Prevalence and predictors of heated tobacco product use and its relationship with attempts to quit cigarette smoking among Korean adolescents

Kang, Seo Young; Lee, Sungkyu; Cho, Hong‐Jun

doi:10.1136/tobaccocontrol-2019-055114

Cited by 40 publications

(48 citation statements)

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“…The odds of HTP use were much greater in EC users than in CC users, as with prior studies 7,9,12 . Among CC-only users, moderate smokers were more likely to use HTPs as in a previous study 9 .…”

Section: Discussionsupporting

confidence: 78%

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Prevalence and correlates of current use of heated tobacco products among a nationally representative sample of Korean adults: Results from a cross-sectional study

Kim¹,

Cho²

2020

Tob. Induc. Dis.

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Heated tobacco products (HTPs) release aerosols containing nicotine and toxic chemicals upon heating of the tobacco without combustion 1. IQOS was introduced in 2014 and is now available in 51 countries 2. HTPs were introduced in Korea in June 2017 and their market share increased rapidly; in 2019, they accounted for 10.5% of the total tobacco in the country 3. The rate of current HTP use was 5.0% among Japanese adults in 2018 4. In 2017, 1.4% of Italian adults were ever users of HTPs 5. However, in countries where their sale started later, the proportion of adult users was lower. As of 2017, there were 0.8% current users in Great Britain 6 and 1.1% in the United States 7 , where IQOS had been available since 2016 and 2019, respectively. In Korea, the prevalence of HTP use was 3.5% in 2017 8 , and 2.13% in 2018 9. Philip Morris International claimed that switching completely from combustible cigarettes (CCs) to IQOS would reduce health risk 10. However, most HTP users used CCs or/and electronic cigarettes (ECs) rather than switching to HTPs completely 6-9. According to independent studies, the levels of some harmful and potentially harmful constituents of HTPs were lower than those of CCs 10,11. Nevertheless, the longterm effects of HTPs on individual-or populationlevel health are yet to be determined. According to a recent study, CC users who had used HTPs were ABSTRACT INTRODUCTION Heated tobacco product (HTP) use has increased rapidly in Korea since its introduction in 2017. We investigated the prevalence and correlates of the current use of HTPs among a nationally representative sample of Korean adults. METHODS A total of 6182 participants aged ≥19 years took part in the 2018 Korea National Health and Nutrition Examination Survey conducted one year after the introduction of HTPs in Korea. Descriptive statistics, bivariate analysis and multivariable logistic regressions were used. RESULTS The prevalence of current HTP use (defined as past 30-day use) among Korean adults was 4.4% (7.8% for males and 0.9% for females) in 2018. Among current HTP users, approximately 90% were dual users with combustible cigarettes (CCs) or electronic cigarettes (ECs), or triple users with CCs and ECs. In multivariable logistic regression analysis, males, younger participants, and current CC and/or EC users showed greater odds of being current users of HTPs compared with females, older participants, and non-users of CCs and ECs. Moreover, current EC-only users were more likely to use HTPs than current CC-only users. Compared with current CC-only use, using HTPs with CCs concurrently was not associated with attempts to quit smoking during the past year or with intentions to quit CC smoking. CONCLUSIONS The popularity of HTP use and the pattern of its poly use with CCs and ECs is a new challenge for Korean tobacco control policy.

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Section: Discussionsupporting

confidence: 78%

“…significantly less likely to be former CC users despite having made more attempts at smoking cessation 12 .…”

mentioning

confidence: 98%

Prevalence and correlates of current use of heated tobacco products among a nationally representative sample of Korean adults: Results from a cross-sectional study

Kim¹,

Cho²

2020

Tob. Induc. Dis.

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“…According to another Korean study using KYRBS 2019 data, ever HTP use among adolescents was greater among men, higher-grade students, current cigarette smokers and/or e-cigarette users, and risky alcohol drinkers. 39) In one Japanese study, the prevalence of HTP use among adult men was highest among the following groups: individuals aged 20-49 years old, with 10 or more years of education, who were not bereaved or divorced, with high household income, who were current internet users, and with risky behaviors related to alcohol. Among adult women, those who were 20-39 years old, with 15 or fewer years of education, with a household size of three or more people, employed or self-employed, current internet users, and with risky behaviors related to alcohol were more likely to use HTPs.…”

Section: Characteristics Of Heated Tobacco Product Usersmentioning

confidence: 99%

The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea

Lee

2020

Korean J Fam Med

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Heated tobacco products (HTPs), a hybrid between conventional and electronic cigarettes, were first launched in South Korea in June 2017. Owing to advertisements stating that HTPs are odorless, tar-free, and less harmful to health, the sales of HTPs have grown quickly enough to account for about 10% of the total tobacco market in a year. HTP use by young, highly educated, and high-income groups had a significant impact on both the overall tobacco market over the past 3 years and the smoking and quitting behaviors of smokers. Based on national smoking rate statistics, tobacco sales trends, and the number of visitors to smoking cessation clinics, the following changes have been identified: (1) The decline in current smoking rates has slowed or rose in some groups. (2) The decline in total cigarette sales has slowed but rose again in the first quarter of 2020. (3) The number of visitors to smoking cessation clinics decreased just after the advent of HTPs. These results may be due to the insufficient support of tobacco regulation policies but also coincide chronologically with the appearance of HTPs in South Korea. It is necessary to investigate the usage rate of various tobacco products, including HTPs and e-cigarettes, to examine the health risks of novel tobacco products and provide accurate information to users and policymakers. Finally, tobacco companies are continuously developing new product concepts to escape the regulation of existing cigarettes; thus, comprehensive management measures for all nicotine-containing products are needed.

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“…First, the prevalence of ever (former or current) and current HTP users among Korean adolescents was 4.9% and 2.6%, respectively, within two years of the launch of HTPs. Compared to the previous year (2.9%) [ 13 ], the prevalence of ever HTP users increased by approximately 1.8 times (2.0% p). Moreover, the 2019 prevalence of current HTP use among adolescents was slightly higher than among adults (2.1%) in 2018 from a study on Korean adults [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…A study conducted in Korea revealed that 2.9% of Korean adolescents (men: 4.4%, women: 1.2%) were HTP ever users, most of whom were dual users of HTP and CC or triple users of HTP, CC, and electronic cigarettes (EC). However, due to the unavailability of data, it was not possible to assess current or former HTP use status and related factors in the aforementioned study [ 13 ]. Dual or poly-tobacco use among adolescents is a public health problem [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Cigarette or E-Cigarette Use as Strong Risk Factors for Heated Tobacco Product Use among Korean Adolescents

Hwang

Ryu

Park

2020

IJERPH

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Heated tobacco products (HTPs) were first introduced in Korea in June 2017. This study examined the prevalence of current HTP use among Korean adolescents and its association with conventional cigarette (CC) or electronic cigarette (EC) use. The study analyzed nationally representative data (the 2019 Korea Youth Risk Behavior Web-based Survey) from a sample of 57,303 Korean students from grades 7–12. Multinomial logistic regression models were designed to evaluate the association between EC or CC use and HTP use. A total of 2.6% of respondents were current HTP users and 95.9% of them were dual or triple users of CC or EC. The likelihood of HTP use was higher among current CC or EC users and highest among dual users. When the association between each tobacco product and current HTP use was analyzed, the dual use tendency of HTPs and other products steadily increased with the increase of CC or EC smoking frequency. Adolescents who use ECs and/or CCs are likely to use HTPs. Thus, HTPs could be a new public health concern for adolescents in terms of dual or triple use patterns of CC or EC.

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Prevalence and predictors of heated tobacco product use and its relationship with attempts to quit cigarette smoking among Korean adolescents

Cited by 40 publications

References 23 publications

Prevalence and correlates of current use of heated tobacco products among a nationally representative sample of Korean adults: Results from a cross-sectional study

Prevalence and correlates of current use of heated tobacco products among a nationally representative sample of Korean adults: Results from a cross-sectional study

The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea

Cigarette or E-Cigarette Use as Strong Risk Factors for Heated Tobacco Product Use among Korean Adolescents

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