2.1. Data Collection

During 45–90-min semi-structured interviews, we invited participants to unbox and explore an IQOS device, tobacco sticks (with and without menthol), accessories, and marketing materials (Figure 1) for 10–15-min. Participants opened, touched, assembled, and smelled the product. We did not allow them to smoke IQOS. While unboxing, we encouraged participants to “think aloud” by narrating their impressions of and opinions about each component and the whole system, including their tactile, visual, and aromatic sensations. After the unboxing activity, we debriefed participants thoroughly about the lack of scientific evidence on the health risks of HTPs [23,24]. Each participant completed a questionnaire about their sociodemographic, behavioral, and health information prior to the interview and received a gift card for participation. The unboxing was audio and video-recorded and professionally transcribed. This research protocol was approved by the University of California, San Francisco’s Institutional Review Board (IRB number: #11-06516).

IQOS products and marketing materials used in the study. (A) IQOS 2.4 device (same as the one available in the US at time of publication): charger (left) and holder (right) in the box; (B) IQOS Quick Start Guide, (C) Tobacco sticks (HEETS; Left: Canada, “Red”; Right: Korea, “Green Label”, warning label reads “danger of addiction” and “e-cigarettes cause nicotine addiction” and lists a Quitline number); (D) other marketing materials (Left: IQOS device brochure; Right: HEETS brochure). The device brochure includes claims of “cutting edge technology”, “a better choice”, “heat not burn”, and “no smoke” (e.g., “no smoke: IQOS leaves no smoke smell on you and around you”). The HEETS brochure describes five different blends (e.g., “Elm” and “Birch”) using metrics on “aroma”, “body”, and “taste” and promotes “finding your perfect flavor”. Menthol HEETS were acquired in Korea; all other products were acquired in Vancouver, BC, Canada.