BACKGROUND: As the smoking cessation rate of combustible cigarette (CC) users increases in South Korea, heated tobacco products (HTPs) are being promoted as less harmful alternatives and targeted at current CC smokers. However, the introduction of HTPs presents a new temptation for former CC smokers, potentially weakening their ability to sustain complete smoking cessation (abstinence from both CCs and HTPs) even after a prolonged CC cessation period. This trend poses significant challenges to long-term cessation efforts. This study aims to analyze the prevalence and risks of HTP current use among former CC smokers based on their cessation duration.
METHODS: We used data from the Korea National Health and Nutrition Examination Survey (2019–2023) involving participants aged 19+ who answered HTP and CC ever-use questions. CC quit periods were categorized into pre- and post-2017 groups, as HTPs were first introduced in Korea in 2017. The latter were divided into subgroups by quit duration: 1, 6, 12, and 24 months. Weighted univariate and multivariate logistic regression analyses were conducted.
RESULTS: The prevalence of current HTP use among former CC smokers increased from 6.9% in 2019 to 9.8% in 2023. Among former CC smokers, the prevalence of HTP use was 11.6% for those who quit smoking for 0–1 month and 27.5% for those who quit for 12–24 months. Among the post-2017 group, individuals who quit CC smoking for 12–24 months had the highest OR for current HTP use (OR = 2.12, 95% CI: 1.53–2.84), followed by those who quit for 6–12 months (OR = 1.73, 95% CI: 1.17–2.57).
CONCLUSIONS: CC Former smokers are experiencing an increasing prevalence of HTP use, alongside a growing risk of HTP use, even after a prolonged cessation period. Targeted interventions and continued surveillance are necessary to address the increasing HTP use among this population.