PERCEPTION AND BEHAVIOR STUDIES

      Perception and behavior studies on smoke-free products

      Perception and behavior studies help us to evaluate risk perceptions and patterns of use of smoke-free products among various adult consumer groups. For smoke-free products to have an overall positive impact on public health, it is not enough to know whether a smoke-free product has a reduced-risk profile compared with cigarettes. It is equally important that these products are used by the right audience: adult smokers who would otherwise continue to smoke. 

      Perception and behavior studies are critical to predicting smoke-free product impacts on population health

      A person’s decision whether to use a smoke-free product is partly based on their perception of the risks of the product. We aim to make it clear in our product communications that quitting is the best way to reduce smoking-related health risks, and that smoke-free products are only for adult smokers who would otherwise continue to smoke. Our perception and behavior assessments for our Tobacco Heating System (THS) show that we are taking the right approach. Our product claims and risks, which are based on our robust aerosol, toxicology, and clinical assessments, are properly understood by smokers and nonsmokers alike. Our continued assessment of product use after the launch of THS has supported our pre-market assessment.

      We will continue to observe product use patterns in countries where THS and any other of our smoke-free products are available. The longer a smoke-free product is on the market, the more opportunity there is to observe the impact that the product has in the countries where it is available. In our long-term assessment of smoke-free products, we gather real-world data on our products alongside our own studies with the aim to demonstrate that our smoke-free products can benefit public health. 

      You can find a summary of our entire product assessment program in the PMI Science Booklet, and our publications, most of which are open-access, can be found via the publications library.

      Jump to a specific result from our perception and behavior studies on THS:

      • Low initiation among never TNP users

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      • low intention to use among nonsmokers

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      • Adult smokers likely to switch to THS

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      Our studies show very low to nonexisting tobacco or nicotine-containing products (TNP) initiation with the Tobacco Heating System among never TNP users

      We conducted repeated post-market cross-sectional surveys that monitor THS use prevalence post commercialization in representative samples of adult populations in Japan, Italy, and Germany in 2016 and 2017. The results of these surveys show very low to non-existing TNP initiation with THS among never TNP users (<0.1%). More than 99% of current THS users have a history of TNP use before switching to THS, and only 1 to 2% of current THS users relapsed or re-initiated tobacco use with THS. There is also independent research showing that multiple countries report that heated tobacco product use is found among only a small percentage of youth. 

      Find more details in the related publication:

      Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product (IQOS®): a cross-sectional study

      Our studies showed a low intention to use the Tobacco Heating System among nonsmokers and that smokers correctly understand that switching to THS presents less risk of harm than continued cigarette smoking

      Our pre-market studies conducted in the U.S. showed that substantial proportions of current adult smokers (up to 39%) expressed intention to use THS after viewing a product brochure that was provided during the study. At the same time, the studies showed that low proportions of nonsmokers expressed intention to use THS (i.e., adult former smokers ≤6.4%, adult never smokers and legal age to 25-years-old never smokers ≤1.1%). 

      Moreover, we also conducted studies for THS with adults who were not consumers of TNPs in several countries in 2020 and 2021. The results of those studies also show very low intention to use THS among adult former users of TNPs and adults who had never used TNPs. According to the study results, adult smokers correctly understand that switching to THS presents less risk of harm than continued cigarette smoking, while not being risk free. Furthermore, among adult smokers who had the intention to quit smoking, our data showed a low impact of THS communication materials on these peoples’ intention to quit.

      Review several of our presentations of the data on this topic:

      Intention to Use and Perceptions of Health and Addiction Risk for the Tobacco Heating System 2.2
      Intent to Use for a New Menthol HeatSticks Variant in Japan
      Study to Quantitatively Assess Tobacco Heating System 2.2 Potential Messages
      Intention to use the Tobacco Heating System, associated with variants of a potential product brochure
      Potential Predictors of Intended Use of a Novel Heat-not-burn Tobacco Product
      Potential Predictors of Intended Use of a Novel Heat-not-burn Tobacco Product

      Our studies showed that a sizeable proportion of smokers were likely to switch from cigarettes to exclusive or predominant use of the Tobacco Heating System

      Our pre-market study conducted in the U.S. aimed to measure the effect of THS on tobacco use behavior among adult daily cigarette smokers. This 6-week observational study showed that 15% of smokers switched from cigarettes to THS exclusive or predominant use. The study findings also showed that the availability of THS did not lead to an increase in total tobacco product consumption (THS and cigarettes). The U.S. actual use study findings were aligned with similar pre-market studies conducted in Germany, Italy, South Korea, Japan, and Switzerland which showed that between 10 and 37% of smokers switched from cigarettes to THS exclusively or as the main product they used. 

      We have conducted post-market studies after the commercialization of THS, and the study results show that these pre-market actual use studies well predicted THS future use behavior. Our repeated post-market cross-sectional surveys in a representative sample of the adult population from Japan, Italy, and Germany, monitoring the use prevalence of THS after its commercialization show that the total use prevalence of TNP in these countries is overall stable across time, with higher total TNP use prevalence in Italy and Germany compared to Japan. These studies also show a growing prevalence of THS use among TNP users across time with a higher prevalence of THS use in Japan (2019: 18.4%) compared to Italy (2019: 4.1%) and Germany (2019: 1.2%). Moreover, these studies show that more than half of the THS users no longer smoke cigarettes and use THS exclusively.

      Learn more about these results in these publications:

      Potential predictors of adoption of the Tobacco Heating System by U.S. adult smokers: An actual use study
      Pre-market studies from five countries in Asia and Europe to measure the adoption of the tobacco heating system (THS) in smokers
      Prevalence and patterns of tobacco and/or nicotine product use in Japan (2017) after the launch of a heated tobacco product (IQOS®): a cross-sectional study
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      Reduced Risk Products ("RRPs”) is the term we use to refer to products that present, are likely to present, or have the potential to present less risk of harm to smokers who switch to these products versus continuing smoking. PMI has a range of RRPs in various stages of development, scientific assessment and commercialization. All of our RRPs are smoke-free products that deliver nicotine with far lower quantities of harmful and potentially harmful constituents than found in cigarette smoke.