The heated tobacco market has become increasingly competitive, requiring companies to strengthen their brands and better understand consumer behavior to influence purchase decisions. As a premium heated tobacco product, IQOS offers an alternative smoking experience through its heat-not-burn technology. However, preliminary observations indicated that consumer awareness, brand associations, perceptions, and purchase decisions toward IQOS in Medan City were still relatively low. This study aims to analyze the influence of brand awareness and brand association on purchase decisions, with consumer perception serving as an intervening variable. A quantitative research approach was employed using a survey of 160 respondents consisting of active smokers aged 21 years and above who had used or were familiar with IQOS products in Medan City. Data were analyzed using Structural Equation Modeling based on Partial Least Squares (SEM-PLS). The results reveal that brand awareness, brand association, and consumer perception have positive and significant effects on purchase decisions. Furthermore, brand awareness and brand association significantly influence consumer perception. Consumer perception was also found to partially mediate the relationships between brand awareness and purchase decisions as well as between brand association and purchase decisions. These findings indicate that stronger brand recognition and favorable brand associations contribute to more positive consumer perceptions, which in turn enhance the likelihood of purchase. The study contributes to the brand equity and consumer behavior literature by providing empirical evidence that consumer perception serves as an important mechanism linking brand-related factors to purchase decisions in the context of heated tobacco products, particularly IQOS in Medan City.