Assessing use of inhalable nicotine products within complex markets: the dilemma of heated tobacco products

Abstract

The introduction of electronic inhalable products, such as nicotine vaping products (NVPs) and heated tobacco products (HTPs), has further diversified the nicotine market landscape. This poses unique challenges in measuring self-reported nicotine use behaviours, which have been the hallmark of tobacco surveillance systems. This paper raises concerns of potential measurement error for electronic inhalable product use in surveys due to similarities in product design between NVPs and HTPs, as well as changing trends in cannabis administration. We identify several strategies for addressing this issue (eg, including descriptive preambles in surveys that differentiate product classes from one another; incorporating survey questions that probe beyond an initial question regarding product use). In the absence of comprehensive validation studies, caution is warranted when interpreting survey results that rely on self-reported HTP use.

Global prevalence of heated tobacco product use, 2015–22: A systematic review and meta‐analysis

“…In Canada and the United States (US), similar trends of substantial growth in HTP use are seen for other manufacturers, such as BAT and their HTP brand glo , which launched in Romania of 2015 [12]. There are also ‘hybrid’ HTPs, most notably Ploom TECH , glo Sens and lil Hybrid , which are commonly regulated as HTPs but contain a nicotine liquid‐containing pod in addition to a tobacco stick/capsule [13].…”

‘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

“…Precise and consistent nomenclature is lacking for HTPs [2,5]. Many HTPs, including IQOS, use tobacco sticks that resemble combustible cigarettes in shape and branding [2]. Conversely, the electronic nature of HTP devices resemble e-cigarettes [2].…”

“…Many HTPs, including IQOS, use tobacco sticks that resemble combustible cigarettes in shape and branding [2]. Conversely, the electronic nature of HTP devices resemble e-cigarettes [2]. Tobacco companies have marketed HTPs as 'heat-not-burn' products, 'tobacco vapour products', 'heated tobacco systems' and 'tobacco heating products' [2,5].…”

“…The tobacco and nicotine marketplace has experienced unprecedented diversification over the past decade [1], including the introduction of heated tobacco products (HTPs) such as glo, Ploom and IQOS [2]. HTPs are electronic devices manufactured by tobacco companies, such as Philip Morris International.…”

“…Conversely, the electronic nature of HTP devices resemble e-cigarettes [2]. Tobacco companies have marketed HTPs as 'heat-not-burn' products, 'tobacco vapour products', 'heated tobacco systems' and 'tobacco heating products' [2,5]. Language can construct identity, which in turn can shape behaviour [6,7].…”