An MRTP application submitted by smokeless tobacco maker Swedish Match in 2014 was the first ever accepted for review by the US FDA. On June 11, the 135,000-page MRTP application was submitted electronically to the FDA in compliance with formatting and data requirements. Swedish Match sought approval to remove warnings about mouth cancer, gum disease, and tooth loss from packaging of eight of its General Snus products. The company also asked the US FDA to strike a statement reading "this product is not a safe alternative to cigarettes" as required by the Family Smoking Prevention and Tobacco Control Act. The company asked the US FDA to replace the statement with language acknowledging the harmful nature of all tobacco products and the reduced risk profile of Swedish snus by comparison. In December 2016, the FDA initially rejected Swedish Match's application on the grounds that its snus were not actually safer than other smokeless tobacco products or cigarettes. In October 2019, FDA finally approved the MRTP request for the product. The US FDA has also accepted applications from the R. J. Reynolds Tobacco Company for removing warnings from its Camel Snus product and from Philip Morris International for permission to market its heat-not-burn tobacco product iQOS as safer than a traditional cigarette. iQOS was ultimately approved for sale in the United States using pre-market tobacco application method on April 30, 2019, which subjected it to marketing restrictions.
Public FDA scientific advisory committee meetings
At the conclusion of public meetings hosted by the US FDA on April 9–10, 2015, the Tobacco Products Scientific Advisory Committee voted against recommending a labeling change that would give Swedish Match's snus product a modified risk designation. The committee tied 4-4 in a yes or no vote when asked whether the snus product demonstrated substantially lower risk compared to cigarettes. The panel's recommendations are not legally binding. On January 25, 2018, the TPSAC rejected Philip Morris' claims that its iQOS heat-not-burn tobacco product was safer than a traditional cigarette. The committee voted 8-0 with one abstention to reject Philip Morris' claim that switching from cigarettes to iQOS can reduce the risks of tobacco-related disease and 5-4 to reject its claim that iQOS is less harmful than a traditional cigarette. However, it voted 8-1 to approve Philip Morris' claim that iQOS contains fewer harmful chemicals than a traditional cigarette.