Perceptions of Harmfulness of Heated Tobacco Products Compared to Combustible Cigarettes among Adult Smokers in Japan: Findings from the 2018 ITC Japan Survey

Shannon Gravely, Geoffrey T. Fong, Edward Sutanto, Ruth Loewen, Janine Ouimet, Steve S. Xu, Anne C. K. Quah, Mary E. Thompson, Christian Boudreau, Grace Li, Maciej L. Goniewicz, Itsuro Yoshimi, Yumiko Mochizuki, Tara Elton-Marshall, James F. Thrasher and Takahiro Tabuchi
Additional contact information
Shannon Gravely: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Geoffrey T. Fong: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Edward Sutanto: Division of Cancer Prevention and Population Sciences, Department of Health Behaviors, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Ruth Loewen: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Janine Ouimet: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Steve S. Xu: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Anne C. K. Quah: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Mary E. Thompson: Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Christian Boudreau: Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Grace Li: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Maciej L. Goniewicz: Division of Cancer Prevention and Population Sciences, Department of Health Behaviors, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Itsuro Yoshimi: Division of Tobacco Policy Research, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
Yumiko Mochizuki: Japan Cancer Society, 13th Floor, Yurakucho Center Bldg. 2-5-1, Yurakucho, Chiyoda-ku, Tokyo 100-0006, Japan
Tara Elton-Marshall: Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, London, ON N6G 4X8, Canada
James F. Thrasher: Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Takahiro Tabuchi: Cancer Control Center, Osaka International Cancer Institute, Chome-1-69 Otemae, Chuo Ward, Osaka 541-8567, Japan

IJERPH, 2020, vol. 17, issue 7, 1-14

Abstract: In Japan, the tobacco industry promotes heated tobacco products (HTPs) as a reduced-risk tobacco product. This study examines: (1) smokers’ harm perceptions of HTPs relative to combustible cigarettes; (2) differences in relative harm perceptions between exclusive smokers and smokers who use HTPs (concurrent users) and between concurrent users based on frequency of product use; and (3) if smokers who were exposed to HTP advertising hold beliefs that are consistent with marketing messages of lower harmfulness. This cross-sectional study included 2614 adult exclusive cigarette smokers and 986 concurrent users who reported their perceptions of harmfulness of HTPs compared to cigarettes, as well as their exposure to HTP advertising in the last six months. Among all smokers, 47.5% perceive that HTPs are less harmful than cigarettes, 24.6% perceive HTPs to be equally as harmful, 1.8% perceive HTPs as more harmful, and 26.1% did not know. Concurrent users are more likely than exclusive smokers to believe that HTPs are less harmful (62.1% versus 43.8%, p < 0.0001) and less likely to report that they did not know (14.3% versus 29.4%, p < 0.0001). Frequent HTP users are more likely than infrequent users to believe that HTPs are less harmful (71.7% versus 57.1%, p ≤ 0.001). Believing that HTPs are less harmful than cigarettes was associated with noticing HTP advertising on TV ( p = 0.0005), in newspapers/magazines ( p = 0.0001), on posters/billboards ( p < 0.0001), in stores where tobacco ( p < 0.0001) or where HTPs ( p < 0.0001) are sold, on social media ( p < 0.0001), or in bars/pubs ( p = 0.04). HTP users were significantly more likely than non-HTP users to believe that HTPs are less harmful than cigarettes, with this belief being more prominent among frequent users. Smokers who have been exposed to HTP advertising were more likely to perceive HTPs as less harmful than cigarettes.

Keywords: heated tobacco products; heat-not-burn; modified risk tobacco products; combustible cigarettes; perceptions of harm; risk (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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