Heat-not-burn tobacco product use in Japan: its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-burn tobacco aerosol

Abstract

ObjectivesA heat-not-burn (HNB) tobacco product, IQOS, was first launched in Japan and Italy as test markets and is currently in commerce in 30 countries. Using two data sources, we examined interest in HNB tobacco (IQOS, Ploom and glo), its prevalence, predictors of its use and symptoms from exposure to secondhand HNB tobacco aerosol in Japan, where HNB tobacco has been sold since 2014.MethodsPopulation interest in HNB tobacco was explored using Google search query data. Prevalence of HNB tobacco current use (ie, use in the previous 30 days) was calculated using a longitudinal internet survey of 8240 individuals (15–69 years old in 2015) followed up to 2017. Rates of perceived symptoms from exposure to exhaled aerosol of others’ HNB tobacco were also calculated.ResultsThe largest internet search volume for IQOS occurred in April 2016 in the week after a popular national entertainment TV show introduced IQOS. For Ploom and glo, search volumes have remained limited since their launch. Prevalence of IQOS users increased from 0.3% in January–February 2015 to 0.6% in January–February 2016 and up to 3.6% in January–February 2017, while estimated rates of use of other HNB tobacco products remained low in 2017. Respondents who had seen the TV programme in 2016 were more likely to have used IQOS than those who had not seen it (10.3% vs 2.7%). Among never-smokers who had been exposed to secondhand HNB tobacco aerosol, nearly half reported at least one acute symptom, although these symptoms were not serious.ConclusionsA popular TV programme triggered IQOS diffusion in Japan. Extrapolating from survey results to the general population, around 3.1 million people currently use IQOS in Japan. Tobacco control organisations and governments should closely monitor HNB tobacco and consider how to regulate it.

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

“…After the sale of HTPs in Japan, they have been rapidly diffusing. 8 Currently, three types of HTPs-IQOS, Ploom Tech, and glo-are sold, and the prevalence of use of these tobacco has increased from A c c e p t e d V e r s i o n 1.4% in 2015 to 4.7% in 2017. 8 The spread of HTPs and the characteristics of their users must be studied to monitor tobacco control efforts.…”

“…8 Currently, three types of HTPs-IQOS, Ploom Tech, and glo-are sold, and the prevalence of use of these tobacco has increased from A c c e p t e d V e r s i o n 1.4% in 2015 to 4.7% in 2017. 8 The spread of HTPs and the characteristics of their users must be studied to monitor tobacco control efforts. 10 Despite the lack of epidemiological evidence for the reduction of the harmful effects of HTPs, they have been sold at relatively higher prices with smoke-free and low-risk images.…”

Heated tobacco products: another tobacco industry global strategy to slow progress in tobacco control

“…In 2016 in Japan, the appearance of IQOS in a popular television programme was followed by a rapid increase in IQOS use, highlighting the need to regulate HTP marketing and use 28 . The agency that represented the TV celebrities that included IQOS on their television show stated that ‘they received absolutely no payment from Philip Morris or affiliated companies’ to discuss IQOS on their show’ 29 .…”

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.…”