Introduction: Over the last few decades in Italy we observed a substantial reduction in conventional tobacco cigarette consumption, the introduction of electronic cigarettes (e-cigarette) in 2010, and the launch of heated tobacco products (HTP) in 2015.
Methods: We investigated novel products, i.e., e-cigarettes and HTP, use in Italy in 2018-2020 using data from the cross-sectional annual PASSI survey conducted in representative samples of adults aged 18-69 (overall n=79,529). We compared characteristics of conventional cigarette smokers with those of novel product users.
Results: A stall in e-cigarette use at around 2.5% and a three-fold increase in HTP use from 0.5% in 2018 to 1.5% in 2020 were recorded, with around 60% of e-cigarette or HTP users who kept on smoking conventional cigarettes. Around 90% of smokers did not use novel products at all. Novel products use among former smokers was more likely in younger e-cigarette users, whereas older users of both novel products were less able to completely shift to an exclusive use.
Conclusions: After 10 years from the introduction of e-cigarettes and 5 years from that of HTP, the majority of smokers in Italy were still loyal to conventional tobacco cigarettes, and more than half of novel product users kept on smoking conventional cigarettes.