Level of tobacco dependence and beliefs towards heated tobacco products

Abstract Nicotine dependence affects not only behaviors related directly to smoking, quit attempts or looking for alternative products but also beliefs about smoking. We sought to assess whether the level of tobacco dependence is associated with beliefs and feelings towards heated tobacco products (HTP) and to assess the relationship between tobacco dependence and the motivators to quit HTP use. Random population sample of Polish citizens aged 18+ years, former smokers, current HTP users was recruited. Tobacco dependence was assessed using 5 question; participants were classified into two groups of tobacco dependence (low or high) using a two-stage cluster analysis. An extensive questionnaire on beliefs on HTP use was administered. The χ2 test and logistic regression were used. There were 2,500 participants (62.6% women) of median age=36 years (Q1=29, Q3=45). The median number of years of smoking was 10 (Q1=5, Q3=15) and median number of years of HTP use was 2 (Q1=1, Q3=3). High tobacco dependence was found in 958 (38,3%) participants. Compared to low dependence, high tobacco dependence was related with feeling of strong need for HTP use (69.7% vs. 47.6%, p < 0,001). High level of tobacco dependence was positively related to perceived social pressure against smoking (72.9% vs. 44.9%, p < 0,001), but it did not differentiate perceived social pressure against HTP use. Compared to low tobacco dependence, participants with high tobacco dependence more often indicated fear of illness OR = 1,73 95%CI=1,46-2,07, own resolution OR = 1,32 95%CI =1,12-1,55 and price OR = 1,34 95%CI=1,13-1,59 as possible motivators to quit HTP use. Level of tobacco dependence in former smokers shaped beliefs and feelings towards HTP use. High tobacco dependence contributed to strong need to use HTP and also increased perception of social pressure against smoking, but not against using HTP. It also increased the importance of fear of illness, price and one’s own resolution as motivators to quit HTP use. Key messages • High level of tobacco dependence in former smokers results in stronger perceived social pressure against smoking but not against HTP use. • High tobacco dependence in former smokers is related with stronger need to use HTP.