Heated Tobacco Products Have Reached Younger or More Affluent People in Japan

Abstract

word count: 248 Number of figures: 1 Number of tables: 3 Number of supplementary files: 3 A c c e p t e d V e r s i o n AbstractBackground: The trend of the diffusion of heated tobacco products (HTPs) is a great concern because HTPs have become available worldwide. This study examined the sociodemographic characteristics of HTPs users in Japan, which were first launched.Methods: This cross-sectional study used data from an online survey conducted in 2017. A total of 4,926 participants, aged 20-69 years, were included. The dependent variable was the type of tobacco products used. The independent variables were age and equivalent income. Two analyses estimated the odds ratios (ORs) for 1) being smokers compared to "non-smokers", and 2) being "HTP smokers" compared to "only combustible cigarette smokers." Analyses were stratified by sex. Educational attainment and occupation were also used in the sensitivity analyses.Results: The percentages of "non-smokers," "only combustible cigarette smokers," and "HTP smokers" were 82.8%, 14.2%, and 3.0%, respectively. When compared to the oldest participants (aged 60-69), the youngest participants (aged 20-29) tended to be "HTP smokers" (OR=7.90 (95% CI=3. 09-20.22) for men and 9.28 (2.14-40.28) for women). Compared to participants with the lowest incomes (<2 million), those with the highest incomes (≥4 million) tended to use HTPs (OR=2.93 (95% CI=1.56-5.49) in men and 1.82 (0.73-4.54) in women). These trends were consistent when analyses included only smokers. There were consistent results in other SES measurements; educational attainment and occupation.Conclusions: Younger or more affluent people tended to use HTPs, although smoking rates among A c c e p t e d V e r s i o n these populations were generally lower. New tobacco control efforts are required.

Occupational difference in use of heated tobacco products: a cross-sectional analysis of retail workers in Japan

“…However, reverse causality appears to be unlikely because occupational classes are a fundamental SES indicator, and studies suggest a potential SES gap in smoking HTPs. 11 Second, although our data were extracted from a sizeable working population in the retail sector, the numbers of male and female workers were not balanced. In addition, the study participants only included workers in department stores, thereby limiting the generalisability of our findings.…”

“… 4 11 13 14 A recent online cross-sectional survey suggested a potential ‘positive’ socioeconomic difference in HTP usage. 11 In that study, individuals with higher socioeconomic status (SES), in terms of educational attainment and household income, were more likely to smoke HTPs compared with their lower SES counterparts. However, the occupational difference, one of three fundamental SES indicators (education, income, and occupation), remains unclear in relation to the use of HTPs.…”

“…According to the Erikson–Goldthorpe–Portocarero scheme, an internationally valid occupational class measurement for SES 15 and previous studies that adapted the Erikson–Goldthorpe–Portocarero scheme for Japanese occupational classes, 11 16 17 we defined two groups of occupational classes: office workers (managerial and professional workers, 5.2% (n=399) and clerical workers, 9.4% (n=723)) and other workers (service workers, 78.4% (n=6047) and manual workers, 7.1% (n=545)). In the Erikson–Goldthorpe–Portocarero scheme, clerical workers (classified as lower non-manual workers) are considered as a lower job class group compared with managerial and professional workers (classified as upper non-manual workers).…”

“…In our analytical model for explaining the association between occupational class and smoking HTPs, potential confounding variables included basic demographics (age and sex) and employment type (full-time or part-time workers). 11 As a potential mediating variable that could explain the association (but not be a confounding factor), we included the total sum score of smoking-related health knowledge as an explanatory variable in our regression model. Although HTP-related risks for common chronic diseases have not been established and health-related knowledge regarding cigarette smoking might not provide a complete substitute for the potential motivations for smoking HTPs, we empirically employed this indicator as a potential behavioural mediator.…”

“…To examine the association for each smoking status against occupational classes, we estimated multinomial ORs using multinomial logistic regression. 11 Again, we adjusted for age, sex and employment type in model 1 and additionally adjusted for smoking-related health knowledge in model 2. Analyses were also stratified by sex.…”