Introduction: The adoption of heated tobacco products (HTPs) has grown as smokers transition away from conventional cigarettes for harm reduction. However, the impact of HTP use on smoking behaviours remains unclear.
Methods: We analysed data from 8890 records of smokers seeking smoking cessation therapy (SCT) between 2014 and 2019 using the Japan Medical Data Center claims database. September 2015, when the HTP 'IQOS' was launched in 12 major prefectures in Japan, marked the first dissemination phase of HTP. April 2016, when IQOS became available nationwide, marked the second phase. Interrupted time series analysis was applied to evaluate changes in SCT uptake rates across these phases.
Results: Following the first dissemination phase, there was a significant immediate decrease in SCT uptake (-0.21%, 95% CI: -0.41% to -0.16%, p=0.035), followed by a further significant reduction after the second phase (-0.26%, 95% CI: -0.48% to -0.10%, p=0.008). Additionally, the slope of SCT uptakes was significantly decreased after the second phase (-0.007% per month, 95% CI: -0.012 to -0.02, p=0.008).
Conclusions: Our study showed that SCT uptake decreased sharply when HTPs were disseminated to all prefectures in Japan, and this downward trend continued thereafter. These findings are considered to result from the widespread adoption of HTP in the Japanese market, as these products were perceived to be less harmful than traditional cigarettes. Therefore, it is worrying that the widespread availability of HTP resulted in reduced smoking cessation behaviour among cigarette users.
Keywords: Cessation; Electronic nicotine delivery devices; Non-cigarette tobacco products.
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