Impact of exposures to Heated Tobacco Products in the media and through social connections on product perceptions and use

Lorien C. Abroms*, Zongshuan Duan, Yael Bar-Zeev, Yuxian Cui, Yan Wang, Cassidy R. LoParco, Amal Khayat, Hagai Levine, Carla J. Berg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


INTRODUCTION Little is known about media exposures to heated tobacco products (HTPs). In this study, we examined sources of HTP exposure, including from paid and unpaid media and social connections, in relation to HTP use and use intentions. METHODS In the fall of 2021, we conducted a cross-sectional survey among adult online panelists (aged 18–45 years) in the US and Israel, oversampling tobacco users. The current study analyzed data from participants who responded to the question about HTP awareness or use (n=2061). Multivariable linear and logistic regression analyses examined the relationship between sources of HTP exposure, HTP use, and use intentions. RESULTS Among those aware of HTPs, both Israelis and Americans reported past-month HTP media exposure via advertisements (58.2% vs 48.0%), non-advertisement sources (49.7% vs 30.7%), and social connections (51.5% vs 33.6%), respectively. Factors associated with HTP awareness (n=677/2061; 32.9%) included media use frequency (AOR=1.13; 95% CI: 1.01–1.28) and social connections using HTPs (AOR=2.45; 95% CI: 1.92–3.15). Among those aware of HTPs, past-month HTP exposure via digital media advertisements (AOR=2.06; 95% CI: 1.09–3.91) and non-advertising promotion via radio, podcast, movie, television or theatre (AOR=2.30; 95% CI: 1.19–4.44) and websites (AOR=2.36; 95% CI: 1.32–4.21) were associated with current HTP use. Exposure to digital media advertisements (β=0.35; 95% CI: 0.07–0.62) and non-advertising promotion via social media (β=0.62; 95% CI: 0.34–0.91) were correlated with higher use intentions. Having social connections using HTPs was correlated with higher use (AOR=2.21; 95% CI: 1.19–4.11) and intentions (β=0.66; 95% CI: 0.42–0.91). No significant differences were found across countries. CONCLUSIONS Digital media (e.g. online, social media) were particularly salient correlates of HTP intentions and use. Future studies are needed that further examine media exposures to these products, as well as that examine possible regulations to limit HTP promotion via these channels.

Original languageEnglish
Article number20
JournalTobacco Prevention and Cessation
Issue numberMay
StatePublished - 2024

Bibliographical note

Publisher Copyright:
Published by European Publishing on behalf of the European Network for Smoking and Tobacco Prevention (ENSP). © 2024 Abroms L. C. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License. (


  • advertising
  • heated tobacco product
  • IQOS
  • media
  • promotions
  • tobacco


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