Results from a 2018 cross-sectional survey in Tokyo, Osaka and Sendai to assess tobacco and nicotine product usage after the introduction of heated tobacco products (HTPs) in Japan

Jason Adamson,Elisabeth Beyerlein,Yoga Keralapura Bhagavan,James Murphy,Claudia Kanitscheider,Krishna Prasad,Christopher Proctor,Oscar M Camacho

doi:10.1186/s12954-020-00374-3

Jason Adamson, Elisabeth Beyerlein + Show 6 more

Open Access

https://doi.org/10.1186/s12954-020-00374-3

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Abstract

BackgroundFor novel tobacco products that potentially reduce the risk of tobacco harm, post-market surveillance is important to observe population usage and behaviours associated with everyday use. This pilot study was performed to examine the use of tobacco products in three Japanese urban regions.MethodsThis study was a cross-sectional epidemiological survey administered in Sendai, Tokyo and Osaka, Japan, from May 19th to June 25th, 2018. Participants were selected with a three-stage probability random sampling process that first identified primary sampling units, then households and finally individuals. Eligible participants were aged at least 20 years who were willing to participate after information about the study was provided. People younger than 20 years and those living in institutions were excluded. Questionnaires were paper based and administered door to door.ResultsResponses were obtained from 4154 participants. Sixty-five percent self-reported being never, 19% current and 16% former users of any tobacco product at the time of the survey. Combustible tobacco products (almost all being cigarette) were used most (16%) followed by HTPs (5%). In the categories of combustible tobacco users and HTP users, 70% and 16%, respectively, used these products exclusively. Dual use was reported by 11% of respondents. Compared with 12 months before the survey, 12% of sole combustible tobacco products users were using HTPs exclusively or as dual users and 6% had quit tobacco products completely; 94% of sole HTP users remained sole users and 4% had quit tobacco products completely; and amongst dual users 12% had reverted to exclusive use of combustible tobacco products, 14% had switched to sole use of HTPs and 4% had quit tobacco products completely.ConclusionHTPs seem to be accepted as an alternative tobacco product amongst combustible tobacco users. Given complex findings for dual use, improved understanding of the motivations underlying this behaviour would be of interest.

Highlights

For novel tobacco products that potentially reduce the risk of tobacco harm, post-market surveillance is important to observe population usage and behaviours associated with everyday use
Heated tobacco product (HTP) seem to be accepted as an alternative tobacco product amongst combustible tobacco users
For all current and former regular HTP users, reasons for HTP use were assessed with tools identified in the literature ([16]; PMI MRTPA THS-PBA-07 Rescreening Questionnaire [22];)

Summary

Introduction

For novel tobacco products that potentially reduce the risk of tobacco harm, post-market surveillance is important to observe population usage and behaviours associated with everyday use. This pilot study was performed to examine the use of tobacco products in three Japanese urban regions. For adult smokers who wish to reduce cigarette consumption or for those who have tried to quit smoking but failed, while nicotine-replacement therapy is widely available, non-combustible tobacco and nicotine products such as heated tobacco products (HTPs), electronic cigarettes (e-cigarettes) and oral tobacco products, might offer other opportunities for tobacco harm reduction [4, 13, 21]. Usage patterns by consumers and the fundamental risks of these products need to be clearly contextualised within everyday use to evaluate the public health effects

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