Last updated: March 2018
Suggested citation: Greenhalgh, EM. 18C. Heated tobacco (‘heat-not-burn’) products. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2018. Available from: http://www.tobaccoinaustralia.org.au/chapter-18-harm-reduction/indepth-18c-non-combustible-cigarettes/18c-2-extent-of-use
As heated tobacco products cannot be legally sold in Australia (see Section 18C.5), the prevalence of use among Australians is likely extremely low; there are no current estimates available.
Research on awareness and use of heated tobacco products is so far extremely limited. A study in Japan found that in 2015, 0.3% of respondents were current (past month) users of Philip Morris’ iQOS, and 0.3% were current users of Japan Tobacco’s Ploom Tech (respondents could choose multiple products). In 2016, use was similar; however, in 2017, the iQOS current user rate had increased more than 10-fold to 3.6%. The Ploom Tech current user rate increased to 1.2%, and 0.8% were current British American Tobacco Glo users.1, 2 Among all electronic products (Including e-cigarettes) and age groups, current use was highest among 20–29 year old users of iQOS, at 5.8%. About one in five (18.8%) current smokers intending to quit reported current use of iQOS, compared with 10.3% of smokers not intending to quit.2
In England in 2017, awareness and ever use of heated tobacco products were very rare. Among the 2,185 last year smokers that were surveyed for the Smoking Toolkit Study, four reported using heated tobacco products in recent quit attempts, six reported use to help cut down the amount smoked, one reported use in situations where smoking is prohibited, and none reported use for any other reason. Among never and long-term ex-smokers (n=9,777), five said they were using heated tobacco products.3
An Italian study found that in 2017, one in five (19.5%) respondents were aware of iQOS (the only available heated tobacco product), 1.4% had tried it and 2.3% intended to try it. One per cent of never smokers, 0.8% of ex-smokers and 3.1% of current cigarette smokers had tried iQOS, while 1.2% of never e-cigarette users, 2.9% of ex-e-cigarette users and 7.7% of current e-cigarette users had tried iQOS.4
1. Tabuchi T, Kiyohara K, Hoshino T, Bekki K, Inaba Y, et al. Awareness and use of electronic cigarettes and heat-not-burn tobacco products in Japan. Addiction, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26566956
2. Tabuchi T, Gallus S, Shinozaki T, Nakaya T, Kunugita N, et al. Heat-not-burn tobacco product use in Japan: Its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-burn tobacco aerosol. Tobacco Control, 2017. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29248896
3. McNeill A, Brose L, Calder R, Bauld L, and Robson D, Evidence review of e-cigarettes and heated tobacco products 2018. A report commissioned by Public Health England. London: Public Health England; 2018. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/680964/Evidence_review_of_e-cigarettes_and_heated_tobacco_products_2018.pdf.
4. Liu X, Lugo A, Spizzichino L, Tabuchi T, Pacifici R, et al. Heat-not-burn tobacco products: Concerns from the Italian experience. Tobacco Control, 2018. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29374094