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Perception of heated tobacco products and support for regulations: a cross-sectional study in Hong Kong
  1. Yongda Socrates Wu1,
  2. Yee Tak Derek Cheung1,
  3. Sai Yin Ho2,
  4. Henry Sau Chai Tong3,
  5. Vienna Wai Yin Lai3,
  6. Tai Hing Lam2,
  7. Man Ping Wang1
  1. 1 School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
  2. 2 School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
  3. 3 Hong Kong Council on Smoking and Health, Hong Kong, Hong Kong
  1. Correspondence to Dr Man Ping Wang, School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong; mpwang{at}


Background Hong Kong has proposed banning the sale of heated tobacco products (HTPs). Perceptions of reduced harms and effectiveness for quitting combustible cigarettes (CCs) of HTPs due to their promotions may erode public support for regulations. We assessed the associations between perceptions of HTPs and support for regulations in Hong Kong.

Methods In two population-based landline surveys conducted in 2018–2019, 1985 respondents (51.4% male; 22.7% aged 60+ years) reported perceived relative harm of HTPs to CCs and effectiveness for quitting CCs, and support for five HTP regulations (ban on promotion and advertisements, use in smoke-free areas, sales to minors, registration before sale, sale licence) and a total ban on sale. Current and former smokers were oversampled due to low prevalence. Descriptive statistics were weighted to the general population. Associations were analysed, adjusting for sociodemographic characteristics, smoking status and ever HTP use.

Results 27.4% (N=515) of respondents perceived HTPs as less harmful, and 18.8% (N=1299) perceived them as effective for quitting CCs. Support was generally high (at least one regulation, 99.1%, N=1959; all five regulations, 66.8%, N=1114; total ban, 63.5%, N=946). Perceptions of reduced harm were associated with lower support for all five regulations (adjusted risk ratio 0.85, 0.75 to 0.96) and a total ban on sale (0.58, 0.51 to 0.66). Results were similar for perceptions of effectiveness for quitting.

Conclusions Lower support for HTP regulations and a total ban on sale were associated with perceptions of reduced harm and effectiveness for quitting CCs of HTPs in Hong Kong.

  • Non-cigarette tobacco products
  • Public opinion
  • Public policy

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  • Contributors MPW, THL, YTDC and SYH conceptualised the survey and obtained funding. Felix Lee coordinated the survey under the supervision of YTDC. YSW and MPW conceptualised the study. YSW analysed the data. This manuscript was written by YSW and MPW with input from all coauthors. All authors read and approved the final version of the manuscript.

  • Funding The surveys were funded by Hong Kong Council on Smoking and Health.

  • Disclaimer The funder had no role in the design, analyses, interpretation of the data or decision to submit results.

  • 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.