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Heated tobacco products use in Chinese adults in Hong Kong: a population-based cross-sectional study
  1. Yongda Socrates Wu1,
  2. Man Ping Wang1,
  3. Sai Yin Ho2,
  4. Ho Cheung William LI1,
  5. Yee Tak Derek Cheung1,
  6. Takahiro Tabuchi3,
  7. Antonio CS Kwong4,
  8. Vienna Lai4,
  9. Tai Hing Lam2
  1. 1 School of Nursing, The University of Hong Kong, Hong Kong, China
  2. 2 School of Public Health, The University of Hong Kong, Hong Kong, China
  3. 3 Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  4. 4 Hong Kong Council on Smoking and Health, Hong Kong, China
  1. Correspondence to Dr Man Ping Wang, School of Nursing, The University of Hong Kong, Hong Kong 852, China; mpwang{at}


Introduction We investigated heated tobacco products (HTPs) use and associated factors in Chinese adults in Hong Kong where HTPs are not formally marketed yet, and cigarette smoking prevalence was the lowest in the developed world.

Methods A population-based landline telephone survey in 2017 interviewed 5131 (45.2% male; 26.7% aged ≥60) adults to collect information on awareness, intention to use, ever use of HTPs, cigarette smoking status and sociodemographic characteristics. Descriptive statistics were weighted by the age, sex and smoking status of the Hong Kong adult population. Sociodemographics were mutually adjusted in logistic regression to yield adjusted ORs (AORs) for awareness of HTPs, controlling for smoking status.

Results Overall, 11.3% (95% CI 10.0% to 12.7%) were aware of HTPs and 1.0 % (0.8%–1.2%) had ever used it. Awareness was associated with aged 40–49 years (AOR 1.37, 95% CI 1.01 to 1.87) or 30–39 years (2.03, 1.41–2.91) (vs ≥60 years), born in Hong Kong (1.37, 1.11–1.68) and higher monthly household income (p for trend 0.001). Ever HTP users had higher educational attainment and monthly household income, and more were aged 30–39 and economically active (all p<0.003). In never HTP users, intention to use HTPs (7.3%, 4.9%–10.8%) were more prevalent in respondents with similar characteristics (all p<0.008). More current (vs never) smokers were aware of HTPs, intent to use HTPs and had ever used HTPs (all p<0.001).

Conclusion Higher socioeconomic status was associated with HTP use and intention to use. Public health education on HTPs is needed especially for this high-risk group.

  • heated tobacco products
  • prevalence
  • socioeconomic status
  • electronic cigarettes

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  • Contributors MPW had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: MPW, SYH, HCWL, YTDC, TT, ACSK, VL and THL. Obtained funding: MPW, SYH, YTDC, and THL. Survey administration: MPW, HCWL, and YTDC. Statistical analysis: YSW and MPW. Drafting of the manuscript: YSW and MPW. Critical revision of the manuscript for important intellectual content: MPW, SYH, HCWL, YTDC, TT, ACSK, VL and THL.

  • Funding The Tobacco Control Policy-related Survey 2017 was funded by the Hong Kong Council on Smoking and Health. This work received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was granted by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (Ref: UW15-108).

  • Provenance and peer review Not commissioned; externally peer reviewed.