Patterns of heated tobacco product use and biochemically verified smoking status among customers of dedicated heated tobacco product stores.

To understand the population impact of heated tobacco products (HTPs), examining the profile of their users is crucial. This study aimed to assess characteristics, patterns of HTP use, and biochemically verified smoking status of customers visiting specialized HTP stores in Greece. Two specialized stores selling IQOS HTPs were randomly selected in Athens. Researchers recruited consecutive adult customers purchasing products for personal use during store visits. Current smoking status was determined by measuring exhaled carbon monoxide (eCO), with ≥ 7 ppm classifying participants as current smokers. A questionnaire explored demographics, past and current smoking history, HTP use patterns, and dependence indicators. A total of 373 HTP users participated. The vast majority (98.1%) had a smoking history prior to HTP initiation. Former smokers represented 67.8% of the study sample, defined based on self-report and having eCO < 7 ppm, with 90.1% of them reporting they had quit with the use of HTPs. Current smokers represented 30.3% of the sample and reported a 50% median reduction in daily cigarette consumption post-HTP use initiation. Never-smokers represented 1.9% of the sample, all of whom had eCO ≤ 3 ppm. Daily HTP use was the predominant pattern of use in both groups, but was more prevalent among former smokers. Most participants perceived HTPs as less harmful than cigarettes. From logistic regression analysis, factors associated with being a former smoker were HTP use duration (OR: 1.06, 95% CI 1.02-1.09) and daily HTP use (OR: 6.93, 95% CI 1.93-24.92). Customers of specialized HTP stores in Greece were predominantly individuals with a history of smoking. A substantial proportion was biochemically verified former smokers and reported they had quit with the help of HTPs. Use by never-smokers was rare in this retail setting, and did not lead to subsequent smoking.