Korean National Health Insurance screening records for 7,260,125 adults across three biennial rounds from 2019 to 2023 were used to model transitions between combustible cigarettes, heated tobacco products and e-cigarettes. Current users of heated tobacco or e-cigarettes had higher odds of cigarette cessation but also of initiation and relapse, and lower odds of discontinuing all tobacco, and more than 70% of dual users of cigarettes and heated tobacco moved to cigarette-only use.
Why it is interesting: Associations run towards cessation and towards initiation and relapse in the same cohort, and the authors describe the net public health impact as uncertain.