Tobacco Use, Perceptions, and Characteristics of Adults Who Use IQOS® in the United States: Findings from a Cross-Sectional Study

Abstract Background The smoke-free heated tobacco product IQOS ® was introduced in the United States (US) in 2019 and authorized by the US Food and Drug Administration as a modified risk tobacco product (MRTP) in 2020. The aim of this study was to describe selected sociodemographic characteristics of adults who used IQOS ® (AUI), tobacco use patterns relevant to IQOS ® use (e.g., tobacco use history, exclusive and dual-use, switching from cigarette smoking, etc.), risk perceptions of IQOS ®, and understanding of IQOS ® MRTP messages among AUI. Methods The IQOS® cross-sectional Postmarket Adult Consumer Study was a study of AUI aged ≥ 21 years who were recruited from an IQOS ® consumer database via direct mail and emails. Participants completed the online survey between September and November 2021. Results The survey was completed by 645 current and 43 former AUI who had used at least 100 Marlboro® HeatSticks ® prior to the assessment. Of the 688 participants, 61% were male, 73% were non-Hispanic white, and the mean age was 45. The vast majority (99%) of AUI had ever smoked combusted cigarettes before first trying IQOS ®. At the time of assessment, 49% were still smoking after an average of 1 year of IQOS ® use. Among those, 83.6% smoked fewer cigarettes compared to before first trying IQOS ®. Among all AUI, over 80% had never used a cessation treatment or had not used it in the past 12 months. Approximately 80% of AUI demonstrated correct understanding of the MRTP message. Conclusions This study is the first to provide evidence that IQOS ® can help adult smokers in the US completely switch away from cigarettes or reduce smoking.