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Heated tobacco product use and combustible cigarette smoking relapse/initiation among former/never smokers in Japan: the JASTIS 2019 study with 1-year follow-up
  1. Yusuke Matsuyama1,
  2. Takahiro Tabuchi2
  1. 1 Global Health Promotion, Tokyo Medical and Dental University, Bunkyo, Japan
  2. 2 Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
  1. Correspondence to Dr Yusuke Matsuyama, Global Health Promotion, Tokyo Medical and Dental University, Bunkyo 113-8510, Japan; matsuyama-thk{at}umin.org

Abstract

Background Use of heated tobacco products (HTPs), which were first launched in Japan, has been rapidly spreading worldwide. The present study aimed to investigate whether HTP use was associated with combustible cigarette smoking relapse/initiation among former/never combustible cigarette smokers.

Methods A prospective cohort study was conducted by analysing two waves of data from the Japan ‘Society and New Tobacco’ Internet Survey. Among the 7766 never/former combustible cigarette smokers who answered the baseline survey in 2019, 5947 (follow-up rate: 76.6%) responded to the follow-up survey in 2020 (age range 18–73 years old; 50.5% men). The association between HTP use and combustible smoking after 1 year was investigated by multivariable logistic regression analysis adjusting for potential confounders.

Results Of the respondents, 308 (5.2%) used HTPs at baseline. One year later, 97 (1.7%) non-HTP users and 39 (12.7%) HTP users were smoking combustible cigarettes. Among former smokers who had quit for 1 year or more and among never smokers, HTP use was significantly associated with combustible cigarette smoking 1 year later (OR=2.80, 95% CI 1.42 to 5.52 and OR=9.95, 95% CI 3.39 to 29.16, respectively), while the association was not significant among former smokers who recently quit.

Conclusion HTP use was associated with relapse/initiation of combustible cigarette smoking after 1 year. The risks of HTP use, including subsequent combustible smoking, should be carefully monitored.

  • non-cigarette tobacco products
  • prevention
  • cessation

Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author (YM) upon reasonable request.

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Data availability statement

Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author (YM) upon reasonable request.

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Footnotes

  • Contributors Both authors conceptualised the study. Acquisition of data: TT. Analysis and interpretation of data: both authors. Drafting of the manuscript: YM. Critical revision of the manuscript for important intellectual content: TT. Both authors gave final approval and agree to be accountable for all aspects of the work.

  • Funding The work was supported by Health Labour Sciences Research Grants (20FA1005, 19FA0501, 19FA2001 and 19FA1011) and the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant (18H03062).

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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