5. It’s not what you’d term normal smoking’: A qualitative exploration of HTP user identity
Tobacco and nicotine marketplaces have diversified substantially over the past decade, including with the introduction of Heated Tobacco Products (HTPs) such as IQOS. HTP nomenclature is lacking, and how HTP users define and identify themselves remains understudied. This study aims to explore users’ language choice when describing HTP and IQOS use, and how language relates to user identity.
Method: Qualitative interviews in London, UK, with 30 adult current and former IQOS users.
Overall, participants expressed confusion and a lack of suitable terminology for how to describe IQOS use. Verbs such as ‘heating’ and ‘IQOSing’ were rarely endorsed. Most often, participants reverted to ‘smoking’ when describing IQOS use and commonly referred to HEETS (tobacco sticks) as ‘cigarettes.’ Yet, the lack of combustion, electronic device, ‘cleaner’ experience, and perceived reductions in health risks led some to frame IQOS as distinct from smoking. ‘Vaping’ was generally considered inappropriate for describing IQOS use. Participants also manipulated language to suit their circumstances and manage their identity: while some IQOS users embraced the terms ‘smoking’ and ‘smoker,’ most were eager to distinguish between using IQOS and being labelled ‘a smoker’ due to the associated negative connotations of being a smoker and to align with theirs and others’ perceptions of IQOS use as a ‘better’, less harmful behaviour. Instead, when describing their identity, IQOS users more willingly identified as ‘vapers,’ ‘exsmokers,’ or created new identities (e.g., ‘HEET user’).
There was great ambiguity around HTP terminology, with participants commonly referring to HTP use as ‘smoking’ for lack of a more suitable term but being eager to distinguish from being labelled as ‘smokers.’ Further work is required to understand how HTP user identity impacts smoking cessation and abstinence. Researchers and healthcare professionals should also use clear terminology when asking people to report their cigarette smoking, e-cigarette vaping, and HTP use.