Sutanto Edward, Miller Connor R, Smith Danielle M, O'Connor Richard J, Gravely Shannon, Hammond David, Hyland Andrew, Cummings Kenneth M, Quah Anne C K, Fong Geoffrey T, Agar Thomas K, Goniewicz Maciej L
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, United States.
Department of Psychology, University of Waterloo, Waterloo, Canada.
Tob Induc Dis. 2020 Sep 21;18:81. doi: 10.18332/tid/127233. eCollection 2020.
Tobacco companies have introduced heated tobacco products (HTPs), such as IQOS, which may compete with e-cigarettes among smokers interested in switching to potentially reduced-risk products. Non-smokers may also start using IQOS if they believe this product is less harmful than other nicotine products. Smokers' and non-smokers' decisions may be driven by relative harm perceptions of emerging nicotine products. We aimed to examine relative harm perceptions between IQOS, e-cigarettes, and cigarettes, among nicotine product users and non-users.
We conducted a web survey with Canadian respondents (aged ≥20 years; n=268) in September-October 2018. Perceptions about relative harm between IQOS (available for sale since 2017 and subject to the same comprehensive marketing restrictions as cigarettes in Canada), e-cigarettes, and cigarettes, were assessed among non-users (n=79), exclusive smokers (n=78), exclusive e-cigarette users (n=32), and dual users (n=79). Multiple logistic regression explored the association between relative harm perceptions and nicotine-use status, adjusting for sociodemographic variables.
Over half of respondents perceived IQOS as equally or more harmful than e-cigarettes (53.7%), while almost a quarter either reported IQOS as less harmful than e-cigarettes or were uncertain (22.7% and 23.5%, respectively). Two-thirds of respondents (65.7%) perceived e-cigarettes as less harmful than cigarettes, yet only half (48.1%) perceived IQOS as less harmful than cigarettes. Both exclusive and dual e-cigarette users, but not exclusive smokers, had higher odds of perceiving IQOS as more harmful than e-cigarettes and less harmful than cigarettes compared to non-users.
Most nicotine users and non-users perceive differential health risk across IQOS, e-cigarettes, and cigarettes. Although e-cigarettes are generally viewed as less harmful than cigarettes, the perceived harm of IQOS was unclear.
烟草公司推出了加热烟草产品（HTP），如IQOS，这类产品可能会在有意转向潜在低风险产品的吸烟者中与电子烟展开竞争。如果非吸烟者认为该产品比其他尼古丁产品危害小，他们也可能开始使用IQOS。吸烟者和非吸烟者的决定可能受对新兴尼古丁产品相对危害认知的影响。我们旨在研究尼古丁产品使用者和非使用者对IQOS、电子烟和卷烟的相对危害认知情况。
2018年9月至10月，我们对加拿大受访者（年龄≥20岁；n = 268）进行了一项网络调查。在非使用者（n = 79）、纯吸烟者（n = 78）、纯电子烟使用者（n = 32）和双重使用者（n = 79）中，评估他们对IQOS（自2017年起在加拿大上市销售，且与卷烟受到相同全面营销限制）、电子烟和卷烟相对危害的认知。多元逻辑回归分析探讨了相对危害认知与尼古丁使用状况之间的关联，并对社会人口统计学变量进行了调整。
超过一半的受访者认为IQOS与电子烟危害相当或更大（53.7%），而近四分之一的受访者要么认为IQOS比电子烟危害小，要么不确定（分别为22.7%和23.5%）。三分之二的受访者（65.7%）认为电子烟比卷烟危害小，但只有一半（48.1%）的受访者认为IQOS比卷烟危害小。与非使用者相比，纯电子烟使用者和双重使用者更有可能认为IQOS比电子烟危害大且比卷烟危害小，而纯吸烟者则不然。
大多数尼古丁使用者和非使用者认为IQOS、电子烟和卷烟的健康风险存在差异。虽然电子烟通常被认为比卷烟危害小，但IQOS的危害认知尚不清楚。
