Heated tobacco products: Cigarette complements, not substitutes

Background: In Korea, the sale of the first heated tobacco product (HTP), IQOS (R), commenced in June 2017. This study evaluates the rates of HTP use and examines HTP users' smoking patterns of various tobacco products. Methods: The study analyzed the 2018 Korea Community Health Survey data of a Korean provincial division, which includes 11 cities and 14 counties. Of 21,100 participants, the proportion of current HTP users was calculated and their smoking patterns, in regard to cigarette use, were examined. A multinomial logistic regression model was used to evaluate the related factors of HTP use. Results: The proportion of current HTP users (HTP use within the past 30 days) was 2.13% of the study population. Of these current HTP users, 96.25% were dual users of cigarettes. The adjusted odds ratio (AOR) for current HTP use increased proportionately with frequency and amount of cigarette consumption with statistical significance. The AOR values showed a quadratic curve, descending after the peak value for moderate daily smokers (10-19 cigarettes/day) (P-trend < 0.001, P-quadratic < 0.001). Current cigarette smokers who also used HTPs were not associated with an intention to quit cigarette smoking within a month. Conclusions: Given the smoking pattern of HTP users in terms of mutual use with cigarettes, HTPs might not be an alternative to cigarettes as tobacco companies claim.