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      Awareness and interest in IQOS heated tobacco products among youth in Canada, England & the United States.

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      , PhD 1 , 2 , , MSc 3 , , MSc 3 , , PhD 4 , , PhD 3
      Tobacco control

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          Abstract

          Introduction

          Heated tobacco products (HTPs), such as IQOS, have been introduced in a growing number of international markets. However, little is known about perceptions of HTP products among youth.

          Methods

          Data are from Wave 1 of the International Tobacco Control Youth Tobacco and E-cigarette Survey (2017), a web-based cohort survey of 16- to 19-year-olds from Canada, England, and the United States (US). Respondents (n=12,064) were shown an image of IQOS and asked about their awareness, interest in trying, and susceptibility to trying the product. Youth awareness, interest in trying, and susceptibility to trying IQOS were analyzed using descriptive statistics, and logistic regression models were used to examine correlates of these outcomes.

          Results

          Overall, 7.0% of youth reported awareness of IQOS (England=5.6%, Canada=6.4%, and US=9.1%) and 38.6% expressed interest in trying the product (England=41.8%, Canada=33.0%, and US=40.9%). Within each country, all key outcomes varied by smoking status: greater proportions of youth who were currently smoking or had a history of smoking reported being aware of, interested in trying, and susceptible to trying IQOS. Interest and susceptibility to trying IQOS were associated with male sex, current tobacco use, and current e-cigarette use. Across all countries, susceptibility to trying IQOS (25.1%) was higher than for tobacco cigarettes (19.3%), but lower than for e-cigarettes (29.1%).

          Conclusions

          Awareness of heated tobacco products, such as IQOS, is emerging among youth in Canada, England, and the US. Interest in trying these products is very high among smokers, but also present among non-smokers.

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          Most cited references27

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          Heat-Not-Burn Tobacco Cigarettes

          This study analyzed the content of smoke from heat-not-burn tobacco cigarettes compared with that of conventional cigarettes to determine whether similar toxic compounds are released in heat-not-burn cigarette smoke.
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            Heat-not-burn tobacco product use in Japan: its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-burn tobacco aerosol

            Objectives A 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. Methods Population 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. Results The 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. Conclusions A 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.
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              Comparison of Chemicals in Mainstream Smoke in Heat-not-burn Tobacco and Combustion Cigarettes

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                Author and article information

                Journal
                9209612
                20367
                Tob Control
                Tob Control
                Tobacco control
                0964-4563
                1468-3318
                20 February 2021
                29 January 2019
                January 2020
                15 March 2021
                : 29
                : 1
                : 89-95
                Affiliations
                [1 ]School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
                [2 ]Heart and Stroke Foundation of Canada, Ottawa, Canada
                [3 ]School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
                [4 ]Department of Health Behavior, Roswell Park Comprehensive Cancer Centre, Buffalo, USA
                Author notes

                submitting author: Christine D. Czoli, School of Epidemiology and Public Health, University of Ottawa

                Contributorship statement

                Dr. Czoli led analysis and interpretation of data, drafted the initial manuscript, and reviewed and revised the manuscript. Ms. White coordinated data acquisition and reviewed and revised the manuscript. Ms. Reid coordinated data acquisition, assisted with data analysis, contributed to the interpretation of data, and reviewed and revised the manuscript. Dr. O’Connor contributed to the interpretation of data, and reviewed and revised the manuscript. Dr. Hammond conceptualized and designed the study, led data collection, contributed to the interpretation of data, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

                corresponding author: David Hammond, PhD, School of Public Health & Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1 Canada, Phone: 519-888-4567, x36462, Fax: 519-886-6424, dhammond@ 123456uwaterloo.ca
                Article
                NIHMS1674357
                10.1136/tobaccocontrol-2018-054654
                7958490
                30696783
                d4a9ff1b-c35c-4718-9ba6-cb13b7f16d2f

                Exclusive license

                The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non-exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd and its Licensees to permit this article (if accepted) to be published in Tobacco Control and any other BMJPGL products to exploit all subsidiary rights, as set out in our licence http://journals.bmj.com/site/authors/editorial-policies.xhtml#copyright and the Corresponding Author accepts and understands that any supply made under these terms is made by BMJPGL to the Corresponding Author. Where the Corresponding Author wishes to make the article available on an open access basis (and intends to pay the relevant open access fee), the terms of such open access shall be governed by a Creative Commons licence – details of these licences and which Creative Commons licence will apply to this article are set out in our licence referred to above.

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