Purpose: This study examined nicotine dependence levels among heated tobacco product (HTP) users and identified associated factors. Methods: This cross-sectional study conducted a secondary analysis of data from 186 HTP users, drawn from 286 adults recruited via convenience sampling through an online survey. Nicotine dependence was measured using the Fagerström Test for Nicotine Dependence (high ≥6, low ≤5). Group differences were examined using χ² tests, and associated factors were identified via logistic regression. Results: The mean nicotine dependence score was 2.98±2.40, with 15.6% classified as highly dependent. High dependence was more prevalent in participants with no intention to quit (30.3%) than in those with a quit plan (7.5%) (χ²=16.82, p<.001). Regarding usage, 48.3% of those using ≥20 HTPs per day showed high dependence, compared to 10.9% (1~10 HTPs per day) and 3.4% (11~19 HTPs per day) (χ²=28.90, p<.001). Logistic regression showed that having no intention to quit (OR=4.31, 95% CI=1.61~11.49) and using ≥20 HTPs per day (OR=6.36, 95% CI=1.84~21.99) were significantly associated with high dependence. Conclusion: Higher HTP use was associated with greater nicotine dependence and may be linked to continued smoking. Efforts to improve users' risk perceptions of HTPs are therefore needed.

https://doi.org/10.12934/jkpmhn.2026.35.2.163