Use of Heated Tobacco Products within Indoor Spaces: Findings from the 2018 ITC Japan Survey.

Edward Sutanto,Itsuro Yoshimi,Danielle M Smith,Andrew Hyland,Maciej L Goniewicz,Richard J O’Connor,Steve Xu,Janine Ouimet,Anne C K Quah,K Michael Cummings,Takahiro Tabuchi,Connor Miller,Yumiko Mochizuki,Geoffrey T Fong

doi:10.3390/ijerph16234862

Abstract

Although heated tobacco products (HTPs) have become increasingly popular in Japan, little is known about whether these emerging tobacco products are being used within indoor public spaces. Nationally representative data were obtained prior to implementation of a comprehensive smoke-free law in Japan as part of Wave 1 of the International Tobacco Control Japan Survey (February–March 2018). We estimated the weighted prevalence of HTP use within indoor public spaces among tobacco users and compared these to estimates for combustible cigarettes (CCs). Overall, 15.6% of current tobacco users in Japan declared that they used HTPs within indoor public spaces. Any HTP use within indoor public spaces was significantly lower than any CC use (80.1% vs. 96.7%). Dual HTP + CC users reported using CCs more frequently than using HTPs within indoor public spaces (97.7% vs. 76.0%). In conclusion, HTP use is less common than CC use within indoor public spaces. Findings of this study can inform the development of targeted smoke-free policies to benefit public health.

Highlights

Since their introduction in 2014 [1], heated tobacco products (HTPs) have become increasingly popular in Japan
In addition to describing the prevalence of indoor HTP and combustible cigarettes (CC) use in Japan, this study aimed to examine whether (1) the use of HTPs is more common within indoor public spaces than the use of CCs and (2) dual HTP and CC users use HTPs within indoor public spaces to circumvent smoke-free policy
HTP use was significantly lower than CC use within any indoor public spaces

Summary

Introduction

Since their introduction in 2014 [1], heated tobacco products (HTPs) have become increasingly popular in Japan. From 2015 to 2017, an estimated twelve-fold increase in past-30-day use of IQOS (a leading HTP brand) was observed among the Japanese general population, equating to millions of users nationwide [1]. As HTP use becomes more commonplace, it is important to examine potential health risks to non-users that may occur through secondhand exposure. While extensive research has implicated secondhand exposure to combustible cigarettes (CCs) as a cause of deleterious health effects [2,3], only a handful of independent studies have explored secondhand exposures to HTPs. Int. Res. Public Health 2019, 16, 4862; doi:10.3390/ijerph16234862 www.mdpi.com/journal/ijerph

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