Odor Reduction Drives Transition to Heat-Not-Burn Tobacco Products in Poland

BACKGROUND The World Health Organization has identified tobacco smoking as a major global health crisis, responsible for over 8 million deaths annually and posing significant public health, social, and economic challenges. In response, harm reduction strategies, including the use of heated tobacco products (HnB), have gained attention as potential tools to mitigate the adverse health effects of smoking by offering less harmful alternatives to conventional cigarettes. The aim of this study was to identify the most important decision-making factors for using heat-not-burn (HnB) products among the adult smoker population in Poland. MATERIAL AND METHODS We conducted 35 semi-structured interviews (qualitative study) with Polish HnB and non-HnB users aged 18-64 years (males and females). RESULTS There are 2 main factors to switch from to HnB: 1) willingness to eliminate the characteristic odor of conventional cigarettes (CC), resulting in greater comfort for both the users themselves and those around them, and 2) neutralizing the effects of CC smoking and improving health. The study showed that some participants considered HnB to be fashionable and novel products that appeal to those open to novelties and new technologies. It also revealed a new trend of self-identification among those who consciously choose CC and defined themselves as "traditionalists". CONCLUSIONS Reduction of the characteristic odor is the main reason for transitioning from CC to HnB products and is more often cited than health-related issues. HnB users want to continue HnB because they believe it is a much better alternative than smoking CC. Future research should consider the impact on the social acceptance of HnB products, especially in the context of the perceived comfort related to eliminating the odor of conventional cigarettes. This could be an important aspect to analyze within the broader context of public health and social acceptance.