Heated tobacco product marketing: a mixed-methods study examining exposure and perceptions among US and Israeli adults

Authors

Yuxian Cui, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA.
Yael Bar-Zeev, Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, 7 Ramat Gan, Jerusalem, 9112102, Israel.
Hagai Levine, Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, 7 Ramat Gan, Jerusalem, 9112102, Israel.
Cassidy R. LoParco, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC 20052, USA.
Zongshuan Duan, School of Public Health, Georgia State University, 140 Decatur St. SE, Atlanta, GA 30303, USA.
Yan Wang, GW Cancer Center, George Washington University, 800 22nd Street NW, Washington, DC 20052, USA.
Lorien C. Abroms, GW Cancer Center, George Washington University, 800 22nd Street NW, Washington, DC 20052, USA.
Amal Khayat, Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, 7 Ramat Gan, Jerusalem, 9112102, Israel.
Carla J. Berg, GW Cancer Center, George Washington University, 800 22nd Street NW, Washington, DC 20052, USA.

Document Type

Journal Article

Publication Date

5-13-2024

Journal

Health education research

DOI

10.1093/her/cyae018

Abstract

The marketing of heated tobacco products (HTPs), like IQOS, influences consumers' perceptions. This mixed-methods study analyzed (i) survey data (2021) of 2222 US and Israeli adults comparing perceptions of 7 IQOS attributes (design, technology, colors, customization, flavors, cost and maintenance) and 10 marketing messages (e.g. 'Go smoke-free…') across tobacco use subgroups and (ii) qualitative interviews (n = 84) regarding IQOS perceptions. In initial bivariate analyses, those never using HTPs (86.2%) reported the least overall appeal; those currently using HTPs (7.7%) reported the greatest appeal. Notably, almost all (94.8%) currently using HTPs also currently used cigarettes (82.0%) and/or e-cigarettes (64.0%). Thus, multivariable linear regression accounted for current cigarette/e-cigarette use subgroup and HTP use separately; compared to neither cigarette/e-cigarette use (62.8%), cigarette/no e-cigarette use (17.1%) and e-cigarette/no cigarette use (6.5%), those with dual use (13.5%) indicated greater overall IQOS appeal (per composite index score); current HTP use was not associated. Qualitative data indicated varied perceptions regarding advantages (e.g. harm, addiction and complexity) of IQOS versus cigarettes and e-cigarettes, and perceived target markets included young people, those looking for cigarette alternatives and females. Given the perceived target markets and particular appeal to dual cigarette/e-cigarette use groups, IQOS marketing and population impact warrant ongoing monitoring to inform regulation.

APA Citation

Cui, Yuxian; Bar-Zeev, Yael; Levine, Hagai; LoParco, Cassidy R.; Duan, Zongshuan; Wang, Yan; Abroms, Lorien C.; Khayat, Amal; and Berg, Carla J., "Heated tobacco product marketing: a mixed-methods study examining exposure and perceptions among US and Israeli adults" (2024). GW Authored Works. Paper 4939.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4939

Department

Prevention and Community Health