Nicotine vaping product use, harm perception and policy support among pharmacy customers in Brisbane, Australia

Association of anxiety and depression symptoms with perceived health risk of nicotine vaping products for smoking cessation

As tobacco smoking prevalence is unacceptably high for the one in five Australians reporting a mental health condition in the past year, multiple cessation supports are needed to reduce tobacco-related disease. Nicotine vaping product (NVP)-facilitated smoking cessation is one option requiring a medical prescription in Australia. Yet, people easily obtain NVPs via non-prescription channels. As mental health impacts quitting intentions and health system engagement, this study examined how presence of anxiety and depression symptoms may be associated with perceived health risk of using NVPs from prescription or non-prescription sources for smoking cessation. We used cross-sectional South Australian (15 years +) 2022 survey data on vaping, smoking, anxiety, and depression. Robust linear regression was used to examine the association of anxiety and depression symptoms and nicotine addiction concern on perceived health risk of using NVPs from prescription or non-prescription sources. For prescription NVPs, vaping was associated with lower perceived health risk (b=-0.732). Higher perceived addiction risk was associated with higher perceived health risk from prescription NVPs (b=0.784). For non-prescription NVPs, vaping (b=-0.661) or smoking (b=-0.310) was associated with lower perceived health risk, and higher perceived addiction risk (b=0.733) was associated with a higher perceived health risk. Although anxiety and depression were not directly associated with NVP health risk perceptions, vaping while having depression symptoms was associated with higher perceived health risk ratings for prescription (b=0.700) but not non-prescription sources. People with depression who vape may see health risk barriers in NVP prescription access for smoking cessation, a smoking cessation support gap.

Noticing education campaigns or public health messages about vaping among youth in the United States, Canada and England from 2018 to 2022

Public health campaigns have the potential to correct vaping misperceptions. However, campaigns highlighting vaping harms to youth may increase misperceptions that vaping is equally/more harmful than smoking. Vaping campaigns have been implemented in the United States and Canada since 2018 and in England since 2017 but with differing focus: youth vaping prevention (United States/Canada) and smoking cessation (England). We therefore examined country differences and trends in noticing vaping campaigns among youth and, using 2022 data only, perceived valence of campaigns and associations with harm perceptions. Seven repeated cross-sectional surveys of 16-19 year-olds in United States, Canada and England (2018-2022, n = 92 339). Over half of youth reported noticing vaping campaigns, and noticing increased from August 2018 to February 2020 (United States: 55.2% to 74.6%, AOR = 1.21, 95% CI = 1.18-1.24; Canada: 52.6% to 64.5%, AOR = 1.13, 1.11-1.16; England: 48.0% to 53.0%, AOR = 1.05, 1.02-1.08) before decreasing (Canada) or plateauing (England/United States) to August 2022. Increases were most pronounced in the United States, then Canada. Noticing was most common on websites/social media, school and television/radio. In 2022 only, most campaigns were perceived to negatively portray vaping and this was associated with accurately perceiving vaping as less harmful than smoking among youth who exclusively vaped (AOR = 1.46, 1.09-1.97). Consistent with implementation of youth vaping prevention campaigns in the United States and Canada, most youth reported noticing vaping campaigns/messages, and most were perceived to negatively portray vaping.

The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis

Background

The purpose of this systematic review study was to determine the national, regional, and global prevalence of electronic cigarettes (e-cigarettes) vaping.

Method

The articles were searched in July 2020 without a time limit in Web of Science (ISI), Scopus, PubMed, and Ovid-MEDLINE. At first, the titles and abstracts of the articles were reviewed, and if they were appropriate, they entered the second stage of screening. In the second stage, the whole articles were reviewed and articles that met the inclusion criteria were selected. In this study, search, selection of studies, qualitative evaluation, and data extraction were performed by two authors independently, and any disagreement between the two authors was reviewed and corrected by a third author.

Results

In this study, the lifetime and current prevalence of e-cigarettes vaping globally were 23% and 11%, respectively. Lifetime and current prevalence of e-cigarettes vaping in women were 16% and 8%, respectively. Also, lifetime and current prevalence of e-cigarettes vaping in men were 22% and 12%, respectively. In this study, the current prevalence of e-cigarettes vaping in who had lifetime smoked conventional cigarette was 39%, and in current smokers was 43%. The lifetime prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 24%, 26%, 16%, and 25%, respectively. The current prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 10%, 14%, 11%, and 6%, respectively.

Conclusions

Based on the results of this study, it can be concluded that the popularity of e-cigarettes is increasing globally. Therefore, it is necessary for countries to have more control over the consumption and distribution of e-cigarettes, as well as to formulate the laws prohibiting about the e-cigarettes vaping in public places. There is also a need to design and conduct information campaigns to increase community awareness about e-cigarettes vaping.

Cigarette smoking and e-cigarette use among university students in Queensland, Australia and New Zealand: results of two cross-sectional surveys

OBJECTIVES

Examine the patterns of cigarette smoking and e-cigarette use (vaping), the perceived harm of e-cigarettes compared with tobacco cigarettes, and associations between smoking and vaping with student characteristics.

DESIGN

Cross-sectional studies.

SETTING

The University of Queensland (UQ), Australia and eight New Zealand (NZ) universities.

PARTICIPANTS

Students at UQ: 4957 (70.8% aged <25 years, 63.0% women) and NZ: 1854 (82.5% aged <25 years, 60.1% women).

METHODS

Χ2 tests compared smoking by age and gender, and vaping by age, gender and smoking status. Two-sided p<0.05 was considered significant and 95% CIs reported where appropriate. Multinomial logistic regression examined associations between smoking and vaping (exclusive smoking, exclusive vaping, dual use and non-use) with age, gender and student type (domestic vs international).

RESULTS

Smoking (UQ vs NZ, 95% CI): ever 45.2% (43.8% to 46.6%) vs 50.0% (47.7% to 52.3%), current 8.9% (8.1% to 9.7%) vs 10.4% (9.1% to 11.9%) and daily 5.2% (4.6% to 5.8%) vs 5.6% (4.6% to 6.7%), and not smoking in indoor 98.3% vs 87.7% or outdoor smoke-free spaces 83.8% vs 65.3%.Vaping (UQ vs NZ, 95% CI): ever 20.9% (19.8% to 22.1%) vs 37.6% (35.4% to 39.9%), current 1.8% (1.5% to 2.2%) vs 6.5% (5.4% to 7.7%) and daily 0.7% (0.5% to 1.0%) vs 2.5% (1.9% to 3.4%), and not vaping in indoor 91.4% vs 79.6% or outdoor smoke-free spaces 84.4% vs 71.3%. Of respondents, 71.7% (70.3% to 73.2%) vs 75.3% (72.9% to 77.6%) perceived e-cigarettes as less harmful than tobacco cigarettes.Men were more likely than women to smoke and vape, and to believe that e-cigarettes are less harmful. Regression models containing all predictors for smoking and vaping were significant and the effect of gender was significant for dual use, exclusive smoking and exclusive vaping (all p<0.01). Men had higher odds for smoking, vaping or dual use.

CONCLUSIONS

Results suggest significant differences in patterns of smoking and vaping of university students in Australia and NZ, and a strong influence of gender on smoking and vaping.

How are nicotine vaping products represented to pharmacists? A content analysis of Australian pharmacy news sources

BACKGROUND

With the growing popularity and use of nicotine vaping products (NVPs), it is important that pharmacists have evidence-based information in order to provide guidance to their customers. The news media can play an important role in shaping how pharmacists think, feel and act regarding NVPs. This paper examines how NVPs are portrayed and framed in Australian pharmacy news sources.

METHODS

Four leading Australian online pharmacy professional news sources were searched for articles published between 2007 and August 2019. A combination of qualitative and quantitative methods was employed to explore how the safety, efficacy and regulation of NVPs was communicated.

RESULTS

We identified and analysed 103 relevant articles. Academic research findings and/or expert opinions were either cited or referenced most often, appearing in a total of 59% of articles analysed, followed by government sources quoted in 41% of articles. Health effects and safety issues of NVPs were the most frequently mentioned topic appearing in a total of 79% of the stories, followed by NVP-related regulatory issues (47%). The majority of NVP-related articles were framed in a loss rather than gain contexts, with more emphasis given to the concern that NVPs have the potential to addict youth to nicotine and undermine Australia's progress in tobacco control.

CONCLUSION

Australian pharmacy news media have more often reported the potential risks than the potential benefits of NVPs. Such portrayal is likely to contribute to misperceptions about the relative harm of NVPs. Pharmacy staff need access to unbiased and evidence-based guidance on how to handle customer enquiries regarding NVPs.

Prevalence of Electronic Cigarette Use and its Determinants among 13-to-15-Year-Old Students in Greece: Results from the 2013 Global Youth Tobacco Survey (GYTS)

Electronic cigarette use has increased over the past decade. Its potential role in smoking cessation, in addiction and as a 'gateway' to tobacco smoking is subject to intense research. This cross-sectional study, carried out in 2013, aims to present the habits of students aged 13-15 in Greece with regard to e-cigarettes and investigate potential risk factors and the relationship between e-cigarettes, tobacco smoking and other nicotine products. It is the first such study to be carried out in Greece. The survey was based on the standardized methodology of the Global Youth Tobacco Survey. All potential associations were investigated using multiple logistic regression. In total 2.8% of the 4096 participating students were current e-cigarette users and 12.3% of them were ever users. E-cigarette use was associated with male gender, being older, current use of combustible tobacco products and e-cigarette use in the family. Ever e-cigarette use, being older, female gender and higher pocket money were associated with an increased susceptibility to tobacco smoking. E-cigarette prevalence in Greece in 2013 was similar to that of other, developed countries. The smoking and vaping habits of adolescents must be monitored in order to assess trends over time and whether any policy alterations are necessary.

Policy Debates Regarding Nicotine Vaping Products in Australia: A Qualitative Analysis of Submissions to a Government Inquiry from Health and Medical Organisations

Australia has maintained a highly restrictive regulatory framework for nicotine vaping products (NVPs) and the regulatory approach differs from most other high income countries. This paper employed a thematic analysis to assess policy consultation submissions made to a government inquiry regarding use and marketing of NVPs. We included in the analysis submissions (n = 40) made by Australian institutions that influence or contribute to health policy-making including government agencies, health bodies and charities (n = 23), and public health academics and healthcare professionals (n = 18). Submissions from commercial entities and consumers were excluded. The majority of submissions from representatives of government agencies, health bodies and charities recommended maintaining current restrictions on NVPs. Arguments against widening access to NVPs included the demand for long-term evidence on safety and efficacy of an unusually high standard. There was widespread support for restrictions on sales, advertising and promotion, with most submissions supporting similar controls as for tobacco products. In contrast, the majority of individual submissions from healthcare professionals and public health academics advocated for widening access to NVPs for smokers and emphasized the potential benefits of smokers switching to vaping and the policy incoherence of regulating less harmful nicotine products more strictly than tobacco cigarettes. Progress in resolving the policy debate concerning NVP regulation in Australia will require policy makers, clinicians and the public health community to engage in a meaningful dialogue which gives due consideration to both intended and unintended consequences of proposed policies.

E-cigarette use and its predictors: Results from an online cross-sectional survey in Poland

INTRODUCTION

Since the invention of electronic cigarettes (ECs) in 2003, their use has spread worldwide; however, little is known about the profiles of EC users. Understanding the motivators for using ECs enables more accurate prediction of their use and more effective direction of pro-health activities. Our objective was to identify the factors that may influence the decision to use ECs and their possible adverse effects according to the experiences of EC users.

METHODS

A cross-sectional online survey was administered between 1 July 2016 and 1 January 2017 among 1288 Polish-speaking users of social networks and EC forums. To explore associations between current EC use and other factors, multivariate binary logistic regression analyses were performed.

RESULTS

The final analysis included 1142 survey participants: mean age 25.9 years (± 11.1), 85.6% were male, 50.3% had secondary education, 98.2% were Polish citizens, and 81.0% were current EC users. Male gender, lower education, aged ≤40 years, former cigarette smoking, previous attempts to quit smoking, perception of lack of harmful effects of ECs, perception of ECs as being tastier and cheaper than cigarettes, awareness of the advantages of ECs and their use as a smoking cessation aid were all statistically significant factors increasing the risk of EC use. The majority of study participants claimed that ECs are less addictive or not addictive compared to cigarettes (62.6%) and less harmful or not harmful (89.5%) compared to cigarettes. The most common reported side effects of ECs were dryness in the mouth (8.3%), itching in the throat (4.5%) and nausea (1.9%).

CONCLUSIONS

Males aged ≤40 years with a lower level education were more likely to use ECs in the studied Polish population. The perception that ECs are less harmful than regular cigarettes is a factor increasing the odds of EC use; however, although ECs have few adverse effects, they nevertheless exist.