E-cigarette advertising exposure among South African adults in 2017: findings from a nationally representative cross-sectional survey

E-cigarettes in Nigeria: A scoping review of evidence

Background and Aims

E-cigarettes will continue to be a public health issue in Nigeria. To curb the growing menace of the e-cigarette use in Nigeria through evidence-based approach, it is crucial to first map the empirical research landscape of e-cigarettes in Nigeria. No known study has mapped the existing empirical evidence and gaps concerning e-cigarettes in Nigeria; hence, this scoping review was conducted.

Methods

This scoping review adopted the research design by Arksey and O'Malley. Four databases (PubMed, SCOPUS, CINAHL Complete, and APA PsycINFO) were searched to retrieve literature on e-cigarettes in Nigeria. With the aid of Rayyan web application, all retrieved literature were deduplicated and screened based on the review's eligibility criteria. Only those peer-reviewed journal papers meeting the inclusion criteria were included in the review. Relevant data from the included papers were charted, collated, and summarized.

Results

A total of six papers were included in this review. The reviewed papers reported a lifetime prevalence of e-cigarette use (or vaping) ranging from 5.8% to 19.8%, with a current e-cigarette use prevalence of 11.8%, among different population groups in Nigeria. The major determinants of e-cigarette use, as reported in these articles, include being a youth, having a health condition, severe anxiety, tobacco use, peer influence, and current alcohol use. Dry mouth and oral lesions (gingival inflammation and oral ulcers) were also identified to be the medical conditions associated with e-cigarette use in Nigeria. Lastly, one of the included papers identified a lack of clear regulation on e-cigarettes in Nigeria.

Conclusion

There is an urgent need for more scientific investigations on the sociodemographic, economic, health, and regulatory landscape of e-cigarettes in Nigeria, as robust empirical evidence is needed for the effective planning, implementation, and evaluation of evidence-based policies and interventions on e-cigarettes control and regulation in Nigeria.

Trends in the use and dual use of factory-made combustible cigarettes, other tobacco products and electronic cigarettes: Results from South African Social Attitudes Surveys during 2007 to 2018

INTRODUCTION

Using more than one tobacco product increases the risk of tobacco-related diseases. We investigated trends in the prevalence and dual use of factory-made (FM) cigarettes, other tobacco products, and electronic cigarettes (e-cigarettes) in South Africa over a 12-year period.

METHODS

Data from five waves (2007, 2010, 2011, 2017, and 2018) of the South African Social Attitudes Survey (n=14582) were analyzed. The use of FM, roll-your-own (RYO) cigarettes, cigars, waterpipe, smokeless tobacco (SLT), any combustible tobacco products (CTP), any tobacco product (ATP) use, and e-cigarettes was investigated. The dual use of FM cigarettes with either SLT, waterpipe or e-cigarettes was also explored. Chi-squared analyses and regression models were used to explore trends in prevalence over the 12-year period.

RESULTS

About 51% of the participants were female, and 51.9% were aged 16-34 years. CTP smoking significantly increased from 18.1% (2010) to 23.6% (2018) (p=0.015), while ATPU increased from 20.2% (2010) to 25.9% (2018) (p=0.005). Though dual use of FM cigarettes and SLT, waterpipe, or e-cigarettes was generally low, the prevalence of dual use significantly increased for all product combinations investigated: FM cigarettes and SLT (0.5% in 2007 to 1.3% in 2018, p=0.017), FM cigarettes and waterpipe (0.9% in 2010 to 2.5% in 2018, p=0.014), FM cigarettes and e-cigarettes (0.4% in 2010 to 1.8% in 2018, p<0.001). Compared to 2010, the odds of the prevalence of CTP and ATP use significantly increased by 37% in 2018 (adjusted odds ratio, AOR=1.37; 95% CI: 1.06-1.77; p=0.018 and AOR=1.37; 95% CI: 1.08-1.73; p=0.009, respectively) during the 12-year period after adjusting for demographic characteristics.

CONCLUSIONS

The use and dual use of tobacco and electronic cigarette products have been increasing in recent years in South Africa. Interventions to help users quit and prevent young people from initiating use are urgently needed to curb these increases.

A downstream social norms approach for curtailing e-cigarette waste: Promising social marketing interventions from consumer interactions

Irresponsibly disposed electronic cigarette (e-cigarette) waste poses significant public health and environmental harm. This study explores downstream social marketing interventions that can be used to curtail the growth of e-cigarette waste in South Africa through the lenses of the social norms approach. This study harnesses the power of social marketing to identify downstream interventions that can be used by marketers to curb the problem of e-cigarette waste. An exploratory research design and a qualitative method were employed. Six virtual focus groups were conducted to collect cross-sectional data from South African electronic cigarette users. Reciprocal altruism, social orientation value, moral licensing and ecological beliefs were found to be the main normative influences that characterise e-cigarette waste. The results support the proposition that social marketers should employ a downstream approach to develop interventions to curtail the growth of e-cigarette waste. Such measures are envisaged to complement upstream initiatives. This study offers new insights on how to manage e-cigarette waste in the context of an emerging market.

Exposure to E-Cigarette Advertising and Its Association With E-Cigarette Use Among Youth and Adolescents in Two Largest Cities in Vietnam 2020

BACKGROUND

E-cigarette products have become more popular due to the marketing campaigns on various sources but caused adverse health impacts to users, especially adolescents and youths. This paper aims to describe the situation of exposure to e-cigarette advertisements of youth and adolescents living in two cities of Hanoi and Ho Chi Minh in 2020 and identify the associated factors of e-cigarette marketing with e-cigarettes use in these groups.

METHODOLOGY

This was a cross-sectional study. The study participants were 1211 youth and adolescents aged 15-24 living in Hanoi and Ho Chi Minh City during the time of data collection (from January 2020 to September 2020). Two primary outcome variables included the ever e-cigarettes use and the intention to use e-cigarettes. Multivariate logistic regression models were used to assess the association between the outcome variables and e-cigarette marketing exposure.

RESULTS

The proportion of participants who ever use e-cigarettes was 7.4% and a proportion of 4.8% have intention to use e-cigarettes. The most popular source of exposure to e-cigarettes advertisements was social network (Facebook, Twitter, Instagram, Youtube, etc.) and this source had positive association with the odds of e-cigarette smoking among youth and adolescents (OR = 3.38, 95% CI: 1.59-7.14). In addition, referral marketers also contributed to making the participants more likely to smoke e-cigarettes (OR = 2.68, 95% CI: 1.03-6.95). Attractive color and free sample of e-cigarettes were also found to be the motivated factors associated with smoking behaviour among youth and adolescents.

CONCLUSIONS

New policies should be considered to oppose the impact of youth-oriented e-cigarette advertisements which include regulating and restricting e-cigarette advertisements on social media, as well as through referral marketers.

Evolution of tobacco products: recent history and future directions

Declines in cigarette smoking prevalence in many countries and the consolidation of the tobacco industry have prompted the introduction of other forms of nicotine delivery. These include electronic nicotine delivery systems (ENDS), heated tobacco products (HTPs) and oral nicotine products (ONPs). Evolving over time, some of these products now deliver nicotine at levels comparable to cigarettes and may serve as effective substitutes for smokers. However, certain products, especially ENDS like JUUL, have also appealed to youth and non-smokers, prompting concerns about expanding nicotine use (and potentially nicotine addiction). The tobacco industry could shift away from primarily promoting cigarettes to promoting ENDS, HTPs and/or ONPs, though at this time it continues to heavily promote cigarettes in low and middle-income countries. Differing regulatory regimes may place upward and downward pressures on both cigarettes and these newer products in terms of population use, and may ultimately drive the extent to which cigarettes are or are not displaced by ENDS, HTPs and/or ONPs in the coming decade.