Comparison of Tobacco Use and Cessation Behavior between Conventional Cigarette and Heated Tobacco Product Users: Based on the Analyses of the Eighth Korea National Health and Nutrition Examination Survey 2019

Abstract

Background: After the advent of heated tobacco products (HTPs) in 2017, domestic cigarette sales declined until 2019, but have increased in South Korea since 2020. This study aimed to analyze tobacco use and cessation behavior among HTP users compared with conventional cigarette (CC) users.Methods: We analyzed data from the eighth Korea National Health and Nutrition Examination Survey (2019). Of 6,188 study participants, 1,181 were current tobacco product users (single, dual, and triple), including all combinations of CCs, HTPs, and electronic cigarettes (ECs). Tobacco use and cessation behaviors among single and dual users of CCs and HTPs were assessed using various categorical methods.Results: In 2019, proportions of HTP use in men and women aged ≥19 years in South Korea were 8.8% and 1.5%, respectively, and those of single, dual, and triple users were 23.6%, 58.0%, and 18.4%, respectively. Dual users had more tobacco use than CC only and HTP only users (all P<0.001). Each daily user accounted for a lower percentage of attempt and preparation stages for cessation than intermittent users (all P<0.001, except for dual users).Conclusion: In this study, we analyzed the differences in tobacco use and cessation behavior among CC and HTP users in various populations in South Korea. Additionally, we found that all novel tobacco product users had already experienced CCs in adulthood. Further studies that address HTP’s harmful effects in humans are necessary.

Heated tobacco product use frequency, smoking quit attempts, and smoking reduction among Mexican adult smokers

“…Canada, the United States, England, and Australia) smoked cigarettes and used e-cigarettes 23 . Studies in Korea between 2018 and 2019 consistently reported that around 80% to 96.3% of HTP users also smoked cigarettes or ‘triple use’ HTPs, cigarettes, and e-cigarettes 20 , 24 , 25 . These emerging patterns of multiple nicotine product use may expose users to high nicotine levels that promote addiction and make it harder for them to quit smoking altogether 24 , 26 .…”

“…Similar to prior research, we found that more frequent smoking was associated with more frequent HTP use. For example, one study found that HTP users who smoke cigarettes reported smoking more cigarettes per day and were more nicotine-dependent than exclusive users of either combustible cigarettes or HTPs 24 . Among Korean populations, the odds of being a former smoker were much lower among dual users of combustible cigarettes and HTPs or e-cigarettes and triple users of HTPs, e-cigarettes, and combustible cigarettes, than among non-HTP and non-e-cigarette users 25 .…”