Adolescent Use of and Susceptibility to Heated Tobacco Products

Abstract

BACKGROUND AND OBJECTIVES: A leading brand of heated tobacco products (HTPs), IQOS, was authorized to be sold in the United States in 2019. Researchers have examined the awareness and use of HTPs among US adults. In this study, we examined high school students' awareness, use, and susceptibility pertaining to HTPs.METHODS: A large, cross-sectional population survey of randomly sampled 10th-and 12thgraders in California (N 5 150 516) was conducted online during school hours from September 2019 to March 2020.RESULTS: Overall, 8.9% (95% confidence interval [CI], 8.7%-9.1%) of California high school students had heard of HTPs. Approximately 0.67% (95% CI, 0.61%-0.73%) had ever tried HTPs, and 0.20% (95% CI, 0.17%-0.23%) were current users (ie, 30% of ever users continued to use HTPs at the time of survey). Among those who never tried HTPs, 18.3% (95% CI, 17.9%-18.8%) were susceptible to future use. The susceptibility to HTP use was greater among users of cigarettes or e-cigarettes than among nonusers. CONCLUSIONS:The awareness of HTPs among adolescents was remarkable given the low availability of products at the time of survey. Only a small percentage of adolescents experimented with HTPs. However, almost a third of those who had experimented with HTPs continued to use them. This high ratio and the fact that almost 1 out of 5 never users were susceptible to future HTP use should put the public health community on high alert as more HTP products are coming into the market, with promotion of these products likely to increase.

Global prevalence of heated tobacco product use, 2015–22: A systematic review and meta‐analysis

“…Figure 3 shows the 41 countries and areas from WPR ( n = 4) [56–60, 62–65, 68, 70, 71, 73, 74], EUR ( n = 35) [32–38, 40, 42–45] and AMR ( n = 2) [34, 47, 49–51, 53–55], for which prevalence of current HTP use in the general population was reported with ages 9 years and older included in the analyses. The pooled current use prevalence estimate across all available countries and areas was 1.53% (95% CI = 1.22, 1.87) ( I 2 = 99%).…”

“…Five additional studies that met inclusion criteria were identified from e-mail alerts and the grey literature search. A total of 45 included studies reported on 38 national surveys, covering four regions from 42 countries and areas: 15 studies from EUR [32][33][34][35][36][37][38][39][40][41][42][43][44][45] (Armenia, Austria, Belgium, Bulgaria, Croatia, Cyprus, Czechia, Denmark, Estonia, Finland, France, Georgia, Germany, the United Kingdom, Greece, Hungry, Ireland, Italy, Kosovo, Latvia, Lithuania, Luxembourg, Malta, Montenegro, the Netherlands, North Macedonia, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden and Ukraine), 11 studies from AMR [34,[46][47][48][49][50][51][52][53][54][55] (Canada and the US), 19 studies from the WPR [56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74] (Hong Kong, Japan, South Korea and Taiwan) and one study from AFR…”

“…Figure 2 shows the 42 countries and areas from WPR (n = 4) [56,57,61,62,64,65,67,69,71,72], EUR (n = 37) [33,[35][36][37][38][39][40][42][43][44][45], AMR (n = 1) [46][47][48][49][50][51][52][53][54][55] and AFR (n = 1) [75] for which life-time HTP use in the general population was measured, with ages 9 years and older included in the studies. The pooled estimate across all the available countries and ages was 4.87% (95% CI = 4.16, 5.63; I 2 = 100%).…”

Romanian young adult perceptions on using heated tobacco products following exposure to direct marketing methods

“…Growing research is being conducted on discovering the factors that influence the initiation and use of HTPs as well as product knowledge 9,[11][12][13][14] , yet no previous qualitative study on HTPs has specifically examined young adults. In a qualitative study by Tompkins, conducted in the United Kingdom, there were six main factors (health, financial, physical, practical, psychological, and social) that influenced the initiation and use of HTPs 15 .…”

“It’s Like Jogging Next to the Highway”: A Qualitative Analysis of the Motivations and Experiences of Single-, Dual-, and Ex-Users of IQOS in The Netherlands

“…Furthermore, HTPs have at least some appeal to youth and young adults, including non-smokers [12,13]. Data suggest that IQOS may attract non-tobacco-using adolescents and young adults to initiate tobacco use [1,14].…”