{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T21:35:01Z","timestamp":1783460101291,"version":"3.55.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA215155"],"award-info":[{"award-number":["R01CA215155"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA278229"],"award-info":[{"award-number":["R01CA278229"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA275066"],"award-info":[{"award-number":["R01CA275066"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R21CA261884"],"award-info":[{"award-number":["R21CA261884"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA239178"],"award-info":[{"award-number":["R01CA239178"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["R01TW010664"],"award-info":[{"award-number":["R01TW010664"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Environmental Health Sciences\/Fogarty","award":["D43ES030927"],"award-info":[{"award-number":["D43ES030927"]}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA054751"],"award-info":[{"award-number":["R01DA054751"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Heated tobacco products (HTPs), like IQOS, are marketed as innovative, stylish, harm-reduction products distinct from cigarettes and e-cigarettes. Research is needed to better understand how adults who are newly introduced to HTPs perceive them relative to cigarettes and e-cigarettes, and the impact of these perceptions on use outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>We analyzed 2021 cross-sectional survey data from 1914 adults who never used HTPs from the United States and Israel, two countries where IQOS has unique histories and markets. Exploratory factor analysis examined perceptions of HTPs (vs. cigarettes and e-cigarettes) across 12 perception measures (eg, innovative, trendy, harmful, addictive). Multivariable linear regression examined these factors in relation to self-reported likelihood to: (1) \u201ctry HTPs in the next year\u201d (1\u2005=\u2005not\u20137\u2005=\u2005extremely) and (2) \u201csuggest IQOS to a friend who smokes cigarettes\u201d (1\u2005=\u2005not\u20135\u2005=\u2005very), controlling for demographics and past-month cigarette and e-cigarette use (10.1% dual use, 15.4% cigarette-only, 5.7% e-cigarette-only, 68.8% neither).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Four factors were identified: HTPs\u2019 health and utility (\u201chealth-utility\u201d) and design and appeal (\u201cdesign-appeal\u201d) versus cigarettes and versus e-cigarettes, separately. More favorable perceptions of HTP versus e-cigarette design-appeal (B\u2005=\u20050.30, 95% CI\u2005=\u20050.18, 0.41) were associated with greater likelihood to try HTPs. More favorable perceptions of HTP versus cigarette design-appeal (B\u2005=\u20050.38, 95% CI\u2005=\u20050.26, 0.51) and health-utility (B\u2005=\u20050.25, 95% CI\u2005=\u20050.13, 0.36), and HTP versus e-cigarette design-appeal (B\u2005=\u20050.32, 95% CI\u2005=\u20050.20, 0.45) were associated with greater likelihood to suggest HTPs to smokers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Monitoring perceptions of HTPs versus cigarettes and e-cigarettes is critical given the role of such perceptions in HTP use and their population-level impact.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>This study examined the relationship of perceptions of HTPs relative to cigarettes and e-cigarettes, with regard to adults\u2019 self-reported likelihood to use HTP or to suggest HTPs to those who smoke cigarettes. Favorable perceptions of HTPs\u2019 design and appeal versus e-cigarettes correlated with greater likelihood to try HTPs. Favorable perceptions of HTPs\u2019 design and appeal, as well as health and utility, versus cigarettes and e-cigarettes correlated with greater likelihood to suggest HTPs to those who smoke. Findings underscore the need for ongoing surveillance of HTP marketing and consumer perceptions to inform regulatory efforts and estimate the population-level impact of HTPs and other tobacco products.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntae093","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T19:49:14Z","timestamp":1714074554000},"page":"1394-1403","source":"Crossref","is-referenced-by-count":3,"title":["Perceptions of Heated Tobacco Products (HTPs) Versus Cigarettes and e-Cigarettes in Relation to Likelihood of Trying HTPs or Suggesting HTPs to Those who Smoke Cigarettes"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2598-1752","authenticated-orcid":false,"given":"Zongshuan","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences, School of Public Health, Georgia State University , Atlanta, GA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8931-1961","authenticated-orcid":false,"given":"Carla J","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University , Washington, DC , USA"},{"name":"George Washington Cancer Center, George Washington University , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1916-836X","authenticated-orcid":false,"given":"Yael","family":"Bar-Zeev","sequence":"additional","affiliation":[{"name":"Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center , Jerusalem , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorien C","family":"Abroms","sequence":"additional","affiliation":[{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University , Washington, DC , USA"},{"name":"George Washington Cancer Center, George Washington University , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University , Washington, DC , USA"},{"name":"George Washington Cancer Center, George Washington University , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0525-4889","authenticated-orcid":false,"given":"Amal","family":"Khayat","sequence":"additional","affiliation":[{"name":"Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center , Jerusalem , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxian","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassidy R","family":"LoParco","sequence":"additional","affiliation":[{"name":"Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University , Washington, DC , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5597-4916","authenticated-orcid":false,"given":"Hagai","family":"Levine","sequence":"additional","affiliation":[{"name":"Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center , Jerusalem , 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Philip Morris aims to launch IQOS in two US states in 2024","author":"Rumney"},{"issue":"1","key":"2024092305545041900_CIT0010","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13584-020-00384-3","article-title":"Historic tobacco legislation in Israel: a moment to celebrate","volume":"9","author":"Rosen","year":"2020","journal-title":"Israel J Health Policy Res."},{"key":"2024092305545041900_CIT0011","doi-asserted-by":"crossref","first-page":"s78","DOI":"10.1136\/tobaccocontrol-2018-054619","article-title":"IQOS campaign in Israel","volume":"27","author":"Rosen","year":"2018","journal-title":"Tob Control."},{"key":"2024092305545041900_CIT0012","doi-asserted-by":"crossref","first-page":"106337","DOI":"10.1016\/j.addbeh.2020.106337","article-title":"Adult perceptions of the relative harm of tobacco products and subsequent tobacco product use: longitudinal findings from waves 1 and 2 of the population assessment of tobacco and health (PATH) 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