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 people aged 16–19 years from Canada, England and the USA. 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 analysed 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 USA=9.1%) and 38.6% expressed interest in trying the product (England=41.8%, Canada=33.0% and USA=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 HTPs, such as IQOS, is emerging among youth in Canada, England and the USA. Interest in trying these products is very high among smokers, but also present among non-smokers.
- electronic nicotine delivery devices
- public policy
- surveillance and monitoring
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Contributors CDC led analysis and interpretation of data, drafted the initial manuscript, and reviewed and revised the manuscript. CMW coordinated data acquisition and reviewed and revised the manuscript. JLR coordinated data acquisition, assisted with data analysis, contributed to the interpretation of data, and reviewed and revised the manuscript. RJO contributed to the interpretation of data, and reviewed and revised the manuscript. DH conceptualised 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.
Funding This project has been made possible through a P01 grant (1P01CA200512-01) from the US National Institutes of Health. Additional support was provided by a Canadian Institutes of Health Research (CIHR)-Public Health Agency of Canada (PHAC) Applied Public Health Research Chair (DH), as well as a CIHR-Heart and Stroke Foundation Health System Impact Fellowship (CDC).
Competing interests RJO is a member of the FDA’s Tobacco Products Scientific Advisory Committee which reviewed the IQOS MRTP application. Views expressed herein do not necessarily reflect those of the Committee or of the FDA. DH has provided paid testimony in tobacco litigation on behalf of governments and class-action plaintiffs on issues related to tobacco product science and regulation. The other authors have no competing interest relevant to this article to disclose.
Ethics approval The study was reviewed by and received ethics clearance through a University of Waterloo Research Ethics Committee (ORE#21847) and the King’s College London Psychiatry, Nursing & Midwifery Research Ethics Subcommittee.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Not required.
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