Introduction:
Independent studies assessing the perceived health effects of heated tobacco product (HTP) use are still scarce. Patterns of HTP use may impact on perceived health improvements (HIs) and adverse events (AEs) related to HTP use. The objective of this study is to explore AEs and HIs experienced by current exclusive HTP users and current dual/poly-users (concurrent users of a HTP and combustible cigarettes and/or an e-cigarette) since they started using an HTP.

Material and Methods:
A cross-sectional, web-based survey was conducted among Hungarian adult current HTP users in 2020. Out of 14 AEs and changes in physiological functions listed with yes/no response options, participants (n=1138, 36.6% males) self-reported their experienced symptoms since they started using HTPs. Distribution of each listed symptom and reporting any AEs or HIs were analyzed.

Results:
Exclusive HTP users (78.9%) experienced any HIs more likely than dual/poly-users (89.0% vs 63.8%, respectively, OR=4.59, 95%CI=3.28–6.42), while reporting any AEs did not differed significantly among them (64.9% vs 62.1%, respectively, OR=1.13, 95%CI=0.92–1.34). More than half of exclusive HTP users reported improvements in morning cough, breathing, smell, physical status in general, and tooth discoloration (72.5%–50.2%), while dual/poly-users significantly less likely did so. Almost half of the sample experienced sore/dry mouth and throat. Reporting AEs like cough (31.7%) or burning, scratchy feeling in the mouth, lips, and throat (26.3) were significantly more likely among dual/poly-users than exclusive HTP users (15.6% and 16.3%, respectively, p<.001). In comparison, exclusive HTP users experienced gingivitis and gum bleeding more likely than dual/poly-users (11.9% vs 5.4%, p=.004).

Conclusions:
Our results highlight that some exclusive HTP users may experience more beneficial health effects of switching completely from smoking to HTP use than dual/poly-users. However, none of the use patterns is without health risks.