Heated tobacco product use among Korean adolescents

Kang, Hee-Won; Cho, Sung-Il

doi:10.1136/tobaccocontrol-2019-054949

Cited by 44 publications

(42 citation statements)

References 15 publications

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“…ENDS are sometimes considered to reduce the harm of tobacco use 30 ; but this is disputed by our findings on the actual behavior of adolescents. We found that the risk of initiating cigarette use increases markedly after experimentation with ENDS, and a previous study reported that the majority of adolescent ENDS users were also cigarette users 31 . The results of our study showed the prevalence of current cigarette smoking was 1.2fold higher for those who started cigarette smoking subsequent to ENDS use, compared to those who had not experimented with ENDS.…”

Section: Discussionsupporting

confidence: 57%

Longitudinal transitions of cigarettes and electronic nicotine delivery systems among adolescents: Construction of a retrospective cohort using recall data from a cross-sectional sample

Kang

Cho

2020

Tob. Induc. Dis.

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The global progress made in reducing the prevalence of cigarette smoking 1 may have led to another challenge for tobacco control. The tobacco industry's fear of ABSTRACT INTRODUCTION A major concern regarding non-cigarette tobacco or nicotine products (NCTNPs) is whether they facilitate or mitigate overall tobacco or nicotine use. We examined longitudinal transitions of cigarettes and electronic nicotine delivery systems (ENDS) by constructing a retrospective cohort based on the recall data of a cross-sectional sample. METHODS Using the Korea Youth Risk Behavior Survey, we constructed crosssectional data of 59576 adolescents into retrospective cohort data. Participants were categorized into 4 mutually exclusive tobacco or nicotine use states. We used a multistate Markov model to identify transitions between the states to calculate transition intensity ratios (TIRs), and examined the current use of tobacco or nicotine products to assess both gateway effects to cigarettes, and whether ENDS use helps adolescents quit cigarette smoking. RESULTS Compared with never use, use of ENDS was associated with an increased risk of initiation of cigarette use (TIR=6.8; 95% CI: 4.5-10.2). The risk of transitioning from cigarette ever use to ENDS, compared with never use to ENDS, was even more pronounced (TIR=44.1; 95% CI: 34.1-56.9). The prevalence of current cigarette smoking was higher among those who started ENDS then cigarettes, compared to those who began cigarette use without experimenting with ENDS (43.1% vs 35.8%). Moreover, 27.8% (95% CI: 23.6-32.0%) of adolescents who experimented first with cigarettes then moved to ENDS were current users of cigarettes, and 46.4% (95% CI: 42.1-51.1%) of these adolescents were current users of both cigarettes and ENDS. CONCLUSIONS Based on the recall data of a cross-sectional sample, we demonstrate that ENDS experimentation increases the likelihood of cigarette smoking initiation. A significant proportion of these adolescents continue to use cigarettes. Moreover, those who experimented with cigarettes then ENDS also continue smoking cigarettes or both cigarettes and ENDS. We suggest comprehensive tobacco control policies for all tobacco/nicotine products and monitoring the timing of NCTNP initiation in cross-sectional surveys.

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Section: Discussionsupporting

confidence: 57%

Longitudinal transitions of cigarettes and electronic nicotine delivery systems among adolescents: Construction of a retrospective cohort using recall data from a cross-sectional sample

Kang

Cho

2020

Tob. Induc. Dis.

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“…reported having used IQOS (referred to in this study as "ever HTP use") and 3.5% were current users. 29) Kang and Cho 30) reported that 2.8% of adolescents in the KYRBS 2018 studies were ever HTP users.…”

Section: Prevalence Of Heated Tobacco Product Usementioning

confidence: 99%

“…Among 228 young adults aged 19–24 years old, 5.7% reported having used IQOS (referred to in this study as “ever HTP use”) and 3.5% were current users [ 29 ]. Kang and Cho [ 30 ] reported that 2.8% of adolescents in the KYRBS 2018 studies were ever HTP users. Compared with e-cigarettes, this data representative of the South Korean population showed a much faster expansion of HTP use.…”

Section: Trends In Tobacco Use In South Koreamentioning

confidence: 99%

The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea

Lee

2020

Korean J Fam Med

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Heated tobacco products (HTPs), a hybrid between conventional and electronic cigarettes, were first launched in South Korea in June 2017. Owing to advertisements stating that HTPs are odorless, tar-free, and less harmful to health, the sales of HTPs have grown quickly enough to account for about 10% of the total tobacco market in a year. HTP use by young, highly educated, and high-income groups had a significant impact on both the overall tobacco market over the past 3 years and the smoking and quitting behaviors of smokers. Based on national smoking rate statistics, tobacco sales trends, and the number of visitors to smoking cessation clinics, the following changes have been identified: (1) The decline in current smoking rates has slowed or rose in some groups. (2) The decline in total cigarette sales has slowed but rose again in the first quarter of 2020. (3) The number of visitors to smoking cessation clinics decreased just after the advent of HTPs. These results may be due to the insufficient support of tobacco regulation policies but also coincide chronologically with the appearance of HTPs in South Korea. It is necessary to investigate the usage rate of various tobacco products, including HTPs and e-cigarettes, to examine the health risks of novel tobacco products and provide accurate information to users and policymakers. Finally, tobacco companies are continuously developing new product concepts to escape the regulation of existing cigarettes; thus, comprehensive management measures for all nicotine-containing products are needed.

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“…That is much lower than the general tobacco use rate (21.56%) but strongly suggests that 96.25% of HTP users are or were dual users 2 . It is also noteworthy that the rate of use amongst adolescents reached 2.8% one year after their introduction 3 . As of April 2019, sales of HTPs reached approximately 11.8% of total tobacco sales in Korea 4 .…”

Section: Introductionmentioning

confidence: 98%

Gendered factors for heated tobacco product use: Focus group interviews with Korean adults

Kim

Cho

2020

Tob. Induc. Dis.

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INTRODUCTION Since June 2017, heated tobacco products (HTPs) have been on sale in Korea, comprising approximately 11.8% of total tobacco sales in April 2019. This research illuminates hitherto unexplored gendered factors influencing the use of HTPs. METHODS The participants for the focus group interviews (FGI) were recruited among those who use or have used HTPs. Participants were separated into six groups (a total of 38 persons: 20 men and 18 women). Each FGI, lasting for two hours, was audio-recorded and transcribed, and subsequently coded to conduct a content analysis using NVivo V12. RESULTS Both male and female participants shared the same opinion that HTPs were 'less smelly' and that despite their significant merit, HTPs had slightly different usages and places of use. First, male participants used them to avoid family members' pressure to quit smoking, and female participants used them to avoid the stigma associated with female smoking. Second, men tended to use HTPs indoors, mostly in non-smoking areas, while women used them outdoors, mainly in the streets. Both genders were dissatisfied with the taste of HTPs and often used them in combination with combustible cigarettes (CCs). In terms of taste, dual use, absence of smoking cessation, and perception of harm, no definite gendered difference was found. Almost half of the participants considered HTPs to be less harmful than cigarettes, while others contended that they were equally harmful. Many agreed that there was no strong correlation between the use of HTPs and smoking cessation. CONCLUSIONS Since HTPs have the potential to weaken motivating factors for smoking cessation in both male and female users, an understanding of their characteristics with gendered factors is beneficial to establishing policies to prevent the spread of HTP use and increase the overall rate of smoking cessation.

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Heated tobacco product use among Korean adolescents

Cited by 44 publications

References 15 publications

Longitudinal transitions of cigarettes and electronic nicotine delivery systems among adolescents: Construction of a retrospective cohort using recall data from a cross-sectional sample

Longitudinal transitions of cigarettes and electronic nicotine delivery systems among adolescents: Construction of a retrospective cohort using recall data from a cross-sectional sample

The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea

Gendered factors for heated tobacco product use: Focus group interviews with Korean adults

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