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Open AccessArticle

Concurrent Daily and Non-Daily Use of Heated Tobacco Products with Combustible Cigarettes: Findings from the 2018 ITC Japan Survey

1
Division of Cancer Prevention and Population Sciences, Department of Health Behaviors, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
2
Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne 3010, Australia
3
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
4
Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
5
Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
6
Division of Tobacco Policy Research, National Cancer Center Japan, Tokyo 104-0045, Japan
7
Japan Cancer Society, Tokyo 100-0006, Japan
8
Cancer Control Center, Osaka International Cancer Institute, Osaka 537-8511, Japan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(6), 2098; https://doi.org/10.3390/ijerph17062098
Received: 4 February 2020 / Revised: 17 March 2020 / Accepted: 20 March 2020 / Published: 22 March 2020
Use of heated tobacco products (HTPs) among current smokers is becoming increasingly popular in Japan. This study aims to compare characteristics and tobacco-related behaviors among concurrent users of HTPs and combustible cigarettes (n = 644) with exclusive smokers (n = 3194) or exclusive HTP users (n = 164). The secondary aim was to explore heterogeneity within concurrent use subgroups. Data were from Wave 1 of the ITC Japan Survey, a nationally representative web survey conducted from February to March 2018. Concurrent cigarette-HTP users were younger and wealthier than exclusive smokers. However, there were no difference in the frequency of smoking, number of cigarettes per day, and smoking cessation behaviors between the two groups, suggesting that HTPs reinforce nicotine dependence. Compared to exclusive HTP users, concurrent cigarette-HTP users reported higher frequency of non-daily HTP use, and lower number of tobacco-containing inserts per day. Almost all concurrent cigarette-HTP users smoked every day (93.9%); 48.4% both smoked and used HTPs daily (dual daily users, n = 396), while 45.5% were daily smokers and non-daily HTP users (predominant smokers, n = 213). Concurrent user subgroups differed from each other on age, tobacco use behaviors, and quit intention. Alongside heterogeneity between concurrent and exclusive product users, differences across concurrent use subgroups highlight the importance of considering frequency of use in characterizing poly-tobacco users. View Full-Text
Keywords: concurrent use; dual use; heated tobacco products; heat-not-burn; combustible cigarettes concurrent use; dual use; heated tobacco products; heat-not-burn; combustible cigarettes
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Sutanto, E.; Miller, C.; Smith, D.M.; Borland, R.; Hyland, A.; Cummings, K.M.; Quah, A.C.; Xu, S.S.; Fong, G.T.; Ouimet, J.; Yoshimi, I.; Mochizuki, Y.; Tabuchi, T.; O’Connor, R.J.; Goniewicz, M.L. Concurrent Daily and Non-Daily Use of Heated Tobacco Products with Combustible Cigarettes: Findings from the 2018 ITC Japan Survey. Int. J. Environ. Res. Public Health 2020, 17, 2098.

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