Heated tobacco product use and its relationship to quitting combustible cigarettes in Korean adults.

Jinyoung Kim,Hong-Jun Cho,Sungkyu Lee,Juna-Ah Lee,Cheol-Min Lee,Heejin Kimm,Stanton A Glantz

doi:10.1371/journal.pone.0251243

Abstract

ObjectiveWe assessed the prevalence of, and factors associated with, heated tobacco product (HTP) use and analysed the association between HTP use and quitting combustible cigarettes (CCs) in Korean adults.MethodsWe conducted an online survey with 7,000 adults (males, 2,300; females, 4,700; ages 20–69) out of 70,000 age-, sex- and provincial-distribution-matched individuals based on 2018 national population statistics. Females were oversampled because the prevalence of tobacco product use is very low among women in Korea. Chi-square tests were used for bivariate analyses, and odds ratios were assessed after adjusting for sociodemographic variables.ResultsThe prevalence of current CC, electronic cigarette (EC), and HTP use was 24.8% (males, 40.4%; females, 9.3%), 6.8% (males, 10.1%; females, 3.4%), and 10.2% (males, 16.2%; females, 4.3%), respectively. Among the 574 current HTP users, 77 (13.4%) were HTP-only users and >80% were either dual users of HTP and CC/EC, or triple users of HTP, EC, and CC. Among the current CC users, the odds of having attempted to quit CCs in the past year were greater among EC-only users (aOR 2.92; 95% CI 1.81–4.69) and dual users of HTPs and ECs (aOR 8.42; 95% CI 4.85–14.62) than among non-HTP and non-EC users. Among 2,121 ever CC smokers, the likelihood of being a former CC smoker was 0.19 (95% CI 0.15–0.24) for HTP users, 0.29 (95% CI 0.20–0.42) for EC users, and 0.03 (95% CI 0.01–0.06) for users of both HTPs and ECs compared with non-HTP and non-EC users.ConclusionEC-only use and dual use of HTPs and ECs were associated with increased attempts to quit CCs; however, HTP and EC use was associated with lower odds of CC smoking abstinence.

Highlights

Heated tobacco products (HTPs) are tobacco products that produce aerosols containing nicotine and other chemicals, which are inhaled by users [1]
Among the current combustible cigarettes (CCs) users, the odds of having attempted to quit CCs in the past year were greater among EC-only users and dual users of HTPs and ECs than among non-HTP and non-EC users
On July 7, 2020, the US Food and Drug Administration (US FDA) authorised marketing of IQOS, an HTP produced by Philip Morris International

Summary

Introduction

Heated tobacco products (HTPs) are tobacco products that produce aerosols containing nicotine and other chemicals, which are inhaled by users [1]. On July 7, 2020, the US Food and Drug Administration (US FDA) authorised marketing of IQOS, an HTP produced by Philip Morris International. The US FDA stated that IQOS significantly reduces the production of harmful and potentially harmful chemicals (HPHC) and reduces the body’s exposure to HPHC when switching completely from conventional cigarettes to IQOS [3]. The market share of HTPs in Korea has grown rapidly [4]. Additional HTP products (Glo, manufactured by the British American Tobacco Company, and Lil, manufactured by KT&G) are available in Korea. The market share by sales of HTPs in Korea reportedly increased from 6.1% in December 2017 to 11.8% in April 2019 [5]. In Japan, IQOS had close to 15% of the national tobacco market share in 2018 [6]. Except for tobacco tax levels on HTPs, which are 89% of those on CCs, HTPs are currently regulated at the same level as CCs; use of HTPs in public places and their sale to minors is banned, advertisement is regulated, and pictorial warning labels are applied to HTP sticks [9]

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