Shifts in motivation to quit cigarette smoking associated with IQOS use

IQOS, a heated tobacco product (HTP), is among a growing number of noncombustible nicotine delivery alternatives marketed to people who smoke combustible cigarettes and are interested in less harmful alternatives. Little is known regarding whether IQOS use and IQOS-associated effects impact motivation to quit cigarette smoking.

Non-treatment-seeking adult daily smokers (n = 87) completed a within-subjects study consisting of a baseline ad-lib smoking period (days 1-5), two laboratory visits (days 6-7) involving IQOS exposure, and a two-week period where participants were instructed to switch from smoking cigarettes to using IQOS (days 8-21). Motivation to quit smoking was measured on days 1 and 22.

A generalized linear model revealed a significant increase in motivation to quit smoking across the 14-day switch phase with an increase of 1.47 ladder steps (Δ=1.47, sd = 1.98, t(86) = 6.92, p < 0.0001), increasing from 5.30 to 6.80. Candidate predictors were identified through a stepwise selection procedure, which resulted in a final model with two predictors, the standardized HeatStick substitution rate (b = 0.54, (CI95% 0.13-0.95), p = 0.01) and standardized relative risk perception score (b = 0.45, (CI95% 0.04-0.85) p = 0.03), CONCLUSIONS: Among those uninterested in quitting cigarette smoking within the next month, IQOS use was associated with increased motivation to quit. Motivation to quit smoking may not be a necessary prerequisite for promoting smoking behavior change but rather bolstered by smoking behavior change in the context of HTP use. Greater perceptions of risk reduction may ultimately aid the transition from combustible to noncombustible tobacco products.