Risk perception of IQOS™ and cigarettes: Temporal and cross-country comparisons

Suzana AlMoosawi; Martha Bajec; Nelly Mainy; Gerd Kallischnigg; Bertram Zwisele; Karina Fischer; Pierpaolo Magnani; Steve Roulet

doi:10.1016/j.ssmph.2022.101123

Risk perception of IQOS™ and cigarettes: Temporal and cross-country comparisons

SSM Popul Health. 2022 May 17:18:101123. doi: 10.1016/j.ssmph.2022.101123. eCollection 2022 Jun.

Authors

Suzana AlMoosawi¹, Martha Bajec², Nelly Mainy¹, Gerd Kallischnigg³, Bertram Zwisele³, Karina Fischer¹, Pierpaolo Magnani¹, Steve Roulet¹

Affiliations

¹ PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland.
² Bajec Senseworks consulting, Hamilton, L9A 1L5, Ontario, Canada.
³ ARGUS - Statistics and Information Systems in Environment and Public Health GmbH, Karl-Heinrich-Ulrichs-Straße 20a, DE-10785, Berlin, Germany.

Abstract

Background: Risk perception (RP) is central to smokers' decision to switch to smoke-free tobacco and nicotine products (TNP). This study assessed temporal trends in the health RP of a novel heated tobacco product, IQOS ^TM , relative to cigarettes, among current IQOS ^TM users.

Methods: The analyses included repeated cross-sectional data from online surveys in Germany (2018-19), Italy (2018-19), and Japan (2016-17, 2017-18, and 2018-19) among a random sample of current adult IQOS ^TM users from local registers of IQOS ^TM users. The health RPs of cigarettes and IQOS ^TM were assessed using the ABOUT™-Perceived Risk instrument, and their difference was described as the relative RP of IQOS ^TM to cigarettes (RP_Cig: IQOS ^TM ).

Results: After adjustment for covariates, the relative RP_Cig: IQOS ^TM was higher in 2018 than in 2019 (0.93; standard error, 0.33; P = 0.005). This was driven by an increase in the RP of IQOS ^TM over time in Italy (2018: 42.6 [95% CI, 41.6-43.5]; 2019: 44.4 [43.4-45.4]) and Japan (2017: 44.0 [43.1-44.9); 2018: 45.9 [45.2-46.7]; 2019: 48.6 [47.9-49.4]), while the RP of cigarettes remained stable.

Conclusions: The relative RP of IQOS ^TM decreased over time, driven by an increase in the RP of IQOS ^TM , in agreement with epidemiological studies indicating a temporal reduction in the relative RP of smoke-free TNPs. Continued surveillance of the RP of novel TNPs is warranted to inform effective TNP risk communication and ensure that adults smokers who would otherwise continue to smoke understand the relative risks of novel TNPs.

Keywords: Epidemiology; Harm reduction; Heated tobacco product; LA, Legal Age; Public health; RP, Risk Perception; Risk perception; THR, Tobacco Harm Reduction; TNP, Tobacco and Nicotine Product; Tobacco.