Background: Smoking cigarettes remains a leading cause of preventable deaths. Although quitting smoking is best way of reducing health risks, reduced-risk tobacco products (RRP) are being developed as alternatives for current adult smokers. Understanding the risk perceptions associated with RRPs may help create appropriate communications to facilitate harm reduction. This study examined risk perceptions of IQOS, a potential RRP, and conventional cigarettes (CC) by tobacco use and behavioral intentions. Methods: The current study pooled data from three waves of an online, cross-sectional survey conducted among a convenience sample of IQOS users (N=1,500) registered in the product’s database in Japan. Descriptive analyses were completed to visualize data. A multiple linear regression examined the relationship between tobacco use and behavioral intentions with perceived health risk. Results: A total of 1,323 IQOS users were included in this analysis. The majority were males (81.9%) aged 30–49 (65.2%). Nearly two-thirds of participants reported using IQOS exclusively, while 20.3% reported using both IQOS and CC. Slightly more than one-third of participants reported an intention to quit all tobacco. In the final regression model examining the difference in perceived health risk between CC and IQOS (CC-IQOS), females and those aged 40–49 perceived a statistically significantly greater difference of risk; poly-users (inclusive of IQOS and CC) perceived a significantly lower difference. Conclusions: Based on these findings, to facilitate harm reduction behaviors, messages explaining risk reduction may need to be tailored on the basis of biological sex, age, and type of tobacco use.