Awareness, experience and prevalence of heated tobacco product, IQOS, among young Korean adults

Abstract

IntroductionPhilip Morris International introduced ‘IQOS’ to the Korean market in June 2017. To monitor the use of IQOS among young Korean adults, we identified their awareness, experience and current use of IQOS.MethodsThree months after the introduction of IQOS in Korea, we conducted an online survey with 228 general young adults, aged 19–24 years.Results87 participants (38.1%) were aware of IQOS, 13 (5.7%) were IQOS ever users and 8 (3.5%) were current IQOS users. All the current IQOS users were triple users of conventional cigarettes and electronic cigarettes (e-cigarettes). There were no IQOS-only users and one IQOS ever user was a non-cigarette smoker. Among the eight current IQOS users who smoked 9.1 conventional cigarettes a day on average, four smoked 10–20 HEETS sticks a day. The current IQOS users decided to use IQOS because they believed it was less harmful or to stop smoking. The current conventional cigarette smokers were much more likely to be aware of IQOS (OR 4.496; 95% CI 2.185 to 9.250) and to be IQOS ever users (OR 11.649; 95% CI 1.024 to 132.564).ConclusionAwareness, experience and use of IQOS among young Korean adults were relatively higher than among their Japanese counterparts. Current IQOS users were more likely to smoke conventional cigarettes and/or e-cigarettes, which contradicts the tobacco industry’s claims that conventional cigarette smokers will switch to heated tobacco products. Until obtaining robust evidence concerning heated tobacco products, the government should regulate the tobacco industry’s marketing tactics and health claims.

New ideas, old problems? Heated tobacco products – a systematic review

“…Furthermore, the analysis of the same PMI MTRP application by Glantz [84] suggested that, in human testing, IQOS did not reveal detectably better measures of the biomarkers of potential Gale HTPs 180 Japanese adult smokers (aged 33± 9.0 years; 50% male); THP1.0 (glo), THS2.2 (IQOS), a combustible cigarette; the smokers smoked combustible cigarettes for 2 days; after this period, they were switched to the following groups: 1) continue smoking, 2) switch to the mentholated or non-mentholated variant of glo, 3) switch to non-mentholated IQOS, or 4) quit nicotine and tobacco product use; each group used their dedicated products for 5 days; the baseline and post-randomization 24-h urine samples were collected, carbon monoxide in exhaled breath was measured daily -glo or IQOS use for 5 days reduced the exposure to smoke toxicants in a manner comparable to quitting tobacco use on day 5 after switching, the urinary biomarkers of toxicants (except the nicotine) and exhaled CO levels were significantly reduced by medians 21-92%, compared with the baseline in all groups using glo or IQOS, or quitting tobacco use BAT -British American Tobacco; CO -carbon monoxide; ppm -parts per million; HPHCs -harmful and potentially harmful constituents; HTPs -heated tobacco products; PMI -Philip Morris International; THP1.0 -tobacco heating product (glo); THS2.1 -tobacco heating system 2.1 (the prototype of IQOS); THS2.2 -tobacco heating system 2.2 (IQOS); 3R4F -reference cigarette. IQOS users were triple users of conventional cigarettes and e-cigarettes, as well as HTPs [86]. HTPs have also gained popularity in the USA [87,88].…”

“…Ever e-cigarette users were also more likely to be aware of HTPs [85]. In Korea and the USA, the highest awareness and ever or current use of HTPs were also observed among current smokers or e-cigarette users [86,87].…”

“…Ever use of HTPs was declared by 1.7% of respondents and 0.8% were current users [85]. Kim et al reported that among 228 young Korean adults, more than one-third (38.1%) were aware of IQOS [86]. The current IQOS use was declared by 3.5% of respondents, wherein all current IJOMEH 2019;32(5) in 2017 0.8% of subjects were current glo users the willingness to use IQOS was significantly higher among current smokers with an intention to quit than among those with no intention to quit (AOR: 13.3 vs. 6.7, respectively)…”

“…In December 2016, PMI applied to the FDA (U.S. Food and Drug Administration) to consider IQOS as a modified risk tobacco product [83]. In January 2018, the FDA Tobacco Products Scientific Advisory Committee concluded that there was no conclusive scientific evidence that IQOS use was less risky than continuing tobacco smoking and PMI should not claim that IQOS use cut the risk of tobacco-related diseases [86,102]. Furthermore, the FDA experts were not convinced that…”

Commentary on Gravely et al (2019): Beginning a new era of nicotine products—beyond the four national‐level determinants of nicotine vaping products (NVPs) use

“…IQOS is currently sold in more than 40 countries or regions world‐wide, particularly in high‐income countries . After becoming popular and widely used in Japan , IQOS has also gained widespread acceptance in the Republic of Korea . Given the marketing strategies of the big tobacco companies, the world‐wide market share of nicotine‐containing products accounted for by HTPs is likely to grow, increasing the potential for public health concern.…”