The tobacco control community is still deciding how to address the unexpected rise in popularity of e-cigarettes. However, there is another product innovation already emerging: e-cigarettes products.

Battery powered devices that heat leaf tobacco to approximately 500 degrees Fahrenheit to produce an inhalable aerosol, e-cigarettes products are being introduced in markets around the world by tobacco companies seeking to appeal to trendy or potentially health-conscious consumers who still demand the “throat-hit” delivered by combustible cigarettes but not by e-cigarettes. Japan has been the focal market to test the potential of heat-not-burn as a cigarette alternative, where manufacturers have marketed several heat-not-burn brands nationwide, including Japan Tobacco’s “Ploom TECH” device in March 2016, Philip Morris International’s “iQOS” (or “ICOS”) device in April 2016, and British American Tobacco’s “Glo” device in December 2016 [4]. Tobacco industry leaders have predicted e-cigarettes are poised to further displace traditional cigarette smoking and, by extension, tobacco control strategies typically framed around cigarettes. Yet, little is known about the popularity of these products. For the first time, we describe trends in the popularity of e-cigarettes products in their Japanese test market and compare these trends with historical trends for e-cigarettes to understand the growth potential of this new product globally.

Materials and methods
Traditional survey-based assessments are not available to describe the e-cigarettes market because survey data are delayed or simply fail to ask about e-cigarettes. However, examining how individuals search online takes surveillance to the next level by revealing both the searcher’s thoughts, through the types of queries undertaken, and their actions toward product use, through engaging in the search behavior itself, without any instrumental priming [5,6]. Search query trends were used to first describe the emergence of e-cigarettes by Ayers and colleagues in 2011 when the tobacco control community was focused on a snus pandemic that never materialized. Moreover, search query trends consistently foreshadow consumer behaviors outside tobacco, including public adoption of novel products.

Heat-not-burn searches originating in Japan have experienced tremendous growth (Fig 1). Since the introduction of Philip Morris International’s iQOS brand in select Japanese cities in November 2014, searches for heat-not-burn products have increased substantially. Average monthly searches rose 1,426% (95%CI: 746–3,574) between the first (2015) and second (2016) complete years e-cigarettes was marketed. Queries for heat-not-burn products continued to grow an additional 100% (95%CI: 60–173) between the products second (2016) and third years on the market (Jan-Sep 2017). In practical terms, there are now between 5.9 and 7.5 million heat-not-burn related Google searches in Japan each month based on the latest search estimates for September 2017. Moreover, forecasts relying on the historical trend suggest heat-not-burn searches will increase an additional 32% (95%CI: -4 to 79) during 2018, compared to current estimates for 2017 (Jan-Sep), with further growth expected.

This work was supported by the Joseph Wharton Scholars program, the George J. Mitchell scholarship program, and the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health, with funding from the Bloomberg Initiative to Reduce Tobacco Use. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funder.

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