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

Abstract

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.

Prevalence and predictors of heated tobacco products use among male ever smokers: results from a Korean longitudinal study

“…HTPs sales exceeded 5% of total cigarette sales four months after its launch and reached 10% in 11 months in South Korea [ 6 ]. At six months after IQOS was launched, 10.7% of smokers so far responded they had experience with HTPs.…”

“…These products have drawn tremendous attention from smokers who are concerned with their health as well as exposing others from smoking [ 5 ]. Accordingly, the market share of HTPs reached about 10% of total tobacco sales within one year of their introduction [ 6 ]. As PMI claims that IQOS emits no smoke because HTPs do not undergo combustion, these new products can be more socially acceptable [ 7 , 8 ].…”

Are Heated Tobacco Product Users Less Likely to Quit than Cigarette Smokers? Findings from THINK (Tobacco and Health IN Korea) Study

“…While the sales of HTPs have increased, two unusual things have been observed. First, the rate of decline in total tobacco sales has slowed since HTPs was introduced (−20131.5% in 2018 and −0.7% in 2019) [ 10 ]. Second, the number of visits to smoking cessation clinics decreased by 13% and the amount of government support allocated for the prevention of smoking medication dropped 27.5% in 2018 [ 11 , 12 ].…”

Directions and Challenges in Smoking Cessation Treatment

“…Even health care products (e.g., electronic sphygmomanometers, electronic scales, and electronic toothbrushes) were provided as incentives. However, this special treatment was terminated on January 1, 2019 [ 3 ]. In the first year of introduction, this program registered more than 200,000 smokers; the number of participants increased to more than 400,000 in 2017.…”

“…The share of e-cigarettes was 11.1% in the same period last year (decrease of 0.57%). The sales of HTPs decreased by 6.6% and that of CSVs plummeted by 80.3% [ 3 ]. The plunge in sales of CSVs may have been affected by the warning against the use of CSVs announced by the Korean government in October 2019, which came after the report of vaping-associated acute lung injury in the United States.…”