Perceived harm of heated tobacco products, e-cigarettes, and nicotine replacement therapy compared with conventional cigarettes among ever and current heated tobacco users

Particle emissions from heated tobacco products

INTRODUCTION

This study determines the particle emissions from five heated tobacco products (HTPs).

METHODS

An aethalometer is used for the determination of black carbon (BC) and an aerosol monitor for total particulate matter (PM) concentration and also PM fractions (1, 2.5, 4, and 10 μm) in the mainstream emissions of 5 HTPs: IQOS, LIL, PULZE, ILUMA, and GLO. Fifteen different flavors were used, five sticks per flavor, which were smoked using a peristaltic pump under both ISO and Canadian smoking regimes. The method repeatability was determined using 15 sticks of one flavor for each brand for each smoking regime.

RESULTS

All HTPs emit particles, and more than 99.7% of the particles emitted are smaller than 1 μm. Both BC and PM emissions show quite low repeatability. Particle emissions increase in relation to the heating temperature and the intensity smoking regime, and are depending on the flavor used. BC corresponds to a small percentage of total PM.

CONCLUSIONS

Although HTPs are promoted as products of reduced risk compared to conventional cigarettes, high particle concentrations are detected in their emissions, depending on the smoking regime, the flavor used, and the operation parameters. PM emissions vary significantly between different brands under the ISO smoking regime, probably due to the heating temperature. In contrast, PM emissions under the Canadian smoking regime do not vary significantly between different brands. This could probably be attributed to the fact that increased puff frequency does not allow the device to cool down between puffs, resulting in an increase in PM emissions for all the brands, but not dependent on the maximum heating temperature of the device. BC emissions only consist of a very small fraction of PM and do not vary significantly between different brands under both smoking regimes.

Exposure to IQOS ads and reduced exposure claims, and association with perceived risk from COVID-19 on IQOS purchase and use intentions: results from a web-based survey

Introduction

IQOS was authorized to be marketed as a reduced exposure product by the Food and Drug Administration in October 2020 during the global COVID-19 pandemic. Those who smoke may be more sensitive to reduced exposure marketing claims and may have an increased inclination toward IQOS use. We evaluated the likelihood of trying and purchasing IQOS as a function of exposure to ads, product appeal, and COVID-19 risk perceptions using the original IQOS ads with reduced exposure marketing.

Method

An online cross-sectional survey recruited 604 US adults (18-45 years), both who smoke and do not smoke. Participants saw one of the six randomly assigned IQOS ads with or without reduced exposure claims, and they answered questions about product appeal and likelihood to try and purchase IQOS. Generalized linear models were used to examine associations.

Results

A per unit increase in product appeal was associated with a greater likelihood of purchasing (B = 0.17, 95% CI: 0.15-0.18) and trying IQOS (B = 0.16, 95% CI = 0.14-0.18). Current smokers and former e-cigarette users reported greater intentions to try IQOS than never-smokers and never e-cigarette users, respectively. Likelihood to purchase IQOS was associated with greater confidence in not contracting COVID-19 (B = 0.11, 95% CI: 0.01-0.21). No significant differences were observed between different ad conditions. Current (B = -0.34, 95% CI = -0.50-(-0.19)) and former (B = -0.92, 95% CI = -0.15-(-0.68)) cigarette smokers who were someday e-cigarette users reported less intentions to purchase IQOS than never e-cigarette users. However, never smokers who were someday (B = 0.58, 95% CI = 0.27-0.89; B = 0.68, 95% CI = 0.39-0.98) and former e-cigarette (B = 0.38, 95% CI = 0.15-0.61) users reported greater intentions to purchase and try IQOS, respectively.

Discussion

IQOS may have a higher product appeal, especially for those who currently smoke and those who have lower risk perceptions from COVID-19. Among never smokers, those who currently use or have used e-cigarettes in the past may be more receptive to IQOS marketing. The data are informative for potential trends in the use of IQOS in the future and may have implications for marketing regulations of heated tobacco products (HTPs).