SELF-REPORTED HEALTH AND FUNCTIONING STATUS AFTER AT LEAST 2 YEARS OF TOBACCO HEATING SYSTEM USE VERSUS CIGARETTE SMOKING: A CROSS-SECTIONAL STUDY
Author(s)
Ioulia Barakou, PhD1, Thomas Salzberger, PhD2, Emilie Clerc, MA1, Esther F. Afolalu, PhD1.
1PMI R&D, Philip Morris Products S.A., Neuchâtel, Switzerland, 2WU WIEN (Vienna University of Economics and Business), Wien, Austria.
1PMI R&D, Philip Morris Products S.A., Neuchâtel, Switzerland, 2WU WIEN (Vienna University of Economics and Business), Wien, Austria.
OBJECTIVES: Switching from cigarettes to smoke‑free products (SFPs) has been shown to reduce exposure to harmful substances, which will reasonably likely improve health outcomes. While biomarkers support such improvements, less is known about how long‑term SFPs use impacts perceived health and functioning (HF). This study compared self-reported HF among Tobacco Heating System (THS) users, former, and current cigarette smokers. It assessed sensitivity of a tobacco- and nicotine-specific versus a generic HF instrument, and examined associations between HF, other self-reported outcomes, and biomarkers.
METHODS: Post‑hoc analyses of a cross‑sectional study included current cigarette smokers, THS users (≥2 years of use), and former cigarette smokers (≥2 years abstinent). Outcomes included selected Assessment of Behavioral Outcomes related to Tobacco and nicotine products (ABOUT)-HF domains (General Health; Breathing Difficulty; Coughing, Breathing, Lung Health (CBLH)), SF‑36 (physical and mental health (P&MH)), ABOUT‑Dependence, and Perceived Risk. Group differences were examined using ANOVA/Mann‑Whitney. F‑value ratios assessed discrimination of ABOUT‑HF versus SF‑36. Multiple regressions examined factors associated with perceived HF, and correlations assessed associations between perceived HF and biomarkers of exposure and lung function.
RESULTS: THS users (n=296) reported better perceived HF than current smokers (n=296) across ABOUT-HF General Health (F=34.6, p<0.001, d=0.48), Breathing Difficulty (F=17.4, p<0.001, d=0.34), and CBLH (F=47.8, p<0.001, d=0.57). THS users (p≤0.002) and former smokers (p≤0.004; n=295) reported more favorable SF‑36 P&MH than current smokers. ABOUT‑HF showed greater discrimination than SF‑36 (F‑ratios=1.55-4.89). Higher perceived health risk and dependence were negatively associated with perceived HF. Biomarker correlations were weak, but strongest for CBLH (FEV₁ r=0.171; COHb r=-0.230; NNAL r=-0.181).
CONCLUSIONS: Long‑term THS users reported better perception of their respiratory and general health than those who continued smoking, with findings directionally aligned with biomarkers. The findings highlight the value of a tobacco and nicotine‑specific instrument, with ABOUT‑HF demonstrating greater sensitivity than SF‑36 in detecting relevant perceived HF status differences.
METHODS: Post‑hoc analyses of a cross‑sectional study included current cigarette smokers, THS users (≥2 years of use), and former cigarette smokers (≥2 years abstinent). Outcomes included selected Assessment of Behavioral Outcomes related to Tobacco and nicotine products (ABOUT)-HF domains (General Health; Breathing Difficulty; Coughing, Breathing, Lung Health (CBLH)), SF‑36 (physical and mental health (P&MH)), ABOUT‑Dependence, and Perceived Risk. Group differences were examined using ANOVA/Mann‑Whitney. F‑value ratios assessed discrimination of ABOUT‑HF versus SF‑36. Multiple regressions examined factors associated with perceived HF, and correlations assessed associations between perceived HF and biomarkers of exposure and lung function.
RESULTS: THS users (n=296) reported better perceived HF than current smokers (n=296) across ABOUT-HF General Health (F=34.6, p<0.001, d=0.48), Breathing Difficulty (F=17.4, p<0.001, d=0.34), and CBLH (F=47.8, p<0.001, d=0.57). THS users (p≤0.002) and former smokers (p≤0.004; n=295) reported more favorable SF‑36 P&MH than current smokers. ABOUT‑HF showed greater discrimination than SF‑36 (F‑ratios=1.55-4.89). Higher perceived health risk and dependence were negatively associated with perceived HF. Biomarker correlations were weak, but strongest for CBLH (FEV₁ r=0.171; COHb r=-0.230; NNAL r=-0.181).
CONCLUSIONS: Long‑term THS users reported better perception of their respiratory and general health than those who continued smoking, with findings directionally aligned with biomarkers. The findings highlight the value of a tobacco and nicotine‑specific instrument, with ABOUT‑HF demonstrating greater sensitivity than SF‑36 in detecting relevant perceived HF status differences.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR228
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Mental Health (including addiction), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)