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Objectives: Heated tobacco products (such as IQOS) and e-cigarettes have been introduced and advertised in a variety of ways despite inconclusive evidence regarding their safety and benefit for smoking cessation. In this study, we examine the awareness, use, and perceived risk of these products among recent smokers. Methods: In 2017, we conducted an online survey of 727 current and recent smokers in Ontario. We asked participants about their awareness, use, and perceived risk of heated tobacco products and e-cigarettes. Results: Among respondents, 10% were aware of heated tobacco products, and 3% had ever used them. Compared to non-ecigarette users, e-cigarette users were more likely to agree with statements that heated tobacco is less harmful than regular cigarettes, e-cigarette use is less harmful than regular cigarettes, and both products can help smokers stop smoking regular cigarettes. Conclusions: Respondents who used e-cigarettes were more likely to have positive perceptions about heated tobacco and may be more susceptible to the marketing of these products. It is important to monitor the use of multiple nicotine products to inform policies and programming for these products. [ABSTRACT FROM AUTHOR]

Background Tobacco and non-tobacco-based waterpipe smoking has increased exponentially in many countries in recent decades, particularly among youth and young adults. Although tobacco smoking is banned in many indoor public places, waterpipe smoking, ostensibly non-tobacco, continues in Ontario and other jurisdictions where only tobacco smoking is prohibited. This study assessed air quality and exposure in waterpipe cafes using multiple methods and markers. Methods Indoor (n=12) and outdoor (n=5) air quality was assessed in Toronto, Canada waterpipe cafes from 30 August to 11 October 2012. Real-time measurements of air nicotine, fine particulate matter less than 2.5 microns in diameter (PM2.5) and ambient carbon monoxide (CO) were collected in 2 h sessions. Levels of CO in breath were collected in non-smoking field staff before entering and upon leaving venues. Observations of occupant behaviour, environmental changes and venue characteristics were also recorded. Results In indoor venues, mean values were 1419 mg/m3 for PM2.5, 17.7 ppm for ambient CO, and 3.3 mg/m3 for air nicotine. Levels increased with increasing number of active waterpipes. On outdoor patios, mean values were 80.5 mg/m3 for PM2.5, 0.5 ppm for ambient CO, and 0.6 mg/m3 for air nicotine. Air quality levels in indoor waterpipe cafes are hazardous for human health. Outdoor waterpipe cafes showed less harmful particulate levels than indoors, but mean PM2.5 levels (80.5 mg/m3) were still ‘poor'. Conclusions Staff and patrons of waterpipe cafes are exposed to air quality levels considered hazardous to human health. Results support eliminating waterpipe smoking in hospitality venues indoors and out. [ABSTRACT FROM AUTHOR]