IQOS Use Research Articles

Shifts in motivation to quit cigarette smoking associated with IQOS use

IntroductionIQOS, a heated tobacco product (HTP), is among a growing number of noncombustible nicotine delivery alternatives marketed to people who smoke combustible cigarettes and are interested in less harmful alternatives. Little is known regarding whether IQOS use and IQOS-associated effects impact motivation to quit cigarette smoking. MethodsNon-treatment-seeking adult daily smokers (n = 87) completed a within-subjects study consisting of a baseline ad-lib smoking period (days 1–5), two laboratory visits (days 6–7) involving IQOS exposure, and a two-week period where participants were instructed to switch from smoking cigarettes to using IQOS (days 8–21). Motivation to quit smoking was measured on days 1 and 22. ResultsA generalized linear model revealed a significant increase in motivation to quit smoking across the 14-day switch phase with an increase of 1.47 ladder steps (Δ=1.47, sd = 1.98, t(86) = 6.92, p < 0.0001), increasing from 5.30 to 6.80. Candidate predictors were identified through a stepwise selection procedure, which resulted in a final model with two predictors, the standardized HeatStick substitution rate (b = 0.54, (CI95% 0.13–0.95), p = 0.01) and standardized relative risk perception score (b = 0.45, (CI95% 0.04–0.85) p = 0.03), ConclusionsAmong those uninterested in quitting cigarette smoking within the next month, IQOS use was associated with increased motivation to quit. Motivation to quit smoking may not be a necessary prerequisite for promoting smoking behavior change but rather bolstered by smoking behavior change in the context of HTP use. Greater perceptions of risk reduction may ultimately aid the transition from combustible to noncombustible tobacco products.

Switching from cigarettes to IQOS: the relative importance of IQOS-associated reward, reinforcement and abstinence relief

IntroductionThis study investigated whether IQOS, a heated tobacco product, can fully substitute for combustible cigarettes and the factors that promote substitution.MethodsAdults who smoked cigarettes daily (N=90; 21–65 years) completed a...

Exposure to IQOS ads and reduced exposure claims, and association with perceived risk from COVID-19 on IQOS purchase and use intentions: results from a web-based survey.

IQOS was authorized to be marketed as a reduced exposure product by the Food and Drug Administration in October 2020 during the global COVID-19 pandemic. Those who smoke may be more sensitive to reduced exposure marketing claims and may have an increased inclination toward IQOS use. We evaluated the likelihood of trying and purchasing IQOS as a function of exposure to ads, product appeal, and COVID-19 risk perceptions using the original IQOS ads with reduced exposure marketing. An online cross-sectional survey recruited 604 US adults (18-45 years), both who smoke and do not smoke. Participants saw one of the six randomly assigned IQOS ads with or without reduced exposure claims, and they answered questions about product appeal and likelihood to try and purchase IQOS. Generalized linear models were used to examine associations. A per unit increase in product appeal was associated with a greater likelihood of purchasing (B = 0.17, 95% CI: 0.15-0.18) and trying IQOS (B = 0.16, 95% CI = 0.14-0.18). Current smokers and former e-cigarette users reported greater intentions to try IQOS than never-smokers and never e-cigarette users, respectively. Likelihood to purchase IQOS was associated with greater confidence in not contracting COVID-19 (B = 0.11, 95% CI: 0.01-0.21). No significant differences were observed between different ad conditions. Current (B = -0.34, 95% CI = -0.50-(-0.19)) and former (B = -0.92, 95% CI = -0.15-(-0.68)) cigarette smokers who were someday e-cigarette users reported less intentions to purchase IQOS than never e-cigarette users. However, never smokers who were someday (B = 0.58, 95% CI = 0.27-0.89; B = 0.68, 95% CI = 0.39-0.98) and former e-cigarette (B = 0.38, 95% CI = 0.15-0.61) users reported greater intentions to purchase and try IQOS, respectively. IQOS may have a higher product appeal, especially for those who currently smoke and those who have lower risk perceptions from COVID-19. Among never smokers, those who currently use or have used e-cigarettes in the past may be more receptive to IQOS marketing. The data are informative for potential trends in the use of IQOS in the future and may have implications for marketing regulations of heated tobacco products (HTPs).

IQOS - new heat-not-burn tobacco products and its impact on health

Introduction: Iqos and other heat-not-burn products according to tobacco companies are a safer alternative to cigarettes.&#x0D; The aim of this article is to objectively review the potential impact of iQOS® on human health by searching for and integrating published research findings.&#x0D; This article provides a comprehensive review and analysis of the scientific research conducted on the effects of Iqos use on human health, distinguishing between specific medical fields.&#x0D; Materials and methods: This study is based on medical articles collected from the PubMed database spanning the years 2016-2023. The research was conducted through the analysis of keywords such as "Iqos", "Heat not burn", and "Iqos health impact". &#x0D; Results: Tobacco heaters are seen as potentially less harmful. However, emerging research on their harmfulness clearly shows that despite reduced concentrations of compounds hazardous to health, the aerosol produced by heaters still contains the same harmful substances. Further studies show that the toxic impact of the aerosol is at a similar level to that of smoke from traditional cigarettes.

Nicotine Delivery of a Menthol-Flavored Heat-not-Burn Tobacco Product During Directed Use.

IQOS was authorized by the U.S. Food and Drug Administration (FDA) as a modified-risk tobacco product. We conducted a pharmacokinetic study evaluating the nicotine delivery and subjective effects of IQOS use among current menthol cigarette smokers to better understand if IQOS is an acceptable cigarette alternative in light of the proposed menthol cigarette ban. Participants were adult smokers of >4 menthol cigarettes per day. After 14-hour nicotine abstinence, participants were provided an IQOS device and menthol heatstick to puff every 20 seconds for a total of 14 puffs. Blood samples were collected at baseline and during active use to calculate nicotine boost from baseline to peak concentration. Nicotine withdrawal symptoms were collected before and after IQOS use. In addition, a modified Product Evaluation Scale for IQOS was collected after use. Participants (n = 8) were a mean age of 43.9 years, 63% were female, 88% identified as White, and they smoked a mean of 17.1 menthol cigarettes per day. After IQOS use, the mean nicotine boost obtained was 15.96 ng/mL (SD = 6.91) (range 9.31 to 30.55 ng/mL). Most (75%) participants reported enjoying use of the product "a lot" or greater and more than half (62.5%) reported reduced cigarette cravings. Most participants reported no side effects after use; however, two experienced dry mouth, three experienced dizziness, one experienced throat irritation, and one experienced headache. We found that directed use (14 puffs) of menthol IQOS delivered a mean nicotine boost of 15.96 ng/mL which reduced craving for a cigarette. The majority of participants enjoyed use of IQOS and reported mild side effects. Menthol IQOS delivered a sufficient dose of nicotine perceived as satisfying by menthol cigarette smokers and it reduced craving with mild side effects. Menthol IQOS has potential to serve as a less harmful alternative for menthol cigarette smokers. The availability of modified risk products like IQOS should be considered by FDA's Comprehensive Plan for Tobacco and Nicotine Regulation.

IQOS Use and Interest by Sociodemographic and Tobacco Behavior Characteristics among Adults in the US and Israel.

Heated tobacco products (HTPs) have expanded globally. IQOS, a global HTP leader, was launched in Israel in 2016 and the US in 2019. To inform tobacco control efforts, it is critical to understand who is likely to use HTPs in different countries with distinct regulatory and marketing contexts. Thus, we conducted a cross-sectional survey among adult (ages 18-45) online panelists in the US (n = 1128) and Israel (n = 1094), oversampling tobacco users, in the fall of 2021, and used multivariable regression to identify correlates of (1) ever using IQOS; (2) past-month vs. former among ever users; and (3) interest in trying IQOS among never users. Among US adults, correlates of ever use included being Asian (aOR = 3.30) or Hispanic (aOR = 2.83) vs. White, and past-month use of cigarettes (aOR = 3.32), e-cigarettes (aOR = 2.67), and other tobacco (aOR = 3.34); in Israel, correlates included being younger (aOR = 0.97), male (aOR = 1.64), and cigarette (aOR = 4.01), e-cigarette (aOR = 1.92) and other tobacco use (aOR = 1.63). Among never users, correlates of greater interest included cigarette and e-cigarette use in the US (β = 0.57, β = 0.90) and Israel (β = 0.88, β = 0.92). IQOS use prevalence was low (US: 3.0%; Israel: 16.2%) but represented in vulnerable subpopulations (younger adults, racial/ethnic minorities).

Trends in prevalence and patterns of use of a heated tobacco product (IQOS™) in Japan: A three-year repeated cross-sectional study

Background: Numerous smoke-free tobacco or nicotine-containing product (TNP) alternatives have been introduced to support individual- and population-level harm reduction relative to continued cigarette smoking. This article details the nationwide prevalence and patterns of TNP use between 2016 and 2019 in Japan following the commercialization of IQOS™, a smoke-free heated tobacco product (HTP). Methods: Cross-sectional surveys were conducted over a period of three study years (2016/2017, 2017/2018, and 2018/2019) in representative samples of the Japanese general adult population and samples of Japanese adult IQOS users registered in the IQOS owner database of Philip Morris International’s affiliate in Japan. Results: Across the three study years (Y1-Y3), the prevalence of overall current TNP use (Y1-Y3: 18.5%, 18.9%, and 18.2%) and overall TNP use by age and sex remained similar. However, there was a growing shift from cigarette smoking to smoke-free TNP use across the three study years. While the cigarette smoking prevalence (Y1-Y3: 17.6%, 17.3%, and 16.0%) decreased, the use prevalence of smoke-free TNPs, including the HTP IQOS™ (Y1-Y3: 1.8%, 3.2%, and 3.3%) and e-cigarettes (Y1-Y3, 0.7%, 1.6%, and 2.0%) increased. At the same time, TNP initiation, TNP relapse, and TNP reinitiation with IQOS were all very low across the three study years. Across Y1-Y3, exclusive use of only one type of TNP (Y1-Y3: 82.3%, 75.0%, and 70.4%) decreased, while dual use of two types of TNPs (Y1-Y3: 14.3%, 17.2%, and 16.7%) increased, and poly-TNP use (Y1-Y3: 2.1%, 6.1%, and 10.0%) increased markedly. Moreover, the majority of adult IQOS users were exclusive IQOS users. Conclusions: These trends in IQOS use behavior suggest that IQOS™ has the potential to switch adult smokers from cigarettes to smoke-free tobacco products, which presents a harm reduction opportunity, and that HTPs are effective tools for complementing current tobacco control measures.

'It's not what you'd term normal smoking': a qualitative exploration of language used to describe heated tobacco product use and associated user identity.

Tobacco and nicotine marketplaces have diversified over the past decade, including with the introduction of heated tobacco products (HTPs), such as the brand IQOS. HTPs typically heat tobacco to generate an aerosol that is inhaled. HTP nomenclature is lacking, and how HTP users define and identify themselves remains understudied. Research in this area is important because language can construct identity, and identity can shape behaviour. This study aimed to explore users' language choice when describing IQOS use, and how language relates to user identity. Qualitative interviews in London, United Kingdom, with 30 adult current and former IQOS users. Analyses were guided by Iterative Categorization. Overall, participants expressed confusion and a lack of suitable terminology for how to describe IQOS use. Verbs such as heating and IQOSing were rarely endorsed. Most often, participants reverted to smoking when describing IQOS use and commonly referred to HEETS (tobacco sticks) as cigarettes. Yet the lack of combustion, electronic device, cleaner experience and perceived reductions in health risks led some to frame IQOS as distinct from smoking. Vaping was generally considered inappropriate for describing IQOS use. Participants also manipulated language to suit their circumstances and manage their identity, whereas some IQOS users embraced the terms smoking and smoker, most were eager to distinguish between using IQOS and being labelled a smoker because of the associated negative connotations and to align with perceptions of IQOS use as a better, less harmful behaviour. Instead, when describing their identity, IQOS users more willingly identified as vapers, or ex-smokers, or created new identities (e.g. HEET user). People who use or have used IQOS (a brand of heated tobacco product) are ambiguous about IQOS terminology. Participants in this study commonly referred to IQOS use as smoking for lack of a more suitable term, but also resisted being labelled as smokers, a choice that may influence smoking cessation. Clear terminology must be used in surveys and by healthcare professionals when asking about cigarette smoking and e-cigarette and heated tobacco product use.

'It's like if a vape pen and a cigarette had a baby': a mixed methods study of perceptions and use of IQOS among US young adults.

Young adults' perceptions and use of heated tobacco products (HTPs) are understudied. This mixed methods study analyzed (i) Fall 2020 survey data from 2470 US young adults (meanage = 24.67; 19.5% and 25.2% past-month cigarette and e-cigarette use; 4.1% ever HTP use) assessing HTP use intentions and perceptions (1 = not at all to 7 = extremely) and (ii) Spring 2021 interview data regarding IQOS (most widely available HTP) in a subset of 40 e-cigarette users. Among survey participants, HTPs versus cigarettes and e-cigarettes showed lower use intentions (mean = 1.27 vs. mean = 1.73, mean = 2.16) but were perceived as less addictive (mean = 5.11 vs. mean = 6.28, mean = 5.82) and harmful (mean = 5.37 vs. mean = 6.65, mean = 5.62). HTPs were perceived more socially acceptable than cigarettes but less than e-cigarettes (mean = 3.39 vs. mean = 3.13, mean = 4.37). Among interviewees, most reported limited HTP knowledge. A few perceived IQOS as a hybrid of traditional cigarettes and e-cigarettes. Most perceived IQOS as harmful but less harmful than cigarettes and were uncertain in relation to e-cigarettes. Over half reported minimal interest in trying IQOS; common reasons included IQOS containing tobacco, limited flavors and use complexity. The varied perceptions of IQOS versus cigarettes and e-cigarettes underscore the need for continued surveillance of perceptions, use and marketing of IQOS to inform regulatory oversight and potential interventions.

Switching from cigarettes to IQOS: A pilot examination of IQOS-associated reward, reinforcement, and abstinence relief

BackgroundIt is unknown whether IQOS-associated decreases in cigarette craving, nicotine withdrawal, greater subjective reward, and relative reinforcing value predict subsequent switching from cigarettes to IQOS products. MethodsNontreatment-seeking adult daily smokers (n = 33; 18–65 years old) completed a within-subject pilot study consisting of a baseline ad-lib smoking period (days 1–5), two laboratory visits (days 6–7), and a two-week period where participants switch from using cigarettes to using IQOS (days 8–21). Mixed-effect modelling estimated the percentage of baseline cigarette consumption replaced by daily IQOS HeatSticks used. Predictors of use included IQOS-associated reinforcement, subjective reward, and craving and withdrawal relief. ResultsIQOS use alleviated cigarette abstinence-associated craving (change=−14.22, p < .001) but did not alleviate withdrawal symptoms. Smokers initially substituted IQOS for 59% of their average daily cigarette consumption, increasing to 87% by switch period end (B=0.02 [95%CI=0.01, 0.03], p = .002). Neither subjective reward of IQOS nor relief of cigarette craving and withdrawal symptoms were predictive of this change. By study end, IQOS consumption was 124% of regular cigarette consumption among participants with a low reinforcing value of cigarettes relative to IQOS (β = 0.03 [95%CI=0.00, 0.06], p = .049). In contrast, participants with a higher reinforcing value of smoking replaced 76% of their cigarettes with IQOS. ConclusionsIQOS shows potential as an alternative to combustible cigarettes. However, IQOS use may result in dual-use for most smokers and increase tobacco consumption among a subgroup of smokers. These preliminary findings highlight the need for a larger investigation of the relationship between IQOS use and cigarette smoking.

Trends in prevalence and patterns of use of a heated tobacco product (IQOSTM) in Japan: A three-year repeated cross-sectional study

Background: Numerous smoke-free tobacco or nicotine-containing product (TNP) alternatives have been introduced to support individual- and population-level harm reduction relative to continued cigarette smoking. This article details the nationwide prevalence and patterns of TNP use between 2016 and 2019 in Japan following the commercialization of IQOSTM, a smoke-free heated tobacco product (HTP). Methods: Cross-sectional surveys were conducted over a period of three study years (2016/2017, 2017/2018, and 2018/2019) in representative samples of the Japanese general adult population and samples of Japanese adult IQOS users registered in the IQOS owner database of Philip Morris International’s affiliate in Japan. Results: Across the three study years (Y1-Y3), the prevalence of overall current TNP use (Y1-Y3: 18.5%, 18.9%, and 18.2%) and overall TNP use by age and sex remained similar. However, there was a growing shift from cigarette smoking to smoke-free TNP use across the three study years. While the cigarette smoking prevalence (Y1-Y3: 17.6%, 17.3%, and 16.0%) decreased, the use prevalence of smoke-free TNPs, including the HTP IQOS (Y1-Y3: 1.8%, 3.2%, and 3.3%) and e-cigarettes (Y1-Y3, 0.7%, 1.6%, and 2.0%) increased. At the same time, TNP initiation, TNP relapse, and TNP reinitiation with IQOS were all very low across the three study years. Across Y1-Y3, exclusive use of only one type of TNP (Y1-Y3: 82.3%, 75.0%, and 70.4%) decreased, while dual use of two types of TNPs (Y1-Y3: 14.3%, 17.2%, and 16.7%) increased, and poly-TNP use (Y1-Y3: 2.1%, 6.1%, and 10.0%) increased markedly. Moreover, the majority of adult IQOS users were exclusive IQOS users. Conclusions: These findings suggest that current IQOS use behavior trends are in line with the principles of tobacco harm reduction and that HTPs are effective tools for complementing current tobacco control measures.

Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product ( IQOS®): a cross-sectional study.

Background: Several smoke-free tobacco and/or nicotine-containing products (TNP) have emerged in recent years to support tobacco harm reduction strategies and reduce individual health risks and population harm relative to continued cigarette smoking. This paper describes the nationwide prevalence and patterns of TNP use in Japan following the commercialization of one such smoke-free TNP, the heated tobacco product IQOS® (Philip Morris International). Methods: We analyzed the first annual data (2016-2017) of two repeated cross-sectional surveys conducted in a representative sample of the Japanese general adult (≥20 years of age) population (N = 4,878) and a sample of adult IQOS users (N = 2,000). We assessed the prevalence of current TNP use according to type of product (cigarettes, IQOS, e-cigarettes, and other TNPs) in the general population and patterns of TNP use in the IQOS user sample. Results: The prevalence of current use across all TNP in the sampled general population was 18.5% (95% confidence interval 17.2-19.5%), with 17.5% (16.4-18.6%) for cigarette smoking and 1.8% (1.4-2.2%) for IQOS use. Regarding the distribution of patterns of use in the IQOS user survey, the majority (63.4% [61.2-65.6%]) were exclusive users of IQOS, followed by 20.6% (18.7-22.5%) of individuals who reported dual use of IQOS and cigarettes. Conclusions: In Japan, cigarette smoking remains the most prevalent way of consuming TNP; however, IQOS is being adopted by a growing number of adult Japanese smokers. These findings serve as baseline data for monitoring trends over time in the use and adoption of potential smoke-free TNP in Japan.

Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product ( IQOS ®): a cross-sectional study

Background: Several smoke-free tobacco and/or nicotine-containing products (TNP) have emerged in recent years to support tobacco harm reduction strategies and reduce individual health risks and population harm relative to continued cigarette smoking. This paper describes the nationwide prevalence and patterns of TNP use in Japan following the commercialization of one such smoke-free TNP, the heated tobacco product IQOS® (Philip Morris International). Methods: We analyzed the first annual data (2016–2017) of two repeated cross-sectional surveys conducted in a representative sample of the Japanese general adult (≥20 years of age) population (N = 4,878) and a sample of adult IQOS users (N = 2,000). We assessed the prevalence of current TNP use according to type of product (cigarettes, IQOS, e-cigarettes, and other TNPs) in the general population and patterns of TNP use in the IQOS user sample. Results: The prevalence of current use across all TNP in the sampled general population was 18.5% (95% confidence interval 17.2–19.5%), with 17.5% (16.4–18.6%) for cigarette smoking and 1.8% (1.4–2.2%) for IQOS use. Regarding the distribution of patterns of use in the IQOS user survey, the majority (63.4% [61.2–65.6%]) were exclusive users of IQOS, followed by 20.6% (18.7–22.5%) of individuals who reported dual use of IQOS and cigarettes. Conclusions: In Japan, cigarette smoking remains the most prevalent way of consuming TNP; however, IQOS is being adopted by a growing number of adult Japanese smokers. These findings serve as baseline data for monitoring trends over time in the use and adoption of potential smoke-free TNP in Japan.

IQOS Marketing in the US: The Need to Study the Impact of FDA Modified Exposure Authorization, Marketing Distribution Channels, and Potential Targeting of Consumers.

IQOS, the leading heated tobacco product globally, recently received ‘reduced exposure’ authorization from the US Food and Drug Administration. Independent research focusing on IQOS marketing and potential impact on consumers’ perceptions and behavior, and ultimately public health, is critical. The literature to date has underscored several concerns. First, Philip Morris’s (PM’s) marketing distribution requires scrutiny, particularly given its innovative promotional strategies. For example, IQOS is distributed via unique points-of-sale (POS; e.g., specialty and pop-up stores, “corners” in convenience stores) and uses various other opportunities (e.g., social media, sponsored events, direct-to-consumer). Second, although PM claims that IQOS’ target market is current combustible tobacco users and not young people, the literature indicates that in some populations, IQOS use is equally prominent among smokers and nonsmokers, and that specific subgroups (e.g., young adults, women) are targeted. Third, the impact of IQOS’ use of ad content promoting IQOS health benefits must be studied (e.g., how consumers interpret modified exposure messages). In conclusion, surveillance of IQOS marketing, particularly following reduced exposure authorization, is critical for obtaining valuable data to estimate population impact, particularly among population subgroups (e.g., young adults), and inform future tobacco regulation. These considerations have implications beyond IQOS—to other products and companies.

Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product (IQOS®): a cross-sectional study

Background: Several smoke-free tobacco and/or nicotine-containing products (TNP) have emerged in recent years to support tobacco harm reduction strategies and reduce individual health risks and population harm relative to continued cigarette smoking. This paper describes the nationwide prevalence and patterns of TNP use in Japan following the commercialization of one such smoke-free TNP, the heated tobacco product IQOS® (Philip Morris International). Methods: We analyzed the first annual data (2016-2017) of two repeated cross-sectional surveys conducted in a representative sample of the Japanese general adult population (N = 4,878) and a sample of adult IQOS users (N = 2,000). We assessed the prevalence of current TNP use according to type of product (cigarettes, IQOS, e-cigarettes, and other TNPs) in the general population and patterns of TNP use in the IQOS user sample. Results: The prevalence of current use across all TNP in the general adult population was 18.5% (95% confidence interval 17.2-19.5%), with 17.5% (16.4-18.6%) for cigarette smoking and 1.8% (1.4-2.2%) for IQOS use. With regard to the distribution of patterns of use in the IQOS user survey, the majority (63.4% [61.2-65.6%]) were exclusive users of IQOS, followed by 20.6% (18.7-22.5%) of individuals who reported dual use of IQOS and cigarettes. Conclusions: In Japan, cigarette smoking remains the most prevalent way of consuming TNP; however, IQOS is being adopted by a growing number of adult Japanese smokers. These findings serve as baseline data for monitoring trends over time in the use and adoption of potential smoke-free TNP in Japan.

Comparison of IQOS (heated tobacco) and cigarette smoking on cardiac functions by two-dimensional speckle tracking echocardiography

AimsIQOS is a novel tobacco product claimed to be safer than conventional cigarette smoking due to the heat-not-burn system. This study aimed to evaluate the acute effects of IQOS smoking on myocardial systolic and diastolic functions and also compare the acute impacts of IQOS with cigarette smoking. MethodsIn this prospective study, twenty-seven healthy participants who were using IQOS were included. Transthoracic echocardiography was performed three times for each participant; before smoking any tobacco product (group1), after IQOS smoking (group 2), after cigarette smoking (group3). In addition to conventional echocardiographic measurements, left ventricle (LV) and right ventricle (RV) strain analyses were performed by speckle tracking echocardiography. ResultsIn comparison with non-smoking status, LV global longitudinal strain (GLS) decreased after IQOS and cigarette smoking (−18.9 ± 2.4% in baseline vs. −17.9 ± 2.4% in IQOS vs. −17.9 ± 2.8% in cigarette smoking; p = 0.003, p = 0.001; respectively). LV global circumferential strain (GCS) reduced after IQOS and cigarette smoking (−19.8 ± 4.4% in baseline vs. −18.3 ± 3.9% in IQOS vs. −17.5 ± 3.9% in cigarette smoking; p = 0.005, p < 0.001; respectively). RV GLS was significantly lower in groups smoking IQOS and cigarette (−23.2 ± 4.6% in baseline vs. −21.4 ± 4.1% in IQOS vs. −19.4 ± 4.1% in cigarette smoking; p < 0.001, p = 0.001; respectively). ConclusionIQOS (heat-not-burn) tobacco smoking impairs myocardial systolic and diastolic functions in the acute phase like conventional cigarette smoking. The use of IQOS is rising among young adults in recent years, so further studies should be designed to evaluate the chronic effects of IQOS on myocardial function.

Categorizing IQOS-Related Twitter Discussions.

(1) Background: The heated tobacco product IQOS, by Philip Morris International, is now available in over 55 countries, including the United States. Social media sites such as Twitter are often used to promote or discuss tobacco products, though prior research has not examined how IQOS is presented on Twitter. (2) Methods: This study collected and categorized Twitter conversations involving IQOS. A manual content analysis was performed on N = 3916 English tweets related to IQOS published internationally between 1 January 2020 and 30 June 2020. (3) Results: Most tweets were either online marketing for IQOS (32.3%) or personal testimonials related to IQOS use (34.2%). Personal testimonial tweets made harm reduction claims about IQOS either as an avenue to quit smoking/tobacco use (3.4%), or in comparison to combustible cigarettes (2.0%). Tobacco policy-related tweets were detected (13.9%), split between discussions of United States (4.9%) and international (4.4%) policies. News media tweets (14.2%) were also detected. (4) Conclusions: Our study suggests IQOS may be understood as a less harmful alternative to vaping and combustible cigarettes. Discussions also suggest IQOS is likely to be used to avoid clean air policies or used in areas in which smoking is restricted.

Effects of Visual Exposure to IQOS Use on Smoking Urge and Behavior.

In this study, we examined whether visual exposure to the heated tobacco product (HTP) IQOS, which was authorized for sale by the US Food and Drug Administration in 2019, acts as a cue to increase cigarette craving and smoking behavior among smokers. Young adult smokers (N = 105) were randomly assigned to view a video depicting use of either IQOS or bottled water. Main outcomes were changes in cigarette and e-cigarette desire and latency to smoke between the groups. We also examined participants' attitudes about the actors using IQOS and drinking water in the videos. Exposure to the use of IQOS acutely increased observers' ratings of smoking urge and desire for a cigarette and an e-cigarette. The IQOS cue, compared with the water cue, also produced a marginally significant shorter latency to smoke. Participants perceived actors as less likeable and friendly when using IQOS than when drinking water. Results showed that exposure to IQOS produced smoking urge and behavior in young adult smokers, implicating IQOS use as a smoking and vaping cue. As HTPs gain popularity, product impact on passive observers should be included in their risk-benefit profile.

Prevalence of heated tobacco product use among adolescents in Taiwan.

To determine the penetration of heated tobacco products (HTPs) into the youth market in Taiwan, with a particular focus on the correlation between IQOS use and the usage of other tobacco products. Data from the 2018 Global Youth Tobacco Survey were used to assess previous experience with and current use (within 30 days prior to survey completion) of IQOS products by Taiwanese students aged 12-18 years. Independent variables included the usage patterns of conventional cigarettes and e-cigarettes. The control variables included background information (gender, grade, monthly income/allowance, household educational level, smoking status at home and among close friends), access to free cigarettes, as well as exposure to cigarette advertisements and anti-tobacco courses. Logistic regression was used to identify tobacco usage patterns correlated with IQOS use. In 2018, 2.33% of Taiwan's adolescents were currently using IQOS and 4.17% had tried IQOS. The use of conventional cigarettes and e-cigarettes (individually and together) were associated with an elevated risk of the ever use and current use of IQOS. Despite the fact that HTP products are not sold legally in Taiwan, the use of IQOS products by young people is far from negligible. We recommend amending the "Tobacco Hazards Prevention Act" to include regulations pertaining to the sale and marketing of HTPs.

Verrucous leukoplakia of the red border caused by the use of IQOS heated tobacco product (a case report)

The aim. To analyze possibility of development and describe the clinical case of the red border verrucous leukoplakia caused by the use of IQOS heated tobacco product and HEETS sticks and propose personalized clinical, diagnostic and therapeutic algorithm of a patient management. Materials and methods. Based on own observation, this article describes a clinical case of verrucous leukoplakia of the red border arising in a patient who used IQOS heated tobacco product and HEETS sticks. Clinical, laboratory, instrumental examination and treatment were performed on the basis of the Department of Dermatovenereology and Cosmetology with the course of Dermatovenereology and Aesthetic Medicine of the Postgraduate Education Faculty of Zaporizhzhia State Medical University. Results . The plaque-type verrucous leukoplakia of the red border was diagnosed based on clinical examination of the patient and diagnosis verification by means of laboratory examination and dermatoscopy. Considering the possible traumatic lesion, a high probability of the disease recurrence, patient’s refusal of surgical treatment methods, the topical therapy for affected area with the use of combined drug containing glucocorticosteroid, antibacterial and antimycotic components was prescribed for 1 month followed by long-term therapy using 1 % pimecrolimus cream. Conclusions. Based on the literature analysis, it was found out that IQOS heated tobacco product and HEETS sticks can promote the development of such manifestations of oxidative stress and endothelial dysfunction as inflammation, infection, fibrosis, oncologic pathology and become one of initiating agents for the occurrence of red border verrucous leukoplakia. The use of topical glucocorticosteroids combined with topical inhibitors of calcineurin can be proposed as an alternative to surgical methods of treatment for leukoplakia and it requires more detailed study.