PMI’s IQOS is the most commonly sold heated tobacco product. The battery operated smokeless alternative to combustible cigarettes, works by heating sticks containing tobacco leaves. These refills which look like short cigarettes, must be inserted into the main device and are heated up once the product is switched on.
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Similarly, a 2018 study conducted by renowned anti-smoking expert Dr Konstantinos Farsalinos had analyzed and compared carbonyl emissions from an HnB device (using iQOS), an e-cigarette and a regular cigarette.
Compared with the tobacco cigarettes, levels for HnB devices were found to be 91.6% lower for formaldehyde, 84.9% lower for acetaldehyde, 90.6% lower for acrolein, 89.0% lower for propionaldehyde and 95.3% lower for crotonaldehyde.
The determinants of use
Meanwhile, the current study aimed to identify the determinants or reasons as to why smokers and/or ex-smokers start using, continue or discontinue the use of IQOS. The researchers identified six main factors:
“Six main factors influenced initiation and use of IQOS:
(1) Health—wanting to reduce/quit smoking and perceptions of reduced harm (while understanding IQOS was not risk-free). Branded packaging, absence of pictorial warnings and physical health improvements conveyed reduced harm.
(2) Financial—including high start-up costs, but cheaper ongoing costs than smoking.
(3) Physical—mixed views on enjoyment and satisfaction. Sensory experiences influenced use including discreetness, cleanliness, reduced smell and tactile similarities relative to combustible cigarettes.
(4) Practical—issues of accessibility, shortcomings with maintenance/operation limited ongoing use, whereas use in smoke-free places increased use.
(5) Psychological—similarities in rituals and routines, although new practices developed to charge and clean; some liked trailblazing new technology.
(6) Social—improved social interactions from using IQOS instead of smoking, but with more limited shared social experiences for some.”
Multiple factors influence use behavior
In light of these findings, the study authors concluded that while some switched to IQOS to reduce or quit smoking, factors such as packaging, labeling, risk communication, price and smoke-free policies, all seem to have a significant influence on initiation and use.