Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Associations between the Frequency and Quantity of Heated Tobacco Product Use and Smoking Characteristics among Korean Smoking Adolescents

  • Received : 2022.10.07
  • Accepted : 2023.02.13
  • Published : 2023.04.30
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Abstract

Purpose: Although heated tobacco product (HTP) use among adolescents is an emerging public health problem, little is known about the frequency and quantity of HTP use. Thus, we investigated the associations between the frequency and quantity of HTP use and smoking characteristics (i.e., combustible cigarette [CC] and electronic cigarette [EC] use, and attempts to quit smoking) among CC-smoking adolescents. Methods: We analyzed nationally representative data from 2,470 Korean adolescents who were current CC smokers. To investigate our aim, we conducted multinomial logistic and logistic regression analyses. Results: We found that daily and heavier CC users had greater likelihoods of more frequent and heavier HTP use. In addition, dual users of CCs and ECs were more likely to use HTPs more frequently and heavily than CC users who did not use ECs. Moreover, daily EC users had the highest risk of frequent and heavy HTP use. The frequency and quantity of HTP use were not associated with attempts to quit smoking. Compared to CC-only use, dual use of CCs and HTPs was not associated with quitting attempts, and triple use of CCs, ECs, and HTPs was associated with a lower likelihood of quitting attempts. Conclusion: HTP use was less likely to displace CC use and promote attempts to quit smoking. Thus, strict regulations are required to prevent the promotion of HTPs as a substitute for CCs or as a means of quitting smoking. Additionally, health professionals should consider preventive interventions for HTP, as well as CC and EC use among adolescents.

Keywords

Acknowledgement

This study was supported by the research grants from Daegu Catholic University in 2021 (No: 20211070).

References

  1. World Health Organization (WHO). Heated tobacco products (HTPs): Market monitoring information sheet [Internet]. Geneva: WHO; c2018 [cited 2022 Feb 21]. Available from: https://www.who.int/publications/i/item/WHO-NMH-PND-18.7
  2. Lee S, Kim J. Evolution of tobacco products. Journal of the Korean Medical Association. 2020;63(2):88-95. https://doi.org/10.5124/jkma.2020.63.2.88
  3. Philip Morris International (PMI). IQOS heated tobacco products [Internet]. Stamford: PMI; 2022 [cited 2022 Mar 14]. Available from: https://www.pmi.com/smoke-free-products/iqos-our-tobacco-heating-system
  4. Park S, Lee KS. Association of heated tobacco product use and secondhand smoke exposure with suicidal ideation, suicide plans and suicide attempts among Korean adolescents: A 2019 national survey. Tobacco Induced Diseases. 2021;19:72. https://doi.org/10.18332/tid/140824 Erratum in: Tobacco Induced Diseases. 2022;20:04.
  5. Chung SJ, Kim BK, Oh JH, Shim JS, Chang YS, Cho SH, et al. Novel tobacco products including electronic cigarette and heated tobacco products increase risk of allergic rhinitis and asthma in adolescents: Analysis of Korean youth survey. Allergy. 2020;75(7):1640-1648. https://doi.org/10.1111/all.14212
  6. Cho JH. Association between heated tobacco products use and suicidal behaviors among adolescents. Journal of Environmental Health Sciences. 2020;46(4):388-397. https://doi.org/10.5668/JEHS.2020.46.4.388
  7. 7.Leigh NJ, Palumbo MN, Marino AM, O'Connor RJ, Goniewicz ML. Tobacco-specific nitrosamines (TSNA) in heated tobacco product IQOS. Tobacco Control. 2018;27(Suppl 1):s37-s38. https://doi.org/10.1136/tobaccocontrol-2018-054318
  8. Chun L, Moazed F, Matthay M, Calfee C, Gotts J. Possible hepatotoxicity of IQOS. Tobacco Control. 2018;27(Suppl 1):s39-s40. https://doi.org/10.1136/tobaccocontrol-2018-054320
  9. Ministry of Education; Ministry of Health and Welfare; Korea Disease Control and Prevention Agency. The statistics on the 16th Korea Youth Risk Behavior Survey in 2020 [Internet]. Cheongju: Korea Disease Control and Prevention Agency; c2021 [cited 2021 May 15]. Available from: https://www.kdca.go.kr/yhs/yhshmpg/result/yhsresult/statsBookList.do
  10. Kang H, Cho SI. Heated tobacco product use among Korean adolescents. Tobacco Control. 2020;29(4):466-468. https://doi.org/10.1136/tobaccocontrol-2019-054949
  11. Czoli CD, White CM, Reid JL, OConnor RJ, Hammond D. Awareness and interest in IQOS heated tobacco products among youth in Canada, England and the USA. Tobacco Control. 2020;29(1):89-95. https://doi.org/10.1136/tobaccocontrol-2018-054654
  12. Gentzke AS, Wang TW, Jamal A, Park-Lee E, Ren C, Cullen KA, et al. Tobacco product use among middle and high school students - United States, 2020. MMWR. Morbidity and Mortality Weekly Report. 2020;69(50):1881-1888. https://doi.org/10.15585/mmwr.mm6950a1
  13. McKelvey K, Popova L, Kim M, Chaffee BW, Vijayaraghavan M, Ling P, et al. Heated tobacco products likely appeal to adolescents and young adults. Tobacco Control. 2018;27(Suppl 1):s41-s47. https://doi.org/10.1136/tobaccocontrol-2018-054596
  14. British American Tobacco (BAT). Tobacco heating products: Innovating to lead the transformation of tobacco use [Internet]. London: BAT; 2021 [cited 2022 Mar 14]. Available from: https://www.bat.com/group/sites/UK__9D9KCY.nsf/vwPagesWebLive/DOAWUGNJ
  15. Hwang JH, Ryu DH, Park I, Park SW. Cigarette or e-cigarette use as strong risk factors for heated tobacco product use among Korean adolescents. International journal of Environmental Research and Public Health. 2020;17(19):7005. https://doi.org/10.3390/ijerph17197005
  16. Dai H. Heated tobacco product use and associated factors among U.S. youth, 2019. Drug and Alcohol Dependence. 2020;214:108150. https://doi.org/10.1016/j.drugalcdep.2020.108150
  17. Kang SY, Lee S, Cho HJ. Prevalence and predictors of heated tobacco product use and its relationship with attempts to quit cigarette smoking among Korean adolescents. Tobacco Control. 2021;30(2):192-198. https://doi.org/10.1136/tobaccocontrol-2019-055114
  18. Hwang JH, Ryu DH, Park SW. Heated tobacco products: Cigarette complements, not substitutes. Drug and Alcohol Dependence. 2019;204:107576. https://doi.org/10.1016/j.drugalcdep.2019.107576 Erratum in: Drug and Alcohol Dependence. 2020;208:107872.
  19. Dierker LC, Donny E, Tiffany S, Colby SM, Perrine N, Clayton RR. The association between cigarette smoking and DSM-IV nicotine dependence among first year college students. Drug and Alcohol Dependence. 2007;86(2-3):106-114. https://doi.org/10.1016/j.drugalcdep.2006.05.025
  20. Amato MS, Boyle RG, Levy D. How to define e-cigarette prevalence? Finding clues in the use frequency distribution. Tobacco Control. 2016;25(e1):e24-e29. https://doi.org/10.1136/tobaccocontrol-2015-052236
  21. Sutanto E, Miller C, Smith DM, Borland R, Hyland A, Cummings KM, et al. Concurrent daily and non-daily use of heated tobacco products with combustible cigarettes: Findings from the 2018 ITC Japan survey. International Journal of Environmental Research and Public Health. 2020;17(6):2098. https://doi.org/10.3390/ijerph17062098
  22. Miller CR, Sutanto E, Smith DM, Hitchman SC, Gravely S, Yong HH, et al. Characterizing heated tobacco product use among adult cigarette smokers and nicotine vaping product users in the 2018 ITC four country smoking & vaping survey. Nicotine & Tobacco Research. 2022;24(4):493-502. https://doi.org/10.1093/ntr/ntab217
  23. Li S, Braden K, Zhuang YL, Zhu SH. Adolescent use of and susceptibility to heated tobacco products. Pediatrics. 2021;148(2):e2020049597. https://doi.org/10.1542/peds.2020-049597
  24. Lee J, Thompson LA, Salloum RG. Heated tobacco product use among US adolescents in 2019: The new tobacco risk. Tobacco Prevention & Cessation. 2021;7:01. https://doi.org/10.18332/tpc/130502
  25. Dai H. Prevalence and factors associated with youth vaping cessation intention and quit attempts. Pediatrics. 2021;148(3):e2021050164. https://doi.org/10.1542/peds.2021-050164
  26. Kang MJ, Lee H, Jo M. Analysis of multidimensional factors in attempts to quit using tobacco by Korean adolescents. Environmental Health and Preventive Medicine. 2020;25(1):71. https://doi.org/10.1186/s12199-020-00913-1
  27. Bafunno D, Catino A, Lamorgese V, Del Bene G, Longo V, Montrone M, et al. Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: A systematic review. Journal of Thoracic Disease. 2020;12(7):3844-3856. https://doi.org/10.21037/jtd.2020.02.23
  28. Tattan-Birch H, Hartmann-Boyce J, Kock L, Simonavicius E, Brose L, Jackson S, et al. Heated tobacco products for smoking cessation and reducing smoking prevalence. Cochrane Database of Systematic Reviews. 2022;1(1):CD013790. https://doi.org/10.1002/14651858.CD013790.pub2
  29. Xia W, Li WHC, Luo YH, Liang TN, Ho LLK, Cheung AT, et al. The association between heated tobacco product use and cigarette cessation outcomes among youth smokers: A prospective cohort study. Journal of Substance Abuse Treatment. 2022;132:108599. https://doi.org/10.1016/j.jsat.2021.108599
  30. Barrington-Trimis JL, Kong G, Leventhal AM, Liu F, Mayer M, Cruz TB, et al. E-cigarette use and subsequent smoking frequency among adolescents. Pediatrics. 2018;142(6):e20180486. https://doi.org/10.1542/peds.2018-0486
  31. Lee H. Associations between the frequency of electronic cigarette use and smoking-related characteristics among adolescent smokers. Child Health Nursing Research. 2019;25(4):487-495. https://doi.org/10.4094/chnr.2019.25.4.487
  32. Lee JA, Lee S, Cho HJ. The relation between frequency of e-cigarette use and frequency and intensity of cigarette smoking among South Korean adolescents. International Journal of Environmental Research and Public Health. 2017;14(3):305. https://doi.org/10.3390/ijerph14030305
  33. Kwon M, Chung SJ, Lee J. Use of single, dual, and poly tobacco products in Korean adolescents. Asia Pacific Journal of Public Health. 2021;33(5):571-578. https://doi.org/10.1177/10105395211022950
  34. Miech RA, Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE, Patrick ME. Monitoring the future: National survey results on drug use, 1975-2020: Volume I, secondary school students [Internet]. Ann Arbor: University of Michigan, Institute for Social Research; c2021 [cited 2022 Feb 22]. Available from: https://files.eric.ed.gov/fulltext/ED615087.pdf
  35. StataCorp. Stata Statistical Software: Release 12 [computer Program]. Version. 12. College Station: StataCorp LP; 2011.
  36. Gilbert PA, Kava CM, Afifi R. High-school students rarely use e-cigarettes alone: A sociodemographic analysis of polysubstance use among adolescents in the United States. Nicotine & Tobacco Research. 2021;23(3):505-510. https://doi.org/10.1093/ntr/ntaa037
  37. Farsalinos K, Tomaselli V, Polosa R. Frequency of use and smoking status of U.S. adolescent e-cigarette users in 2015. American Journal of Preventive Medicine. 2018;54(6):814-820. https://doi.org/10.1016/j.amepre.2018.03.003
  38. Huh Y, Lee CM, Cho HJ. Comparison of nicotine dependence between single and multiple tobacco product users among South Korean adults. Tobacco Induced Diseases. 2022;20:22. https://doi.org/10.18332/tid/145899
  39. Lee JA, Lee C, Cho HJ. Use of heated tobacco products where their use is prohibited. Tobacco Control. 2023;32(2):146-152. https://doi.org/10.1136/tobaccocontrol-2020-056398
  40. Glantz SA. Heated tobacco products: The example of IQOS. Tobacco Control. 2018;27(Suppl 1):s1-s6. https://doi.org/10.1136/tobaccocontrol-2018-054601
  41. Gomez Y, Creamer M, Trivers KF, Anic G, Morse AL, Reissig C, et al. Patterns of tobacco use and nicotine dependence among youth, United States, 2017-2018. Preventive Medicine. 2020;141:106284. https://doi.org/10.1016/j.ypmed.2020.106284
  42. Strong DR, Leas E, Noble M, White M, Frissell KC, Glasser A, et al. Predictive validity of the adult tobacco dependence index: Findings from waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) study. Drug and Alcohol Dependence. 2020;214:108134. https://doi.org/10.1016/j.drugalcdep.2020.108134
  43. Huh J, Leventhal AM. Progression of poly-tobacco product use patterns in adolescents. American Journal of Preventive Medicine. 2016;51(4):513-517. https://doi.org/10.1016/j.amepre.2016.04.004
  44. Saebo G, Scheffels J. Assessing notions of denormalization and renormalization of smoking in light of e-cigarette regulation. International Journal on Drug Policy. 2017;49:58-64. https://doi.org/10.1016/j.drugpo.2017.07.026
  45. Kim SH, Cho HJ. Prevalence and correlates of current use of heated tobacco products among a nationally representative sample of Korean adults: Results from a cross-sectional study. Tobacco Induced Diseases. 2020;18:66. https://doi.org/10.18332/tid/125232
  46. Havermans A, Pennings JLA, Hegger I, Elling JM, de Vries H, Pauwels CGGM, et al. Awareness, use and perceptions of cigarillos, heated tobacco products and nicotine pouches: A survey among Dutch adolescents and adults. Drug and Alcohol Dependence. 2021;229(Pt B):109136. https://doi.org/10.1016/j.drugalcdep.2021.109136
  47. Soneji S, Sargent J, Tanski S. Multiple tobacco product use among US adolescents and young adults. Tobacco Control. 2016;25(2):174-180. https://doi.org/10.1136/tobaccocontrol-2014-051638
  48. U.S. Food and Drug Administration (FDA). FDA permits sale of IQOS tobacco heating system through premarket tobacco product application pathway [Internet]. Silver Spring: FDA; c2019 [cited 2023 Feb 16]. Available from: https://www.fda.gov/news-events/press-announcements/fda-permits-sale-iqos-tobacco-heating-system-through-premarket-tobacco-product-application-pathway
  49. Kim SC, Friedman TC. A new ingenious enemy: Heatnot-burn products. Tobacco Use Insights. 2022;15:1179173X221076419. https://doi.org/10.1177/1179173X221076419