Early adoption of heated tobacco products resembles that of e-cigarettes

Abstract

BackgroundHeated tobacco products (HTP) generate nicotine-containing aerosol by heating tobacco rather than burning it. The US Food and Drug Administration (FDA) has recently authorised the sale of one HTP brand, iQOS, in the USA. This study examined the awareness, use and risk perceptions of HTP in the USA following FDA authorisation.MethodsA national probability sample of 20 449 US adults completed an online survey between November 2019 and February 2020. In addition to assessing awareness and use of HTP, two ratios were calculated: the ratio of those who experimented with HTP given that they had heard about it (E/H) and the ratio of those who currently used HTP given experimentation (C/E). These ratios for HTP were compared against those for e-cigarettes from a similar national survey in 2012.ResultsOverall, 8.1% of respondents had heard of HTP. Only 0.55% had tried and 0.10% were current users. The rate of experimentation among those who heard about HTP and the rate of current use among experimenters were, however, similar to those for e-cigarettes in 2012: E/H and C/E for HTP were 6.8% and 18.2%, respectively; and 10.7% and 17.8%, respectively for e-cigarettes. The majority of respondents considered HTP either less harmful than (11.6%), or equally harmful as e-cigarettes (42.7%).ConclusionsOnly a small fraction of US population in 2020 have tried any HTP. However, the similarity in early adoption rates following awareness, suggests that future adoption for HTP may be similar to that for e-cigarettes, if HTP are marketed more aggressively.

Adolescent Use of and Susceptibility to Heated Tobacco Products

“…For adults, the cited study revealed that 18% of those who had tried HTPs were still current users at the time of survey. 12 For adolescents in the current study, 30% of experimenters continued to use the products at the time of survey (Table 5). This continuation ratio for HTPs among adolescent experimenters resembles the continuation ratio for adolescent ecigarette experimenters, 36%, as shown from another CSTS.…”

“…14,38 Interestingly, the levels of HTP awareness and use among California high school students in this 2019-2020 survey were similar to those for US adults found in a recent national survey, conducted from November 2019 to February 2020. 12 The cited study revealed that 8% of American adults had heard of HTPs, 0.55% had tried HTPs, and 0.10% were current users. 12 In other words, 7% of the adults who had heard of HTPs experimented with them (0.55/8 5 6.8%).…”

“…12 The cited study revealed that 8% of American adults had heard of HTPs, 0.55% had tried HTPs, and 0.10% were current users. 12 In other words, 7% of the adults who had heard of HTPs experimented with them (0.55/8 5 6.8%). The current study found a similar percentage: among those who had heard of HTPs, 7.4% (0.67/9 5 7.4%) reported having experimented with these products.…”

“…Researchers have found that 5% to 12% of American adults were aware of HTPs and that some adults have tried them. [10][11][12] The level of awareness of HTPs among adolescents appeared to be similar to that of adults before IQOS' PMTA authorization. 23,24 No study, however, has examined the awareness or usage of HTPs among adolescents after IQOS received its PMTA authorization.…”

“…7,9 HTPs, which generate nicotine-containing aerosols by heating tobacco instead of burning it, have already gained some recognition among US adults. [10][11][12] With novel and slick exterior designs, many HTPs are also flavored. 13,14 Currently, only 1 brand of HTPs, IQOS, has obtained premarket tobacco product application (PMTA) authorization from the US Food and Drug Administration (FDA).…”