Awareness and Ever Use of “Heat-Not-Burn” Tobacco Products Among U.S. Adults, 2017


      Heated tobacco products, sometimes marketed as “heat-not-burn” technology, represent a diverse class of products that heat leaf tobacco to produce an inhaled aerosol. Global sales of heated tobacco products are increasing; however, the extent of current heated tobacco product awareness and use in the U.S. is unknown. This study assessed awareness and ever use of heated tobacco products among U.S. adults.


      Data were obtained from the 2017 SummerStyles, an Internet survey of U.S. adults aged ≥18 years (N=4,107). Respondents were given a description of heated tobacco products, then asked about awareness and ever use. In 2017, descriptive statistics were calculated overall and by sex, age, race/ethnicity, and cigarette smoking status. Logistic regression was used to calculate AORs.


      In 2017, a total of 5.2% of U.S. adults were aware of heated tobacco products, including 9.9% of current cigarette smokers. Overall, 0.7% of U.S. adults, including 2.7% of current smokers, reported ever use of heated tobacco products. Odds of ever use were higher among current smokers (AOR=6.18) than never smokers, and higher among adults aged <30 years (AOR=3.35) than those aged ≥30 years.


      As of July 2017, few U.S. adults had ever used heated tobacco products; however, about one in 20 were aware of the products, including one in ten cigarette smokers. The uncertain impact of heated tobacco products on individual- and population-level health warrants timely and accurate public health surveillance. These first estimates among U.S. adults can serve as a key baseline measure.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Caputi T.L.
        Heat-not-burn tobacco products are about to reach their boiling point.
        Tob Control. 2017; 26: 609-610
        • Caputi T.L.
        • Leas E.
        • Dredze M.
        • Cohen J.E.
        • Ayers J.W.
        They’re heating up: Internet search query trends reveal significant public interest in heat-not-burn tobacco products.
        PLoS One. 2017; 12: e0185735
        • Tabuchi T.
        • Gallus S.
        • Shinozaki T.
        • et al.
        Heat-not-burn tobacco product use in Japan: its prevalence, predictors and perceived symptoms from exposure to secondhand heat-not-burn tobacco aerosol. Tob Control.
        In press. Online December 16. 2017;
      1. Kress M. Is heat-not-burn the next big thing in tobacco? Convenience Store News. October 30, 2017. Accessed November 2, 2017.

        • Auer R.
        • Concha-Lozano N.
        • Jacot-Sadowski I.
        • Cornuz J.
        • Berthet A.
        Heat-not-burn tobacco cigarettes: smoke by any other name.
        JAMA Intern Med. 2017; 177: 1050-1052
      2. GFK. KnowledgePanel® Design Summary.

      3. U.S. Census Bureau. Current Population Survey (CPS). Accessed November 21, 2017.

      4. Wells Fargo Securities LLC.
        Equity Research: Philip Morris International Inc. 2018; (February 8)
        • King B.A.
        • Alam S.
        • Promoff G.
        • Arrazola R.
        • Dube S.R.
        Awareness and ever use of electronic cigarettes among U.S. adults, 2010–2011.
        Nicotine Tob Res. 2013; 15: 1623-1627
        • Regan A.K.
        • Promoff G.
        • Dube S.R.
        • Arrazola R.
        Electronic nicotine delivery systems: Adult use and awareness of the “e-cigarette” in the USA.
        Tob Control. 2013; 22: 19-23
        • HHS.
        The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General.
        CDC, Atlanta, GA2014
        • Schaller J.P.
        • Keller D.
        • Poget L.
        • et al.
        Evaluation of the tobacco heating system 2.2, part 2: Chemical composition, genotoxicity, cytotoxicity, and physical properties of the aerosol.
        Regul Toxicol Pharmacol. 2016; 81: S27-S47
        • Maeder S.
        • Peitsch M.C.
        Perplexing conclusions concerning heat-not-burn tobacco cigarettes.
        JAMA Intern Med. 2017; 177: 1698-1699
        • O’Connell G.
        • Wilkinson P.
        • Burseg K.M.
        • Stotesbury S.J.
        • Pritchard J.D.
        Heated tobacco products create side-stream emissions: implications for regulation.
        J Environ Anal Chem. 2015; 2: 163
        • HHS
        E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.
        CDC, Atlanta, GA2016