Awareness, Attitudes, and Concerns Regarding Heated Tobacco Products Among Physicians in Japan

Abstract

Background: New tobacco products, particularly heated tobacco products (HTPs), have been introduced across several international markets as alternatives to combustible products, such as cigarettes. However, there are limited studies on physicians' perceptions of HTPs. This study analyzes the awareness of HTPs among physicians and assesses their concerns and attitudes toward patients using HTPs. Methods: A self-administered questionnaire was sent to a sample of 7,500 member physicians (6,000 male and 1,500 female) from the Japan Medical Association (JMA). The smoking status of physicians was categorized as never smokers, ever HTP smokers, current HTP smokers, and ever and current smokers of other products. Physicians' awareness and attitudes toward patients using HTPs were analyzed using descriptive statistics. The correlation between the outcomes was examined using logistic regression models, whereas physicians' concerns about HTPs were analyzed using descriptive statistics. Results: Data were obtained from 5,492 physicians (21.9% women; aged 60.4; standard deviation, 12.1 years) with a response rate of 74.6%. Overall, 76.7% of the physicians had awareness of HTP, and about half of whom asked patients about using HTPs. Physicians who took longer to discuss cessation were more likely to discourage patient use. Smoking status was associated with discouraging HTP use in patients. Physicians who had experience with HTP use were primarily concerned about the products' long-term safety and less about product regulation. Conclusion: Japanese physicians do not have sufficient information and knowledge about HTPs. Therefore, evidence-based guidelines are required to support physicians in advising patients against HTP use.

Why Do Physicians in Japan Use e-Cigarettes and/or Heated Tobacco Products? A Cross-Sectional Survey

“…Physicians often serve as role models for health-related behaviors and significantly contribute to smoking cessation initiatives [32]. Notably, the smoking status of physicians was linked to discouraging HTP use among patients [35]. Even a small number of physicians who use e-cigarettes and/or HTPs can influence their patients' smoking behavior.…”

“…Within this group of survey participants, we focused exclusively on current smokers (N = 346, 6.3%, comprising 323 men and 23 women) in alignment with the study's objectives (refer to Figure 1 for a graphical representation). Further elaboration on the survey's design and content can be referenced elsewhere [35].…”

“…Although the smoking prevalence among Japanese physicians is declining [34], a small percentage of physicians are still smokers. The prevalence of smoking among Japanese physicians was recently estimated to be 6.1%, of which 2.6% used HTPs [35]. Regarding the rationale for e-cigarette use, a cross-sectional analysis of Turkish physicians revealed that over 50% of physicians viewed e-cigarettes as part of a "harm reduction strategy" [36].…”

“…However, little is known about physicians' smoking behaviors and e-cigarette and/or HTP use. Examining the smoking behavior of physicians who understand the harmful effects of smoking better than the general population may provide useful insights for future approaches to facilitate smoking cessation and harm reduction [35]. Thus, this study has the following two objectives: (a) to determine the reasons why physicians in Japan use e-cigarettes and/or HTP products and (b) to identify the association between physicians who use e-cigarettes and/or HTPs and their demographics, lifestyle, and smoking preferences.…”

Smoking Status and Risk Awareness of Heated Tobacco Product Use among General Dental Practitioners Belonging to the Aichi Dental Association, Japan

“…This study is among the few that have investigated the use of HTP among dentists. The present study researched the reality of complex forms of smoking, including HTP, in Japan, where awareness of HTPs has generally increased in recent years [ 24 , 25 ]. The rate of current HTP use among dentists was 8.5%, with the highest HTP use among men aged 50−59 years, consistent with conventional cigarettes and the distribution of HTP users.…”