• Journal of Environmental Health Sciences
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• v.49 no.2
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• pp.118-128
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• 2023

Background: The use of heated tobacco products (HTP) causes many adverse health effects. Although the use of HTP by adolescents is prevalent worldwide, research related to it is very limited. There is a considerable lack of research related to the current HTP use rather than ever-HTP use. In particular, research related to predictive factors for current HTP use in adolescents is scarce. Objectives: The purpose of this study was to analyze related characteristics according to the current use of HTP among South Korean adolescents. Methods: This was a cross-sectional study that used data from the Seventeenth Korean Youth Risk Behavior Web-based Survey (KYRBWS). A total of 54,848 students in 2021 were included in this study. Chi-square-test, multiple logistic regression analysis, and chi-square test for trend were used for analyzing related characteristics according to use of HTP. Results: Overall, 715 (1.3%) students responded as having used HTP during the last 30 days among the 54,848 students. It was found that residence type, subjective body type recognition, subjective health recognition, alcohol use, habitual drug experience, close friend current smoking, and conventional cigarette smoking were significantly associated characteristics with the current use of heated tobacco products. Comparing 'very thin recognition' with 'very fat recognition', the adjusted odds ratio (OR) was 1.93 (95% confidence interval [CI]: 1.29~2.87) for current use of HTP. Additionally, comparing 'very unhealthy recognition' with 'very healthy recognition', the aOR was 3.82 (95% CI: 2.40~6.07) for current use of HTP. Conclusions: Based on these results, residence type, subjective body type recognition, subjective health recognition, alcohol use, habitual drug experience, close friend current smoking, and conventional cigarette smoking were associated with significantly increased odds of current HTP use. Therefore, the results of this study can provide useful evidence about adolescent behaviors in predicting current HTP use.

• Journal of Environmental Health Sciences
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• v.46 no.4
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• pp.388-397
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• 2020

Objectives: The aim of this study was to assess the association between the use of heated tobacco products (HTP) and suicidal behaviors such as suicidal ideation, suicide planning, and suicide attempts among adolescents in South Korea. Methods: The study used a cross-sectional design. Data was from the 15th Korea Youth Risk Behavior Web-based Survey (KYRBS) performed in 2019 by the Ministry of Education, Ministry of Health and Welfare, and Korean Center for Disease Control and Prevention. Heated tobacco product use was used as a main independent variable and suicide-related behaviors such as suicidal ideation, planning, and attempts were applied as dependent variables. Out of 60,100 students, 57,303 responded. Results: HTP use significantly increased the odds of a suicide attempt and suicide planning among adolescents. After controlling for confounders, when comparing 'current HTP users' with 'never HTP users', the adjusted odds ratio (OR) was 1.78 (95% confidence interval (CI): 1.38-2.30) for suicide attempts among adolescents. After controlling the confounders, comparing 'current HTP users' with 'never HTP users', the adjusted OR was 1.36 (95% CI: 1.06-1.73) for suicide planning among adolescents. For sadness/despair among adolescents, when comparing 'current HTP users' with 'never HTP users', the adjusted OR was 1.29 (95% CI: 1.11-1.50). However, HTP use had no significant association with suicidal ideation among adolescents. Conclusions: Current HTP users were more likely to attempt to commit suicide, and more likely to plan to commit suicide than never HTP users among adolescents. These results may be useful in developing a scientific basis for designing suicide prevention programs targeting adolescents.

• Journal of Korean Academy of Nursing
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• v.53 no.2
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• pp.155-166
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• 2023

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.

• Journal of Life Science
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• v.34 no.5
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• pp.320-332
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• 2024

The aims of this study were to compare the differences in hemodynamics between cigarette smoking and using heated tobacco products (HTPs) and to determine the acute effects of using HTPs on cardiac autonomic regulation. Another goal was to examine the acute cardiac autonomic responses when using different tobacco sticks in HTPs. Sixteen healthy male smokers completed an open-label, randomized, crossover trial consisting of non-smoking (NS), cigarette smoking, and the use of two different HTPs (IQOS with HEETS; lil SOLID with Fiit). Sub-trials, which included NS, lil SOLID with Fiit, and lil SOLID with HEET, were performed on eight smokers among the total subjects. Hemodynamic variables, such as systolic blood pressure (SBP) and diastolic blood pressure (DBP), and heart rate variability were measured before, during, and 30 minutes after using each tobacco product. Using HTPs resulted in a significant increase in both SBP and DBP, comparable to smoking cigarettes. Cardiac sympathetic activity significantly increased, and cardiac vagal tone (CVT) significantly decreased after acute exposure to HTP aerosol, similar to the effects of cigarette smoke exposure. Furthermore, differences in the withdrawal of CVT were observed when using different tobacco sticks in the same HTPs. The findings of this study indicate that acute exposure to HTP aerosol increases the hemodynamic burden and disrupts cardiac autonomic balance, similar to exposure to cigarette smoke. Moreover, depending on the type of tobacco stick inserted into the HTP device, acute withdrawal of CVT may have been enhanced.

• Journal of Life Science
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• v.33 no.8
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• pp.639-650
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• 2023

The levels of harmful components in aerosols from heated tobacco products (HTPs) have been reported to be significantly lower than in cigarette smoke. However, it remains unclear whether the use of HTPs can mitigate the cardiovascular risks associated with cigarette smoking (CS). The objective of this study was to investigate the effects of a short-term switch from CS to HTP use on cardiac autonomic regulation (CAR). Seven healthy male smokers completed an open-label, randomized, cross-over trial consisting of five days of CS, use of three different HTPs (IQOS use, IQ; lil SOLID use, LS; lil HYBRID use, LH), or non-smoking (NS). Each session was separated by a one-week washout period, and levels of exhaled carbon monoxide (CO) and carboxyhemoglobin (COHb), systolic (SBP) and diastolic blood pressure (DBP), and heart rate variability (HRV) reflecting CAR were assessed before use of the product assigned to each session and at 24, 48, 72, 96, and 120 hr after use. Levels of exhaled CO and COHb were statistically significantly reduced only during NS. There were no statistical changes in SBP and DBP within any session. However, in HRV spectral analysis, log-transformed high frequency (lnHF) increased statistically significantly in IQ, LS, and NS, respectively. Normalized HF (HFnu) was significantly increased in NS and LH, respectively. lnHF and HFnu showed significant interaction effects. The findings of this study suggest that a short-term switch to HTPs instead of CS may lead to different distribution patterns of CAR, primarily driven by enhanced cardiac vagal tone.