A Study on the Current Status of Heated Tobacco and Electronic Cigarette Smoking and Changes in Smoking Status

The number of users of heat-not-burn tobacco (HnB) products and electronic cigarettes (E-cig) is increasing, but few surveys have been conducted on smoking status of HnB and E-cig. We conducted a web-based survey on smoking status in 2018. But the smoking status may be changing due to the increasing the number of type of HnB and E-cig and the amended Health Promotion Law. Therefore, we conducted another web-based survey on smoking of HnB and E-cig in 2021. The respondents of this survey is 1500 smokers and 500 nonsmokers, aged 20-69. Among smokers, 47.2% smoked HnB and 16.5% smoked E-cig, respectively, which increased compared to the 2018 survey results of 39.4% and 15.4%. In the 2018 survey, 30.7% of current smokers used two or more types of cigarettes, and in this study, that percentage was 32.8%. The most smoked HnB brand was IQOS (50.9%), consistent with the 2018 survey results (IQOS, 59.4%), and product was IQOS 3 DUO (35.8%). The average number of cigarettes smoked per week was 73.3 for combustion cigarettes, 50.8 for HnB, and 23.8 for E-cig. Based on the information on smoking status obtained from this study, it is necessary to further conduct research on the measurement of harmful substances in mainstream smoke for each specific product of heated tobacco and electronic cigarettes, as well as conducting health risk assessments that take into account the number of cigarettes smoked for each tobacco type.