Tobacco product use after the launch of a heat-not-burn alternative in Japan: results of two cross-sectional surveys


Authored by  P Langer, L Prieto, C. Rousseau, A. Formey, D Skiada, E. F. Afolalu, Z Sponsiello Wang, K. Fischer, G Baker, R Weitkunat

Presented at GFN 2019    

Background
New tobacco or nicotine-containing products (TNP) are being developed to advance tobacco harm reduction efforts with the potential to reduce the risk of smoking-related diseases. The potential benefit to public health depends on the number of smokers who transition to these products, as compared to the number of non-smokers who (re-)initiate tobacco use with these products. However, most national surveys have not yet been updated to report the prevalence of these products, highlighting the need for tracking use behaviors in countries with these new products. One of these new TNPs is Philip Morris International’s Platform 1, a heated tobacco product, which was launched nationally in Japan in April 2016.

Methods
We conducting cross-sectional surveys to assess tobacco use prevalence and patterns of TNP use in Japan, which were initiated in December 2016. The surveys were conducted in two populations the first was a sample representative of the general adult population and the other was a random sample of registered Platform 1 users. The survey is repeated annually with each annual sampling consisting of four approximately equally sized waves of participants spaced throughout the year to account for potential seasonal differences. Although the study is still ongoing, the current results include the data from the first year and a half of the study.

Results
In the adult general population sample, we observed a tobacco use prevalence of 18.5%, with 17.6% using cigarettes, and 1.8% using Platform 1 during year 1 (n=4,878) and 18.8% for any tobacco product, with 17.6% using cigarettes, and 2.9% using Platform 1 in the first half of year 2 (n=2,394). During the same periods, we obrserved that only a small fraction of Platform 1 user initiated tobacco with Platform 1 (1.3% and 1.6% (year 1 and 2 respectively). In addition the proportion of former smokers (> 2 years cessation) that re-initiated tobacco with Platform 1 was negligible in the samples (0.1% year 1 and 0.0% in year 2). Further the Platform 1 user sample supported that the majority of Platform 1 users are transitioning to Platform 1 from other TNPs (98% year 1 n=2,000 and 98.6% year 2 n=994).

Conclusion 
The survey shows a fairly stable tobacco use prevalence, with the majority of Platform 1 users transitioning from other tobacco products, primarily cigarettes. Uptake by non-tobacco users, initiation, or re-initiation of tobacco use with Platform 1 was minimal.