Are youth using heated tobacco products?

Youth should not use any nicotine-containing product

For years, young people have been rightly warned not to smoke cigarettes. With the current rapid pace of innovation in the tobacco products space, that crucial conversation must evolve as new products arrive. We must be emphatic that youth should not use any nicotine-containing product. Period. Nicotine is addictive and is not risk free.   

We know that great care must be taken when new, innovative smoke-free products are introduced to the market. Youth should not become nicotine users. Former smokers and never smokers should not start using tobacco or nicotine products. The focus must be on providing better choices to adults who would otherwise continue to smoke. But what’s happening now that smoke-free products have been introduced to the market? 

We report here the results of surveys from multiple countries on heated tobacco product (HTP) use among teenagers. The latest reports (reviewed on this page, below) suggest that the percentage of youth users has remained small. Nevertheless, it is essential that we maintain vigilance and prevent the use of HTPs by this unintended audience. 

 

Better choices for public health

Considering the tobacco harm reduction equation, two factors are equally important to have a positive impact on public health. First, a smoke-free alternative must be scientifically substantiated as significantly less harmful than cigarettes. Second, this alternative should be satisfying for its intended audience only, current adult smokers. Not only is it important to encourage intended users to pick up a smoke-free product and stick with it, but it is equally important to minimize use by unintended users. That includes never smokers, former smokers, and youth. 

Philip Morris International (PMI) does not carry out studies on youth use. Based on the data that have been collected on adult smokers in Japan, Italy, and the U.S., the U.S. Food and Drug Administration (FDA) concluded that available data, while limited, also indicate that few non-tobacco users would be likely to choose to start using the Tobacco Heating System (THS), including youth.

Now that HTPs have been available in multiple countries for several years, more data on that point have become available. However, because we don’t conduct research involving participants under the legal age for tobacco use, we need to rely on the data and conclusions reported by the global scientific community to understand whether youth are using HTPs. 

There is currently no global standard, in terms of data collected or terminology used, for research on youth use. For example, the terms ‘ever used’ or ‘lifetime use’ have both been recorded to signify ever having tried a product. Likewise, subjects who use products more regularly might have to tick a box marked ‘occasionally’ or, in a different study, ‘at least once in the past month’. Not all studies even measured regular use of products. Alongside this lack of a shared terminology, there is wide variation between age ranges studied; 12–17-year-olds, 14- and 15-year-olds, or ‘high school students’ (no ages supplied), for example. In addition, it is not always clear whether the percentage of youth users of HTPs are using several products at once. As a result, data cannot be directly compared between studies. However, trends can be observed. 

 

Most surveys worldwide show low prevalence of HTP use by youth  

Although only a limited number of studies have researched youth use of HTPs, there are some data available, mostly from countries where HTPs are sold. Generally, the data show that the population most likely to use HTPs are current adult smokers, with low uptake by youth. Data from studies conducted in Japan, Germany, Switzerland, Denmark, the Netherlands, England, and Canada, by local health ministries and organizations, find that HTP use among youth is in the low single-digits percent.  

Youth should not use any nicotine-containing products. The issue of youth use must be addressed both from a regulatory point of view and by applying responsible marketing practices by manufacturers, and industry stakeholders, including retailers. Beyond our existing responsible marketing practices, we continue to look for, test, learn, and develop technology to guard against unintended use, unintended access to product information and purchase, and prevent youth from initiating nicotine use or using our smoke-free devices. Managing the social impacts of our products by ensuring that they do not reach unintended audiences is a priority, and we continue to put in place youth access prevention safeguards in our direct and indirect retail channels.

 

Overview of key findings from recent studies involving participants under the legal age for tobacco use