Nicotine Dependence and Associated Factors among Heated Tobacco Product Users: A Secondary Data Analysis

Purpose: This study examined nicotine dependence levels among heated tobacco product (HTP) users and identifiedassociated factors. Methods: This cross-sectional study conducted a secondary analysis of data from 186 HTP users,drawn from 286 adults recruited via convenience sampling through an online survey. Nicotine dependence wasmeasured using the Fagerström Test for Nicotine Dependence (high ≥6, low ≤5). Group differences were examinedusing x2 tests, and associated factors were identified via logistic regression. Results: The mean nicotine dependencescore was 2.98±2.40, with 15.6% classified as highly dependent. High dependence was more prevalent inparticipants with no intention to quit (30.3%) than in those with a quit plan (7.5%) (x2=16.82, p<.001). Regardingusage, 48.3% of those using ≥20 HTPs per day showed high dependence, compared to 10.9% (1~10 HTPs perday) and 3.4% (11~19 HTPs per day) (x2=28.90, p<.001). Logistic regression showed that having no intention toquit (OR=4.31, 95% CI=1.61~11.49) and using ≥20 HTPs per day (OR=6.36, 95% CI=1.84~21.99) were significantlyassociated with high dependence. Conclusion: Higher HTP use was associated with greater nicotine dependenceand may be linked to continued smoking. Efforts to improve users' risk perceptions of HTPs are therefore needed.