use, are higher in the Arab than the Jewish population in Israel. The point-of-sale (POS) environment is one of the understudied marketing channels. The way IQOS is promoted to merchants might affect their direct-to-consumer approach. This study aimed to assess and compare POS merchants’ attitudes towards IQOS and IQOS marketing strategies at POS between Arab and Jewish neighborhoods. Methods: We used publicly available data on IQOS Israel website to identify IQOS POS locations in 5 large cities in Israel, Arab, Jewish and mixed. A cross-sectional survey with the POS owner or manager was conducted via phone or in-person. Bivariate analysis was performed using Chi- Square and Fischer's exact test. Results and Conclusion: 69 surveys were filled - 21 Arab and 48 Jewish. More merchants from Arab POS perceived IQOS as an e-cigarette and that it has appealing flavors (p<0.05 for all). IQOS marketing has been mostly uniform, but with more personal communication with Arab merchants (80% vs. 50% among Jewish POS, p-value<0.05). In Arab POS, a higher proportion of merchants were given branded items and invited to IQOS parties, and/or had any interaction with a PMI salesperson (p<0.05 for all) Conclusion: IQOS marketing strategies were similar across Arab and Jewish POS, with more personal communication marketing efforts directed at Arab POS. Surveillance of marketing strategies at the POS should include also those serving minority populations.