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Lei S, Chen L, Ji P, Li K, Li Q, Huang C, Wang G, Ma J, Guo R, Tang L. Global burdens of nasopharyngeal carcinoma in children and young adults and predictions to 2040. Oral Oncol 2024; 155:106891. [PMID: 38878356 DOI: 10.1016/j.oraloncology.2024.106891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/27/2024] [Accepted: 06/06/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES To investigate the epidemiological trend for nasopharyngeal carcinoma among children and young adults and the disease burden they caused. MATERIALS AND METHODS Data were collected from the Global Burden of Disease (GBD) study 2019. A comprehensive analysis was performed, with age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), disability-adjusted life-years (DALYs) and estimated annual percentage changes (EAPC). And decomposition and frontier analyses were done. Future trends were predicted using Bayesian age-period-cohort model. RESULTS Globally, there were decreases in the ASIR (EAPC -0.175, 95 % confidence interval [CI]: -0.352 to 0.002), ASMR (EAPC -2.681, 95 % CI: -2.937 to -2.424), and age-standardized DALYs rates (EAPC -2.643, 95 % CI: -2.895 to -2.391). However, the ASIR for males in global (EAPC 0.454, 95 % CI: 0.302 to 0.606), Asia (EAPC 0.782, 95 % CI: 0.610 to 0.954) and America (EAPC 0.448, 95 % CI: 0.379 to 0.517), as well as females in European (EAPC 0.595, 95 % CI: 0.479 to 0.712) and American (EAPC 0.369, 95 % CI: 0.324 to 0.415), showed an increasing trend. The future ASIR per 100,000 will likely show a slight upward trend in 2020 to 2040 (increased from 0.254 to 0.284), particularly among females (increased from 0.177 to 0.206), and a continued decline in ASMR for both sexes (decreased from 0.070 to 0.061). CONCLUSIONS Globally, NPC in children and young adults remains a major public health issue, with the global distribution and magnitude of the burden varies markedly, highlighting the need to formulate regional and population-based policies for primary prevention.
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Affiliation(s)
- Sen Lei
- Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China
| | - Lin Chen
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China
| | - Pengjie Ji
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China
| | - Kunpeng Li
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China
| | - Qingjie Li
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China; Department of Experimental Research, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China
| | - Chenglong Huang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China
| | - Gaoyuan Wang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China
| | - Jun Ma
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
| | - Rui Guo
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
| | - Linglong Tang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
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Hartono R, Yan C, Chen Y, Ma B, Deng Y, Sun Y, Li P, Dao Y, Deng R. Knowledge, attitude, and practice of e-cigarette use among undergraduate students: A comparative study between China and Indonesia. Tob Induc Dis 2024; 22:TID-22-131. [PMID: 39015939 PMCID: PMC11249499 DOI: 10.18332/tid/190636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/18/2024] [Accepted: 06/30/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION The health risks associated with e-cigarettes are currently the focus of tobacco control efforts and public health initiatives. Given that China and Indonesia have the highest rates of adult smoking worldwide, it is imperative to gain a comprehensive understanding of e-cigarette prevalence among college students in these two nations. METHODS From May to June 2023, a cross-sectional study was employed to conduct an online questionnaire survey among college students in three universities located in Kunming (China) and Jakarta (Indonesia), respectively. The chi-squared test was utilized to compare the rates/ratios, while binary logistic regression analysis was applied to examine the factors influencing e-cigarette knowledge, attitude, and practice. RESULTS A total of 1327 individuals were included in the investigation. The proportion of Indonesian students (75.6%) with a high level of e-cigarette knowledge was lower than that observed among Chinese students (87.4%) (χ2=29.7, p<0.001). Additionally, the prevalence of e-cigarette use among Indonesian students (9.4%) was higher compared to their Chinese counterparts (3.0%) (χ2=22.32, p<0.001). Binary logistic regression analysis revealed that age, place of residence, studies, gender, and e-cigarette use by friends and family, significantly influenced knowledge levels and attitudes toward e-cigarettes in both countries (p<0.05). CONCLUSIONS Despite the positive knowledge, attitudes, and practices towards e-cigarettes among undergraduate students in both countries, a notable knowledge gap exists concerning the harmful effects of e-cigarettes. Chinese students had better e-cigarette knowledge and demonstrated lower usage rates, suggesting that heightened awareness plays a favorable role in preventing e-cigarette use. Furthermore, it becomes imperative for policymakers and health educators to focus on specific factors, such as the influence of close friends and family members, as well as the area of residence.
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Affiliation(s)
| | | | - Ying Chen
- Kunming Medical University, Kunming, China
| | - Boting Ma
- Kunming Medical University, Kunming, China
| | - Yaqi Deng
- Kunming Medical University, Kunming, China
| | - Yijia Sun
- Kunming Medical University, Kunming, China
| | - Pan Li
- Kunming Medical University, Kunming, China
| | - Yuye Dao
- Kunming Medical University, Kunming, China
| | - Rui Deng
- Kunming Medical University, Kunming, China
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Alrasheedi SM, Alrashdi MN, Alhumaidan LS, Alkhdairi A, Alzweihary AM, Alhussaini OM, Alharbi LS, Albalawi AN, Almutairi TF, Alharbi OAG, Bashal AAM. Prevalence of Adverse Respiratory Symptoms Among E-Cigarette Users in Saudi Arabia - A Cross-Sectional Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1641-S1646. [PMID: 38882900 PMCID: PMC11174166 DOI: 10.4103/jpbs.jpbs_1222_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/23/2023] [Accepted: 12/29/2023] [Indexed: 06/18/2024] Open
Abstract
Electronic cigarettes, frequently referred to as e-cigarettes, have emerged as a controversial and rapidly growing phenomenon in the realm of tobacco and nicotine consumption worldwide. This study reports the prevalence of respiratory symptoms among e-cigarette users. This study also helps to understand the potential harmful effects and importance of quitting e-cigarette smoking. An observational cross-sectional study was carried out in Saudi Arabia. The study period was from September 2022 to August 2023. The sample size was 447 participants. Among recent e-cigarette users in this Saudi study, usage varied, with 44.1% using 1-5 days, 33.6% using 6-30 days, and 22.4% using e-cigarettes previously but not in the previous month. Vape devices were predominant (42.7%). There were significant associations emerged between e-cigarette use frequency and symptoms such as fatigue, breathlessness, and shortness of breath. E-cigarette use was notably linked to asthma-related symptoms, underscoring its concerning impact on respiratory health (P < 0.05). E-cigarette consumption has a significant impact on respiratory effects and specifically asthma-related symptoms among this Saudi population.
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Affiliation(s)
- Sami M Alrasheedi
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Kingdom of Saudi Arabia
| | - Mousa N Alrashdi
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Kingdom of Saudi Arabia
| | - Lama S Alhumaidan
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Kingdom of Saudi Arabia
| | - Ahmad Alkhdairi
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Kingdom of Saudi Arabia
| | - Ali M Alzweihary
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Kingdom of Saudi Arabia
| | - Omar M Alhussaini
- Department of Medicine, College of Medicine, Alrayan Medical Colleges, Medina, Saudi Arabia
| | - Lama S Alharbi
- Department of Medicine, College of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia
| | - Amirah N Albalawi
- Department of Medicine, College of Medicine, Tabuk University, Tabuk, Saudi Arabia
| | - Turki F Almutairi
- Department of Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Osama A G Alharbi
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Kingdom of Saudi Arabia
| | - Afaf A M Bashal
- Department of Medicine, King Salman Bin Abdulaziz Medical City, Madinah Health Cluster, Kingdom of Saudi Arabia
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Tao X, Zhang J, Meng Q, Chu J, Zhao R, Liu Y, Dong Y, Xu H, Tian T, Cui J, Zhang L, Chu M. The potential health effects associated with electronic-cigarette. ENVIRONMENTAL RESEARCH 2024; 245:118056. [PMID: 38157958 DOI: 10.1016/j.envres.2023.118056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/17/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
A good old gateway theory that electronic-cigarettes (e-cigarettes) are widely recognized as safer tobacco substitutes. In actuality, demographics also show that vaping cannibalizes smoking, the best explanation of the data is the "common liability". However, the utilization of e-cigarette products remains a controversial topic at present. Currently, there has been a widespread and substantial growth in e-cigarette use worldwide owing to their endless new flavors and customizable characteristics. Furthermore, e-cigarette has grown widespread among smokers as well as non-smokers, including adolescents and young adults. And some studies have shown that e-cigarette users are at greater risk to start using combustible cigarettes while e-cigarettes use was also observed the potential benefits to people who want to quit smoking or not. Although it is true that e-cigarettes generally contain fewer toxic substances than combustible cigarettes, this does not mean that the chemical composition in e-cigarettes aerosols poses absolutely no risks. While concerns about toxic substances in e-cigarettes and their widespread use in the population are reasonable, it is also crucial to consider that e-cigarettes have been associated with the potential for promoting smoking cessation and the clinically relevant improvements in users with smoking-related pathologies. Meanwhile, there is still short of understanding of the health impacts associated with e-cigarette use. Therefore, in this review, we discussed the health impacts of e-cigarette exposure on oral, nasal, pulmonary, cardiovascular systems and brain. We aspire for this review to change people's previous perceptions of e-cigarettes and provide them with a more balanced perspective. Additionally, we suggest appropriate adjustments on regulation and policy for e-cigarette to gain greater public health benefits.
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Affiliation(s)
- Xiaobo Tao
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jiale Zhang
- The Second People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Qianyao Meng
- Department of Global Health and Population, School of Public Health, Harvard University, Boston, USA
| | - Junfeng Chu
- Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - Rongrong Zhao
- Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - Yiran Liu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Yang Dong
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Huiwen Xu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Tian Tian
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jiahua Cui
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Lei Zhang
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China.
| | - Minjie Chu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China.
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Zou W, Wang X, Yang N, Ni X, Zhao Z, Meng R, Ma H. The intention of college students to use electronic cigarettes: A study based on the theory of innovation diffusion. Tob Induc Dis 2024; 22:TID-22-53. [PMID: 38496253 PMCID: PMC10941754 DOI: 10.18332/tid/185644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION The purpose of this study is to examine the use of electronic cigarettes (e-cigarettes) among college students in Hangzhou, and to analyze the influencing factors of their intention to use e-cigarettes. METHODS Using a stratified cluster sampling method, 775 students from two universities in Hangzhou were selected for an on-site questionnaire survey from March to April 2022. Adjusted logistic regression analysis was conducted on the influencing factors of use intention, based on innovation diffusion theory. RESULTS Within our sample of college students, 16.5% of students had tried e-cigarettes; 6.32% had used e-cigarettes in the past month, and 8.0% had the intention to use e-cigarettes. There were significant differences in willingness to use e-cigarettes among different genders, economic status, smoking status of close friends around them, and their own use of tobacco and alcohol (p<0.05). The logistic regression model showed that the observability of e-cigarettes (AOR=1.28; p<0.05), personal factors (AOR=1.39; p<0.05), and social systems (AOR=1.63; p<0.05), were all influencing factors of intention to use e-cigarettes. CONCLUSIONS College students in Hangzhou have a high intention to use e-cigarettes, and the impacts of the product itself, individual characteristics and the living environment are crucial. It is necessary to strengthen the promotion of tobacco knowledge at the social and family levels to reduce the occurrence of vaping.
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Affiliation(s)
- Wenjing Zou
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaowen Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xiaoqing Ni
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhaoyang Zhao
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou, China
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Wang L, Siau CS, Baharom N, Hairol MI, Huang L, Wee LH. Media Search Frequency, Source Credibility About e-Cigarette Health Information, and Motivation to Quit EC Among University Students in Chengdu, China. Int J Gen Med 2024; 17:895-907. [PMID: 38476623 PMCID: PMC10929557 DOI: 10.2147/ijgm.s430997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose E-cigarettes (ECs) are gaining popularity among young people. This study aimed to assess university student vapers' search frequency and source credibility of commonly used media in China, and their association with daily EC users' motivation to quit EC use. Participants and Methods This was a cross-sectional study involving an online quantitative survey in six universities in Chengdu, China. Participants answered questions on their EC use patterns, motivation to quit EC, use frequency and source credibility of media use. Hierarchical linear regression analyses were performed to determine the association between media search frequency and source credibility concerning EC health information with the motivation to quit EC. Results There were a total of 325 participants (Mean age = 20.43, SD = 1.333). Video platforms and social media were ranked frequently used by the participants and were deemed to be more trustworthy. Perceived trustworthiness of online media was the most influential predictor of motivation to quit EC. Those who reported a higher frequency of accessing video platforms and medical health applications recorded higher motivation to quit EC use. Source credibility of news portals were associated higher motivation to quit EC. The association between higher nicotine dependence and lower motivation to quit EC was attenuated when media source credibility and trustworthiness of online media were added into the fully adjusted regression models. Conclusion There is an association between media use frequency and source credibility to search for EC health information and motivation to quit vaping. More studies could be conducted to examine the effects of media use content on perceptions towards vaping and their motivation to quit vaping.
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Affiliation(s)
- Li Wang
- Ya’an Polytechnic College, Ya’an, Sichuan, 625000, People’s Republic of China
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Nizam Baharom
- Primer Healthcare Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, 71800, Malaysia
| | - Mohd Izzuddin Hairol
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Lixin Huang
- Chengdu Sport University, Chengdu, Sichuan, 610000, People’s Republic of China
| | - Lei Hum Wee
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya, Selangor, 47500, Malaysia
- Non-Communicable Diseases and Public Health Research Group, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, 47500, Malaysia
- Digital Health and Innovations Impact Lab, Taylor’s University, Subang Jaya, 47500, Malaysia
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Song B, Li H, Zhang H, Jiao L, Wu S. Impact of electronic cigarette usage on the onset of respiratory symptoms and COPD among Chinese adults. Sci Rep 2024; 14:5598. [PMID: 38454045 PMCID: PMC10920732 DOI: 10.1038/s41598-024-56368-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/05/2024] [Indexed: 03/09/2024] Open
Abstract
The prevalence of dual usage and the relatively low cessation rate among e-cigarette (EC) users suggest that ECs have not demonstrated significant effectiveness as a smoking cessation tool. Furthermore, there has been a substantial increase in the prevalence of EC usage in recent years. Therefore, the objective of this study is to investigate the association between EC use and the incidence of respiratory symptoms and chronic obstructive pulmonary disease (COPD). A total of 10,326 participants aged between 20 and 55 years, without any respiratory diseases or COPD, were recruited for the study. These individuals attended employee physical examinations conducted at 16 public hospitals in Hebei province, China from 2015 to 2020. Logistic regression models were utilized to assess the association between EC use and the risk of respiratory symptoms and COPD using risk ratios along with their corresponding 95% confidence intervals. Restricted cubic spline functions were employed to investigate the dose-response non-linear relationship. The robustness of the logistic regression models was evaluated through subgroup analyses, and sensitivity analyses. During the 5-year follow-up period, a total of 1071 incident cases of respiratory symptoms and 146 incident cases of COPD were identified in this cohort study. After adjusting for relevant confounding factors, EC users demonstrated a respective increase in the risk of reporting respiratory symptoms and COPD by 28% and 8%. Furthermore, dual users who used both ECs and combustible cigarettes exhibited an elevated risk of incident respiratory symptoms and COPD by 41% and 18%, respectively, compared to those who had never used non-users of any cigarette products. The association between daily EC consumption and the development of respiratory symptoms, as well as COPD, demonstrated a significant J-shaped pattern. The potential adverse association between the consumption of ECs, particularly when used in combination with combustible cigarettes, and the development of respiratory symptoms and COPD necessitates careful consideration. Policymakers should approach ECs cautiously as a prospective smoking cessation tool.
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Affiliation(s)
- Beibei Song
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University/Hebei Key Laboratory of Respiratory Critical Care/Hebei Institute of Respiratory Diseases, No. 215 Heping West Road, Shijiazhuang, 050000, China
| | - Honglin Li
- The First Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University/Hebei Key Laboratory of Respiratory Critical Care/Hebei Institute of Respiratory Diseases, No. 215 Heping West Road, Shijiazhuang, 050000, China
| | - Huiran Zhang
- Department of Biological Pharmacy, Hebei Medical University, Shijiazhuang, 050000, China
| | - Libin Jiao
- Hebei Far East Communication System Engineering Company, Shijiazhuang, 050000, China
| | - Siyu Wu
- The Third Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
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An YJ, Kim YH. Assessment of toxicological validity using tobacco emission condensates: A comparative analysis of emissions and condensates from 3R4F reference cigarettes and heated tobacco products. ENVIRONMENT INTERNATIONAL 2024; 185:108502. [PMID: 38368717 DOI: 10.1016/j.envint.2024.108502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/19/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
The tobacco emission condensate, henceforth referred to as "tobacco condensate," plays a critical role in assessing the toxicity of tobacco products. This condensate, derived from tobacco emissions, provides an optimized liquid concentrate for storage and concentration control. Thus, the validation of its constituents is vital for toxicity assessments. This study used tobacco condensates from 3R4F cigarettes and three heated tobacco product (HTP) variants to quantify and contrast organic compounds (OCs) therein. The hazard index (HI) for tobacco emissions and condensates was determined to ascertain the assessment validity. The total particulate matter (TPM) for 3R4F registered at 17,667 μg cig-1, with its total OC (TOC) at 3777 μg cig-1. HTPs' TPM and TOC were 9342 ± 1918 μg cig-1 and 5258 ± 593 μg stick-1, respectively. 3R4F's heightened TPM likely arises from tar, while HTPs' OC concentrations are influenced by vegetable glycerin (2236-2688 μg stick-1) and propylene glycol (589-610 μg stick-1). During the condensation process, a substantial proportion of OCs in 3R4F smoke underwent significant concentration decreases, in contrast to HTPs, where fewer than half of the examined OCs exhibited notable concentration declines. The HI for tobacco emissions exhibited a marginally higher value compared to tobacco condensate, with variations ranging from 7.92% (HTPs) to 18.6% (3R4F), denoting a minimal differential. These observations emphasize the importance of accurate OC recovery techniques to maintain the validity and reliability of toxicity assessments based on tobacco condensates. This study not only deepens the comprehension of chemical behaviors in tobacco products but also establishes a novel benchmark for their toxicity evaluation, with profound implications for public health strategies and consumer protection.
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Affiliation(s)
- Young-Ji An
- Department of Environment & Energy, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896, Republic of Korea
| | - Yong-Hyun Kim
- Department of Environment & Energy, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896, Republic of Korea; School of Civil, Environmental, Resources and Energy Engineering, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896, Republic of Korea; Soil Environment Research Center, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do 54896, Republic of Korea.
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HU SS. Influencing Factors on Cardiovascular Health in China. J Geriatr Cardiol 2024; 21:4-33. [PMID: 38440341 PMCID: PMC10908586 DOI: 10.26599/1671-5411.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. This is the first section of the report, which dissects influential factors across diverse domains. The investigation identifies tobacco use as a paramount concern, portraying China as the global epicenter of tobacco consumption. Cigarette smoking, exacerbated by second-hand smoke exposure, emerges as a critical and preventable risk factor, contributing to a surge in attributable deaths over the past three decades. In the realm of dietary nutrition, the study discerns an overall improvement, yet discerns worrisome deviations, notably an escalating fat intake surpassing recommended guidelines. The shifting dietary structure reveals diminished consumption of cereals and vegetables juxtaposed with an uptick in animal foods, while excessive intake of cooking oil and salt persists, straying substantially from endorsed levels. The exploration of physical activity patterns unfolds a nuanced narrative. Varied trends are observed among students, with concerns arising from sedentary behaviors and inadequate adherence to recommended guidelines. The analysis spans a trajectory of declining physical activity in Chinese adults, coupled with an alarming surge in sedentary leisure time, ultimately linking these factors to heightened risks of cardiovascular diseases and increased adiposity. An examination of overweight and obesity trends uncovers a relentless upward trajectory, projecting substantial prevalence by 2030. Noteworthy prevalence rates underscore the imperative for targeted interventions to curtail this burgeoning health crisis, with the anticipated prevalence extending to nearly two-thirds of the adult population. Psychological factors, notably depression, constitute an integral facet of cardiovascular health. Prevalence rates among patients with coronary artery disease and acute myocardial infarction underscore the intricate interplay between mental health and cardiovascular outcomes. Additionally, persistent depressive symptoms are shown to significantly elevate the risk of cardiovascular diseases and mortality. This first section underscores the multifaceted challenges facing cardiovascular health in China, emphasizing the imperative for tailored interventions across tobacco control, dietary habits, physical activity, obesity management, and psychological well-being to mitigate the escalating burden of cardiovascular diseases in the population.
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Affiliation(s)
- Sheng-Shou HU
- Fuwai Hospital Chinese Academy of Medical Sciences, Beijing, China
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Weng X, Song CY, Liu K, Wu YS, Lee JJ, Guo N, Wang MP. Perceptions of and responses of young adults who use e-cigarettes to flavour bans in China: a qualitative study. Tob Control 2024:tc-2023-058312. [PMID: 38267214 DOI: 10.1136/tc-2023-058312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND China has banned all flavoured e-cigarettes to reduce e-cigarette use among young people, but little is known about the views and reactions of people who use e-cigarettes. This study explored the perceptions of, and responses by, young adults who use e-cigarettes to the flavour ban. METHODS Semistructured interviews were conducted with 25 Chinese young adults aged 18-25 years who had used e-cigarettes daily in the past 3 months. Thematic analysis was used to analyse the interview data. FINDINGS Four themes were identified from the data: (1) understanding of the public health benefits, (2) resistance to and misperceptions of the flavour ban, (3) circumvention of the flavour ban and (4) acceptance of the flavour ban. Some participants expressed support for the ban due to perceived public health benefits, while others who resisted the ban emphasised their right to choose preferred flavours and questioned the rationale behind the policy. Participants responded to the flavour ban by utilising a variety of adaptive strategies, including purchasing flavoured e-cigarettes through illegal channels or exploring alternative ways to obtain flavours. Those who complied with the ban responded with different strategies, including switching back to combustible cigarettes, using tobacco-flavoured e-cigarettes, or quitting vaping. CONCLUSIONS The findings suggest the need for comprehensive regulatory measures, including stringent enforcement measures, transparent health communication and vigilant monitoring of e-cigarette manufacturers' tactics, to reduce e-cigarette use among young adults.
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Affiliation(s)
- Xue Weng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Chu Yu Song
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Kefeng Liu
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Zhuhai, Guangdong, China
| | - Yongda Socrates Wu
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Jung Jae Lee
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Ningyuan Guo
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Man Ping Wang
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, China
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Jiang J, Zheng Z. A Critical Review of E-Cigarette Regulation in China: Challenges and Prospects for Youth Prevention and Tobacco Control. Nicotine Tob Res 2024; 26:126-134. [PMID: 37718628 DOI: 10.1093/ntr/ntad180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/16/2023] [Accepted: 09/15/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION The increasing popularity of electronic cigarettes (e-cigarettes) has led to the emergence of public health concerns, particularly among the youth. As a major producer and exporter of e-cigarettes, China has faced public health challenges in regulating the unregulated e-cigarette industry. AIMS AND METHODS This study aims to evaluate the regulatory development of e-cigarettes in China. We searched and obtained national policy documents related to e-cigarettes and subnational smoke-free laws from LexisNexis on August 2, 2023, which were enacted between January 1, 2023 and July 31, 2023. We used 99 policy documents for the final analysis, specifically 68 national policy documents on e-cigarettes and 31 subnational smoke-free laws. We chronologically reviewed these policy documents in full text and summarized them on the basis of their content and the requirements of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). RESULTS Chinese policymakers established the current regulatory framework for e-cigarettes by amending, enacting, and enforcing laws and regulations. E-cigarettes are categorized as tobacco products, and the State Tobacco Monopoly Administration regulates the e-cigarette industry. The Chinese authorities prioritize youth prevention in strengthening the regulation on e-cigarettes. China adopts various tobacco control measures for e-cigarettes and cigarettes. CONCLUSIONS China gained certain degrees of progress on tobacco control by regulating e-cigarettes and adopting measures required by the WHO FCTC. However, tobacco monopoly hinders the full realization of tobacco control goals, which necessitates the National Health Commission to assume its responsibility for the complete implementation of the WHO FCTC. IMPLICATIONS This study presents a critical review of the development of e-cigarette regulation in China by reviewing relevant policy documents and analyzing tobacco control measures. It recognizes the degrees of progress of tobacco control measures and highlights tobacco monopoly as a significant hindrance of the full implementation of the WHO FCTC. Furthermore, empirical studies are required on the enforcement of tobacco control measures in China.
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Affiliation(s)
- Jiayi Jiang
- Law School, Central South University, Changsha, China
| | - Zexing Zheng
- Law School, Central South University, Changsha, China
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12
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Wang J, Xie CC, Jia XX, Xu K, Gong ZY, Sun YQ, Gao JR, Ding Y, Huang ZY, Chen D. E-cigarette awareness and use, among adult residents in Shanghai, China. Tob Induc Dis 2023; 21:104. [PMID: 37581174 PMCID: PMC10401329 DOI: 10.18332/tid/169559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION The widespread popularity of e-cigarettes is considered an important public health concern. However, only some studies have investigated the prevalence of e-cigarette use in Shanghai, China. Research on the perceived harmfulness of e-cigarettes and public support for e-cigarette regulations in China is limited. This study aimed to estimate e-cigarette awareness, prevalence, and associated factors among adults in Shanghai, China. METHODS This study used data from a representative survey conducted in Shanghai, China, in 2019. The survey was conducted at 64 surveillance points in Shanghai, China, using a multistage, stratified, cluster-randomized sampling design, recruiting community-based Chinese adults aged ≥15 years. Based on the principles outlined in the Global Adult Tobacco Survey (GATS) China Project, data were collected by conducting face-to-face interviews in households. Of the 3200 selected households, 3060 people completed the individual survey. The overall response rate was 97.4%. RESULTS In all, 72.3% of the respondents had heard of e-cigarettes. The respondents who had used e-cigarettes at some point in their life, used them in the last 12 months, and used them currently were 5.8%, 2.6%, and 1.3%, respectively. Among adult residents who had heard of e-cigarettes, 38.2% thought they were less harmful than traditional cigarettes. The respondents who perceived e-cigarettes as more harmful than traditional cigarettes were less likely to have ever used e-cigarettes (AOR=0.2; 95% CI: 0.1-0.5, p=0.0015) and more likely to support incorporating e-cigarettes into the regulation of smoking control (AOR=3.9; 95% CI: 1.8-8.6, p=0.0008). CONCLUSIONS Our findings reveal that the awareness about e-cigarettes was high, and the prevalence of e-cigarette use was similar to the findings from previous studies in China. The harmful perception of e-cigarettes warrants further attention from public health practitioners.
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Affiliation(s)
- Jian Wang
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Chen-Chen Xie
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Xiao-Xian Jia
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Kun Xu
- Shanghai Development Promotion Centre of Undertakings for the Aged, Shanghai, China
| | - Zheng-Yang Gong
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Yuan-Qiao Sun
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Jing-Rong Gao
- Shanghai Development Promotion Centre of Undertakings for the Aged, Shanghai, China
| | - Yuan Ding
- Shanghai Municipal Center for Health Promotion, Shanghai, China
| | | | - De Chen
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
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Gravely S, Yong HH, Reid JL, East KA, Liber AC, Michael Cummings K, Quah AC, Fong GT, Hammond D. An examination of quitting smoking as a reason for vaping by the type of nicotine vaping device used most often among adults who smoke and vape: Findings from the Canada, England and the United States 2020 ITC Smoking and Vaping Survey. Prev Med Rep 2023; 33:102201. [PMID: 37223550 PMCID: PMC10201827 DOI: 10.1016/j.pmedr.2023.102201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 05/25/2023] Open
Abstract
Several nicotine vaping product (NVP) device types are available to consumers, and many people who smoke report vaping to help them quit. This study included data from the Wave 3 (2020) ITC Smoking and Vaping Survey in the US, Canada, and England and included 2324 adults who were smoking cigarettes and vaping at least weekly. Device types currently used most often (disposables, cartridges/pods, or tank systems) were assessed using weighted descriptive statistics. Multivariable regression analyses were used to compare differences between respondents who reported vaping to quit smoking ('yes' vs. 'no/don't know') by device type, overall and by country. Overall, 71.3% of respondents reported vaping to help them quit smoking, with no country differences (p = 0.12). Those using tanks (78.7%, p < 0.001) and cartridges/pods (69.5%, p = 0.02) were more likely to report this reason for vaping than those using disposables (59.3%); respondents using tanks were also more likely than those using cartridges/pods (p = 0.001) to report this reason. By country, respondents in England using cartridges/pods or tanks (vs. disposables) were more likely to report vaping to quit smoking (with no difference between cartridges/pods and tanks). In Canada, respondents using tanks were more likely to report vaping to quit smoking than those using cartridges/pods or disposables (no difference between disposables and cartridges/pods). No significant differences by device type were found in the US. In conclusion, most adult respondents who smoked and vaped reported using either cartridges/pods or tanks, which were associated with greater odds of vaping for the purpose of quitting smoking versus disposables, with some country variations.
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Affiliation(s)
- Shannon Gravely
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Hua-Hie Yong
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia
| | - Jessica L. Reid
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Katherine A. East
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Addictions Sciences Building, 4 Windsor Walk, Denmark Hill, London SE5 8BB, UK
| | - Alex C. Liber
- Lombardi Comprehensive Cancer Center, Georgetown University, 3800 Reservoir Rd NW, Washington, DC 20007, USA
| | - K. Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President St., Charleston, SC 29425, USA
| | - Anne C.K. Quah
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
- Ontario Institute for Cancer Research, 661 University Ave., Toronto, ON M5G 0A3, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
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Yan Y, Lin B, Xu Q, Xie H, Zeng X, Di X, Meng Z, Xiao L, Liu S. Utilization of Smoking Cessation Support Among Adults - 18 PLADs, China, 2020. China CDC Wkly 2023; 5:459-463. [PMID: 37405263 PMCID: PMC10316591 DOI: 10.46234/ccdcw2023.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/16/2023] [Indexed: 07/06/2023] Open
Abstract
What is already known about this topic? In 2018, unassisted smoking cessation (USC) was the predominant method for quitting smoking among Chinese adult smokers, accounting for 90.1% of cases. The utilization of professional smoking cessation support was comparatively low in this population. What is added by this report? In 2020, the prevalence of USC methods increased to 93.1%. Concurrently, there was a slight increase in the utilization of pharmaceuticals (from 4.6% in 2018 to 5.5% in 2020) and counseling and quit line services (from 3.2% in 2018 to 7.5% in 2020). On the other hand, the use of e-cigarettes as a cessation aid decreased from 14.9% in 2018 to 9.8% in 2020. Smokers aged 15-24 years old were more likely to rely on pharmaceutical interventions (7.9%), and less likely to choose USC methods (79.0%). What are the implications for public health practice? The promotion of professional cessation support is essential for enhancing smoking cessation rates.
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Affiliation(s)
- Yongfu Yan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bingliang Lin
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qingqing Xu
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huiyu Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xinying Zeng
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xinbo Di
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zida Meng
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shiwei Liu
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
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15
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Zhang Q, Wen C. The risk profile of electronic nicotine delivery systems, compared to traditional cigarettes, on oral disease: a review. Front Public Health 2023; 11:1146949. [PMID: 37255760 PMCID: PMC10226679 DOI: 10.3389/fpubh.2023.1146949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023] Open
Abstract
The use of electronic nicotine delivery systems (ENDS) has exploded, especially among teenagers and new smokers, amid widespread awareness of the dangers of traditional tobacco and restrictions on smoking. However, the risk effects of ENDS on physical health, especially oral health, are still ambiguous. The purpose of this study was to review the available evidence on risks of ENDS on oral health, and compares the differences between ENDS and traditional cigarettes. For heavy smokers, transferring the addiction of tobacco to ENDS can be less harmful to periodontal condition and physical health but is not completely without risk. The components of ENDS vapor have cytotoxic, genotoxic, and carcinogenic properties, and its usage may be associated with a wide range of oral health sequelae. The chemicals in ENDS increase the susceptibility to tooth decay, increase the risk of periodontal disease, peri-implant, and oral mucosal lesions. Nicotine aerosols from ENDS can be a potential risk factor for oral cancer due to the presence of carcinogenic components. Compared to smoking traditional cigarettes, the harm associated with ENDS use may be underestimated due to the reduced ability to control vaping behavior, ease of ENDS access, fewer vaping area restrictions, and better taste. Currently, the available evidence suggests that ENDS may be a safer alternative to traditional tobacco products. Though most oral symptoms experienced by ENDS users are relatively mild and temporary compared to traditional cigarettes, the dangers of ENDS still exist. However, further research with longer follow-up periods is required to establish the long-term safety of ENDS.
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Affiliation(s)
- Qing Zhang
- Department of Nosocomial Infection Control, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Cai Wen
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Department of VIP Dental Service, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Institute of Stomatology, Southwest Medical University, Luzhou, Sichuan, China
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16
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Deng H, Fang L, Zhang L, Yan X, Wang F, Hao X, Zheng P. A comprehensive content analysis of 104 Chinese electronic cigarette manufacturing enterprise official websites. Tob Control 2023:tc-2022-057759. [PMID: 37137701 DOI: 10.1136/tc-2022-057759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The goal was to analyse website content of Chinese electronic (e) cigarette manufacturing enterprises and understand the marketing strategies to provide evidence for decision-makers to regulate manufacturers. METHODS Through QCC.com, one of the largest enterprise information query platforms in China, we identified 104 official manufacturer websites in 2021. A codebook including 6 sections with 31 items was developed and all webpages were coded separately by two trained researchers. RESULTS Over half of the websites (56.7%) did not have age verification for entry. Thirty-two (30.8%) websites had no restriction for minors to use or purchase e-cigarettes, and 79 (76.0%) had no health warning. Overall, 99 websites (95.2%) displayed their products, and 72 (69.2%) displayed e-flavours. The most frequently used descriptions of products included good taste (68.3%), positive mood (62.5%), leakage resistance (56.7%), enjoyment (47.1%), reduced harm (45.2%), alternatives to cigarettes (43.3%) and long battery life (42.3%). Additionally, 75 websites (72.1%) provided contact information on different channels, including WeChat (59.6%), Weibo (41.3%), Facebook (13.5%), Instagram (12.5%) and brand apps (2.9%). Manufacturers provided investment and franchise information (59.6%) and offline store information (17.3%). In addition, 41.3% websites included content regarding corporate social responsibility. CONCLUSIONS Chinese e-cigarette manufacturers' official websites have become a platform for presenting product and brand information, establishing online and offline marketing loops, and displaying corporate social responsibility with weak age restrictions on access and a lack of health warnings. The Chinese government should implement strict regulatory measures on e-cigarette enterprises.
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Affiliation(s)
- Hui Deng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ling Fang
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Lingyun Zhang
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Xiaotao Yan
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Fan Wang
- Fudan Development Institute, Fudan University, Shanghai, China
| | - Xinyu Hao
- School of Politics and International Relations, East China Normal University, Shanghai, China
| | - Pinpin Zheng
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
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E-cigarettes in the Middle East: The known, unknown, and what needs to be known next. Prev Med Rep 2023; 31:102089. [DOI: 10.1016/j.pmedr.2022.102089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/12/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
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Pettigrew S, Santos JA, Li Y, Miller M, Anderson C, Raj TS, Jones A. E-cigarette-related beliefs, behaviors, and policy support among young people in China. Tob Induc Dis 2023; 21:09. [PMID: 36741540 PMCID: PMC9869085 DOI: 10.18332/tid/156836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/17/2022] [Accepted: 11/23/2022] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION China has recently introduced a range of e-cigarette control policies with a focus on addressing an increase in youth vaping. This study aimed to investigate a wide range of e-cigarette-related attitudes and behaviors in a national sample of Chinese adolescents and young adults to obtain insights into their exposure to, experiences with, and attitudes to e-cigarettes on the cusp of new regulations coming into force. METHODS An online survey was administered to a sample of 1062 adolescents and young adults (aged 15-30 years) in China in November-December 2021. Quotas were applied to achieve an approximately equal gender split, representation across age sub-groups (15-17, 18-20, 21-23, 24-26, and 27-30 years), and approximately two-thirds representing low- and middle-income groups. Adjusted odds ratios (AORs) were also calculated. RESULTS Just under half (47%) reported no knowledge of e-cigarettes and/or vaping. One in five reported ever using e-cigarettes ('even once or twice'), 8% reported being current users, and 3% reported being daily users. Around twothirds of those who had heard of e-cigarettes/vaping had friends who vaped and had seen e-cigarette advertising. Fruit flavors were most popular, and the most frequently nominated reasons for vaping were to cut down on cigarette smoking and because a friend used them. The factors positively associated with ever use of e-cigarettes were current tobacco smoking (AOR=68.26) or previous tobacco smoking (AOR=39.15) and having friends who vape (AOR=1.76). Perceptions of addictiveness were negatively associated with ever use (AOR=0.47). Strong support was evident for most assessed e-cigarette control policies. CONCLUSIONS The results indicate that young people in China have been able to access and use e-cigarettes, although rates of regular use are low. Generally, high levels of expressed support for a range of e-cigarette control policies among members of this age group suggest the new regulatory environment is consistent with their policy preferences.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Yuan Li
- The George Institute for Global Health, Beijing, China
| | - Mia Miller
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Craig Anderson
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Thout S. Raj
- The George Institute for Global Health, Hyderabad, India
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Huang P, Zheng W, Shi Y, Shi L, Wu W, Lin X, Zeng X, He F, Liu M, Chen X. Beliefs and perceptions of electronic cigarettes among medical staff in respiratory departments of Fujian Province, China, in 2021. Tob Induc Dis 2022; 20:111. [PMID: 36561425 PMCID: PMC9743794 DOI: 10.18332/tid/156038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Due to the popularity of e-cigarettes, more and more patients ask about e-cigarettes, and it is particularly important to understand doctors' beliefs and perceptions on e-cigarettes. The aim was to evaluate the belief and perception of electronic cigarettes among medical staff in the respiratory department of medical institutions located in Fujian Province. METHODS The electronic questionnaires were conveyed to the medical staff of the respiratory department in Fujian Province during March to April 2021. Descriptive statistics were calculated for all questions, and the relationship between relevant factors and the perception of e-cigarette-related statements was analyzed by logistic regression analysis. RESULTS Among 1028 medical staff in the respiratory departments of Fujian Province, 90.5% of medical staff agreed that electronic cigarettes are harmful to the human body; 61.4% of medical staff agreed that e-cigarettes cannot be regarded as a type of smoking cessation treatment; 71.7% of medical staff agreed that e-cigarettes could be a 'gateway' to other tobacco use; and 69.2% of medical staff agreed that electronic cigarettes are in 'Three No' states. The multivariate logistic regression analysis showed that the respondents' perception of 'e-cigarettes cannot be regarded as a type of smoking cessation treatment' were related to gender, professional title and whether they participated in the cessation clinic. CONCLUSIONS The medical staff of the respiratory department in Fujian Province put more emphasis on the adverse effects of e-cigarettes on health, but lack the cognition of the effect of e-cigarette smoking cessation. In order to better carry out smoking cessation work, it is necessary to strengthen the training of respiratory medical staff at all levels of medical institutions on e-cigarette knowledge.
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Affiliation(s)
- Pengxiang Huang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Wanyu Zheng
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yangzhen Shi
- Department of Pulmonary and Critical Care Medicine, Jinjiang Municipal Hospital, Quanzhou, China
| | - Liyong Shi
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Weijing Wu
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Xiaoping Lin
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Xiaohong Zeng
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Fei He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Maolin Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoyang Chen
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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20
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Dai L, Lu W, Wang J, Zhang L, Zhu J. Social environment exposure to electronic cigarettes and its association with e-cigarette use among adolescents in Shanghai, China. Front Public Health 2022; 10:1005323. [PMID: 36407975 PMCID: PMC9669338 DOI: 10.3389/fpubh.2022.1005323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Objective This study investigated adolescents' social-environmental exposure to e-cigarettes in association with e-cigarette use in Shanghai, China. We also explored these differences by gender and school type. Methods Sixteen thousand one hundred twenty-three students were included by a stratified random cluster sampling, and the number was weighted according to selection probability. Association between social environment exposure and e-cigarette use was examined by multivariate logistic regressions. Results There were 35.07, 63.49, 75.19, 9.44, and 18.99% students exposed to secondhand e-cigarette aerosol (SHA), e-cigarette sales, e-cigarette information, parents' and friends' e-cigarette use. Students exposed to SHA (aOR = 1.73, 95% CI 1.40-2.14), e-cigarette sales from ≥2 sources (aOR = 1.55, 95% CI 1.18-2.03), e-cigarette information exposure from ≥2 sources (aOR = 1.39, 95% CI 1.05-1.83), and having a social e-smoking environment (friends' e-cigarette use: aOR = 2.56, 95% CI 2.07-3.16; parents' e-cigarette use: aOR = 1.54, 95% CI 1.17-2.02) were significantly associated with their intention to use e-cigarettes. More girls were exposed to e-cigarette sales in the malls, e-cigarette information at points of sale and on social media (P < 0.01), and exposure to sales from ≥2 sources were associated with girls' intention to use e-cigarettes (aOR = 1.84, 95% CI 1.22-2.78). However, boys were more likely to be exposed to friends' e-cigarette use (P < 0.001), and having friends using e-cigarettes was associated with greater intention to use them in boys (aOR = 2.64, 95% CI 1.97-3.55). Less vocational high school students were exposed to parents' e-cigarette use (P < 0.001), but they were more likely to use e-cigarettes in the future after being exposed (aOR = 2.27, 95% CI 1.50-3.43). A similar phenomenon was observed between junior high students and their exposure to SHA. Conclusions This study reported adolescents' high exposure rates to the social environment of e-cigarettes. Exposure to SHA, e-cigarette sales from ≥2 sources, e-cigarette information from ≥2 sources and having a social e-smoking environment were related to adolescents' intention to use e-cigarettes. Differences in gender and school type were observed. More attention should be paid to girls, and different interventions should be designed for different types of school students. Additionally, comprehensive tobacco control policies are needed.
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Pisinger C, Rasmussen SKB. The Health Effects of Real-World Dual Use of Electronic and Conventional Cigarettes versus the Health Effects of Exclusive Smoking of Conventional Cigarettes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013687. [PMID: 36294263 PMCID: PMC9603628 DOI: 10.3390/ijerph192013687] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND A high prevalence of dual use of e-cigarettes and conventional cigarettes has been reported across the world. METHODS A systematic search was carried out. We included original articles on any topic relevant to health, excluding mental health, in all languages. The PRISMA guidelines were followed. Both reviewers independently screened and read all publications. We compared dual use with exclusive smoking of conventional cigarettes (ESCC). RESULTS Fifty-two publications (49 studies) were included. Thirteen papers/10 studies were prospective. There was great heterogeneity across studies. Many methodological weaknesses, such as inaccurate exposure measurement, lack of adjustment for former tobacco consumption, and lack of significance testing were identified. Most prospective studies found dual use to be at least as harmful as ESCC. The longest follow-up was six years. Most of the best available cross-sectional studies found dual use associated with the same and, in several studies, significantly higher risk of self-reported symptoms/disease than in ESCC. The intensity of cigarette smoking seems associated with worse health. CONCLUSION Existing studies indicate that dual use is at least as, or probably even more, harmful than ESCC. Due to the predominance of cross-sectional studies and the methodological weaknesses we judged the overall certainty of the evidence as "low certainty".
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Affiliation(s)
- Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark
- Danish Heart Foundation, 1120 Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Sofie K. Bergman Rasmussen
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark
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Alsanea S, Alrabiah Z, Samreen S, Syed W, Bin Khunayn RM, Al-Arifi NM, Alenazi M, Alghadeer S, Alhossan A, Alwhaibi A, Al-Arifi MN. Prevalence, knowledge and attitude toward electronic cigarette use among male health colleges students in Saudi Arabia-A cross-sectional study. Front Public Health 2022; 10:827089. [PMID: 36276346 PMCID: PMC9580394 DOI: 10.3389/fpubh.2022.827089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 09/07/2022] [Indexed: 01/21/2023] Open
Abstract
Background Health care professionals have an important role in increasing awareness about smoking harms and serving as role models. This study aims to assess knowledge, attitude and perception toward electronic cigarettes (ECs) as well as prevalence of ECs use among male health colleges students. Method This is a cross-sectional survey-based study conducted among students in the male campus of five different health colleges over a 4-month period from February 2020 to May 2020. Descriptive analysis was used to assess the knowledge, perception and attitude, and inferential testing was used to evaluate the association of different participant's variables and knowledge toward ECs usage using SPSS. Results A total of 333 students were included in the analysis. Most of students (n = 205; 61.6%) had never used ECs, while 22.8 and 15.6% used them for recreational and smoking cessation purposes, respectively. Focusing on ECs users from each college individually, medical students had the highest prevalence followed by dental, pharmacy and nursing students (47.4, 40.7, 34.5, and 32%, respectively). Many students had misconceptions and a low level of knowledge about ECs, such as recognizing them as smoking-cessation tools and not knowing whether toxic and carcinogenic components levels in ECs are similar to conventional cigarettes, respectively. Medical students had significantly higher knowledge compared to dental students [3 (2) vs. 2 (1); p = 0.033]. Moreover, smokers were less knowledgeable than non-smokers [2.5 (1) vs. 2.1 (1), p = 0.027]. At least 62.8% of students perceived using ECs as a fashionable alternative smoking method and 59.2% believed that they may become a gateway for smoking addiction. Only 120 (36.0%) health colleges students were confidently able to advise smokers regarding ECs. Conclusion Our study highlights an increased trend of ECs use accompanied with insufficient knowledge and several misconceptions about ECs among health colleges students. This was associated with a negative influence on their attitude toward ECs use, which would potentially lead to negative consequences on public health.
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Affiliation(s)
- Sary Alsanea
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ziyad Alrabiah
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sana Samreen
- Volunteer Researcher, Drug and Poison Information Center (DPIC), Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Wajid Syed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Rawan M. Bin Khunayn
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | | | - Miteb Alenazi
- Department of Clinical Pharmacy, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Sultan Alghadeer
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alhossan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Alwhaibi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia,*Correspondence: Abdulrahman Alwhaibi
| | - Mohamed N. Al-Arifi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Yang HL, Mo BR, Molassiotis A, Wang M, He GL, Xie YJ. Relationship between multimorbidity and composite lifestyle status in Shenzhen, China. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2022; 12:26335565221123990. [PMID: 36090662 PMCID: PMC9449505 DOI: 10.1177/26335565221123990] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The study aimed to understand multimorbidity among adults in a high-tech city in southern coastal China that has undergone rapid economic development and to investigate its relationship with lifestyle status. Methods A population-based survey was conducted among 24 community centers in the Nanshan District of Shenzhen from February to December of 2018. Participants were recruited using a stratified random sampling approach. A self-administered questionnaire on typical chronic diseases, lifestyle factors, body composition, and social demographics was used to collect data. Multimorbidity was defined as two or more chronic diseases coexisting in a single person. An algorithm on body mass index, physical activity, drinking, smoking, and sleep quality was used to calculate lifestyle scores (0-9), with higher scores predicting a healthier lifestyle. Results A total of 2,905 participants were included in the analysis, with men accounting for 52.4%, and single for 25%. The prevalence of multimorbidity was 4.8%, and the mean lifestyle score was 4.79 ± 1.55. People who were old, retired, married, and had less education were more likely to have multimorbidity (all P < .05). A higher prevalence of multimorbidity was found among those who were obese, less engaged in physical activity, consumed more alcohol, and had poorer sleep quality (all p < .05). After adjusting for age, employment, education, and marital status, one unit increase in lifestyle score was associated with 0.74 times lower to have multimorbidity (OR: 0.74; 95% CI: 0.63-0.87, p < .05). Conclusion The prevalence of multimorbidity was relatively low in economically developed Shenzhen. Keeping a healthy lifestyle was related to the lower possibility of suffering from multiple chronic diseases.
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Affiliation(s)
- Hua-Lu Yang
- Department of Nursing, Huazhong University of Science and
Technology Union Shenzhen Hospital, Shenzhen, China,School of Nursing, The Hong Kong Polytechnic
University, Hong Kong SAR, China
| | - Bei-Rong Mo
- Department of Nursing, Huazhong University of Science and
Technology Union Shenzhen Hospital, Shenzhen, China
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic
University, Hong Kong SAR, China
| | - Mian Wang
- School of Nursing, The Hong Kong Polytechnic
University, Hong Kong SAR, China
| | - Gui-Lan He
- Department of Nursing, Huazhong University of Science and
Technology Union Shenzhen Hospital, Shenzhen, China
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic
University, Hong Kong SAR, China,Yao Jie Xie, School of Nursing, The Hong
Kong Polytechnic University, FG424, PolyU, Hong Kong SAR 999077, China.
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Qi Z, Lin B, Xie X, Xiao L. Characteristics and Associated Factors of E-cigarette Use Among Secondary School Students - 6 PLADs in China, 2021. China CDC Wkly 2022; 4:635-639. [PMID: 35919825 PMCID: PMC9339352 DOI: 10.46234/ccdcw2022.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 06/28/2022] [Indexed: 11/14/2022] Open
Abstract
What is already known about this topic? Previous studies on electronic cigarette (e-cigarette) use in China among secondary school students have provided information on the awareness and usage of e-cigarettes. What is added by this report? This study not only described e-cigarette usage rates, but also explored the characteristics of e-cigarette users' behavior and factors associated with the current use of e-cigarettes among secondary school students. What are the implications for public health practice? E-cigarette use among secondary school students, especially among vocational senior high school students, requires more attention. Although some policies have been developed to protect youths from the harmful effects of e-cigarettes, enforcement of these policies needs to be strengthened.
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Affiliation(s)
- Zhaobin Qi
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bingliang Lin
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoyun Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China,Lin Xiao,
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Hod R, Mohd Nor NH, Maniam S. Systematic review on e-cigarette and its effects on weight gain and adipocytes. PLoS One 2022; 17:e0270818. [PMID: 35788209 PMCID: PMC9255744 DOI: 10.1371/journal.pone.0270818] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/20/2022] [Indexed: 12/23/2022] Open
Abstract
Smoking and obesity are leading causes of morbidity and mortality worldwide. E-cigarette which was first introduced in 2000s is perceived as an effective alternative to conventional tobacco smoking. Limited knowledge is available regarding the risks and benefits of e-cigarettes. This study systematically reviews the current literature on the effects of e-cigarettes on body weight changes and adipocytes. The search was performed using OVID Medline and Scopus databases and studies meeting the inclusion criteria were independently assessed. This review included all English language, empirical quantitative and qualitative papers that investigated the effects of e-cigarettes on bodyweight or lipid accumulation or adipocytes. Literature searches identified 4965 references. After removing duplicates and screening for eligibility, thirteen references which involve human, in vivo and in vitro studies were reviewed and appraised. High prevalence of e-cigarette was reported in majority of the cross sectional studies conducted among respondent who are obese or overweight. More conclusive findings were identified in in vivo studies with e-cigarette causing weight decrease. However, these observations were not supported by in vitro data. Hence, the effect of e-cigarette on body weight changes warrants further investigations. Well-designed population and molecular studies are needed to further elucidate the role of e-cigarettes in obesity.
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Affiliation(s)
- Rafidah Hod
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nurul Huda Mohd Nor
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Sandra Maniam
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail:
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Receiving and giving electronic cigarettes as gifts in China: Findings from International Tobacco Control China Survey. Prev Med Rep 2022; 27:101763. [PMID: 35321216 PMCID: PMC8935514 DOI: 10.1016/j.pmedr.2022.101763] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/13/2022] [Indexed: 11/23/2022] Open
Abstract
Cigarette gifting is pervasive in China. As the Chinese are increasingly aware of harm from smoking cigarettes, e-cigarettes, often promoted as less harmful alternatives to cigarettes, may be viewed as appropriate gifts. This study is the first using population-based survey data to examine receiving and giving e-cigarettes as gifts in China. We analyzed 9,274 adults from Wave 5 of the International Tobacco Control China Survey, which was completed in July 2015. We found that the prevalence of receiving e-cigarettes as gifts was 1.3% among all respondents and 5.3% among urban smokers; the prevalence of giving e-cigarettes as gifts was 0.5% among all respondents and 1.2% among urban smokers. These prevalence estimates were very low among nonsmokers and rural respondents. Further analysis on urban smokers (N = 3,312) found that those aged 40–54 and 55+, those with high education levels, heavy smokers, and those who perceived e-cigarettes as equally/more harmful than cigarettes were more likely to receive e-cigarette gifts; and those who ever used e-cigarettes were significantly more likely to both receive and give e-cigarette gifts. Urban smokers with positive attitude about cigarette gifting were also more likely to give e-cigarette gifts to others, but those aged 55+ were less likely to gift e-cigarettes. Findings of this study indicate that the Chinese may perceive e-cigarettes as appropriate gifts for smokers, especially heavy smokers. Precautions should be taken to prevent e-cigarettes from becoming a gift choice for nonsmokers. Health campaigns designed to combat the social acceptance of cigarette gifting may also help reduce e-cigarette gifting.
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Pan L, Morton J, Mbulo L, Dean A, Ahluwalia IB. Electronic cigarette use among adults in 14 countries: A cross-sectional study. EClinicalMedicine 2022; 47:101401. [PMID: 35497060 PMCID: PMC9046112 DOI: 10.1016/j.eclinm.2022.101401] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The tobacco product landscape continues to change. No recent data for electronic cigarette (e-cigarette) use have been reported for multiple countries based on nationally representative surveys. We examined prevalence of e-cigarette use and variations by sociodemographic characteristics in 14 countries using Global Adult Tobacco Survey (GATS) data between Jan 1, 2015, and Dec 31, 2018. METHODS GATS is a nationally representative household survey of tobacco use among adults aged ≥15 years. The analytic sample size ranged from 4347 in Senegal to 74,037 in India. Prevalence of current e-cigarette use was stratified by sociodemographic subgroups. Age-standardized prevalence was estimated according to world 2000-2025 standard population. Significant differences in adjusted prevalence across sociodemographic subgroup was determined by p value for marginal effect contrast in multivariable logistic regression models. FINDINGS More than 50% of adults in Russia, Romania, and Ukraine and additionally more than 30% of adults in China, Costa Rica, Uruguay, Mexico, and Philippines were aware of e-cigarettes. Crude prevalence of current e-cigarette use ranged from 0.02% (95% CI 0.01%-0.04%) in India to 3.5% (2.9%-4.2%) in Russia. Prevalence was <1% in nine countries. Approximately 18.3 million adults currently used e-cigarettes across the 14 countries. Men had a significantly higher prevalence of current e-cigarette use than women in eight countries. Additionally, higher adjusted prevalence was observed in some countries among young adults aged 15‒24 years, urban residents, and adults with higher education levels and higher wealth index. INTERPRETATION The study provides needed baseline data on e-cigarette awareness and use. Continued surveillance is essential to inform interventions and policies to prevent initiation and enhance cessation support. FUNDING None.
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Affiliation(s)
- Liping Pan
- Global Tobacco Control Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Corresponding Author: Liping Pan, Office on Smoking and Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mail Stop S107-7, Atlanta, GA 30341.
| | - Jeremy Morton
- Global Tobacco Control Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- CDC Foundation, Atlanta, Georgia, USA
| | - Lazarous Mbulo
- Global Tobacco Control Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anna Dean
- Global Tobacco Control Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- CDC Foundation, Atlanta, Georgia, USA
| | - Indu B. Ahluwalia
- Global Tobacco Control Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Driezen P, Nordin ASA, Hairi FM, Yee A, Tajuddin NAA, Hasan SI, Danaee M, Kamaludin IS, Kaai SC, Yan M, Grey M, Quah ACK, Thompson ME, Fong GT. E-cigarette prevalence among Malaysian adults and types and flavors of e-cigarette products used by cigarette smokers who vape: Findings from the 2020 ITC Malaysia Survey. Tob Induc Dis 2022; 20:32. [PMID: 35431719 PMCID: PMC8969646 DOI: 10.18332/tid/146363] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION E-cigarettes (ECs) have become increasingly common in many countries, including Malaysia. The prevalence of EC use increased in Malaysia from 0.8% in 2011 to 4.9% in 2019. Three quarters of Malaysian EC users also smoke combustible cigarettes, and the prevalence of EC use among Malaysian smokers in 2014 was consistent with the prevalence of use among smokers from Canada and the US in 2016. The purpose of this study was to estimate the prevalence of EC use among Malaysian adults aged ≥18 years in 2020 and the types of EC products and flavors used by cigarette smokers who also used ECs at least monthly. METHODS Data came from 1253 adults aged ≥18 years who participated in the 2020 International Tobacco Control Malaysia Wave 1 Survey. Weighted descriptive statistics were used to estimate the prevalence of adults who reported ever using ECs and the prevalence who used ECs either monthly, weekly, or daily. The types of EC products and flavors used were compared by frequency of EC use among current smokers who used ECs at least monthly (n=459). RESULTS Overall, 5.4% (95% CI: 3.7-7.5) of Malaysian adults reported using ECs on a daily basis in 2020. Among current cigarette smokers who used ECs daily, 81.0% (95% CI: 72.5-87.7) used nicotine in their ECs, 46.2% (95% CI: 37.8-54.7) used pre-filled ECs, and 60.4% (95% CI: 51.9-68.6) reported being somewhat/very addicted to ECs. The most common EC flavors were fruit, coffee, and menthol/ mint. CONCLUSIONS Continued surveillance of EC use is necessary to monitor EC use in non-tobacco using populations while longitudinal research is needed to determine the extent to which ECs are, or are not, related to quitting smoking.
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Affiliation(s)
- Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Amer Siddiq Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Amani Ahmad Tajuddin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Idayu Hasan
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ina Sharyn Kamaludin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Susan C. Kaai
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Mi Yan
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Matthew Grey
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Anne C. K. Quah
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
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Lin HX, Zhang Y, Chen MJ, Zheng YT, Yun QP, Zhang LC, Zhang WT, Zhu BC, Liu Z. The characteristics and patterns of e-cigarette use and its
association with cigarette cessation intention in a Chinese
smoking population: A mediation analysis. Tob Induc Dis 2022; 20:16. [PMID: 35221859 PMCID: PMC8832540 DOI: 10.18332/tid/144251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The use of e-cigarettes has become more common in China, but the research on e-cigarettes in China, while growing, is still limited. This study examined the characteristics and patterns of e-cigarette use, and analyzed the possible mediators between cigarette cessation intention and e-cigarette use in a Chinese smoking population. METHODS This was a cross-sectional study conducted in mainland China. By convenience sampling method, the participants were recruited from 85 major commercial streets of several large cities in China. The study interviewers completed face-to-face interviews and uploaded the completed questionnaires into the online survey platform. The participants were contacted for clarification if any problems were detected. Logistic regression yielded adjusted odds ratios (ORs) for ever use of e-cigarettes. We further conducted a mediation analysis to estimate the effect of possible mediators. RESULTS From July to August 2020, a total of 738 smokers were invited to participate in this study; 613 smokers were identified as eligible and 609 smokers were included in this analysis. Of them, 24 (3.94%) participants were currently using e-cigarettes, and 165 (27.09%) participants have ever used e-cigarettes. The participants with younger age were more likely to have ever used e-cigarettes, ranging from 37.5% in the 18–29 years age group to 6.5% in the 60–69 years age group. After controlling for demographic characteristics and nicotine dependence, the ever use of e-cigarettes was significantly associated with younger age, higher education level, higher monthly income, previous smoking cessation attempts and quitting intention. With the mediation analysis, the education level is confirmed as a mediating factor, and approximately 42.86% of the effects were mediated through the channel of higher socioeconomic status. CONCLUSIONS This is the first study to examine the possible mediators between cigarette cessation intention and e-cigarette use in a Chinese smoking population. The findings revealed that high socioeconomic status, particularly higher education level, was a major mediating factor.
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Affiliation(s)
- Hao-Xiang Lin
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yan Zhang
- China Journal of Traditional Chinese Medicine and Pharmacy, Beijing, China
| | - Mei-Jun Chen
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yun-Ting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Qing-Ping Yun
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Lan-Chao Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wan-Tong Zhang
- Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bao-Chen Zhu
- Department of Pharmacology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhao Liu
- Tobacco Medicine and Tobacco Cessation Center, China-Japan Friendship Hospital, Beijing, China
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Ke J, Lin T, Liu X, Wu K, Ruan X, Ding Y, Liu W, Qiu H, Tan X, Wang X, Chen X, Li Z, Cao G. Glucose Intolerance and Cancer Risk: A Community-Based Prospective Cohort Study in Shanghai, China. Front Oncol 2021; 11:726672. [PMID: 34527591 PMCID: PMC8435720 DOI: 10.3389/fonc.2021.726672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/11/2021] [Indexed: 01/24/2023] Open
Abstract
Background Cancer becomes the leading cause of premature death in China. Primary objective of this study was to determine the major risk factors especially glucose intolerance for cancer prophylaxis. Methods A cluster sampling method was applied to enroll 10,657 community-based adults aged 15-92 years in Shanghai, China in 2013. A structured questionnaire and physical examination were applied in baseline survey. Prediabetes was diagnosed using 75-g oral glucose tolerance test. After excluding 1433 subjects including 224 diagnosed with cancer before and 1 year after baseline survey, the remaining 9,224 subjects were followed-up to December 31, 2020. Results A total of 502 new cancer cases were diagnosed. The cancer incidence was 10.29, 9.20, and 5.95/1,000 person-years in diabetes patients, those with prediabetes, and healthy participants, respectively (p<0.001). The multivariate Cox regression analysis indicated that age, prediabetes and diabetes, were associated with an increased risk of cancer in those <65 years, the hazard ratios (95% confidence interval) for prediabetes and diabetes were, 1.49(1.09-2.02) and 1.51(1.12-2.02), respectively. Glucose intolerance (prediabetes and diabetes) were associated with increased risks of stomach cancer, colorectal cancer, and kidney cancer in those <65 years. Anti-diabetic medications reduced the risk of cancer caused by diabetes. The multivariate Cox analysis showed that age, male, <9 years of education, and current smoking were associated with increased risks of cancer in those ≥65 years independently. Conclusions Glucose intolerance is the prominent cancer risk factor in adults <65 years. Lifestyle intervention and medications to treat glucose intolerance help prevent cancer in this population.
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Affiliation(s)
- Juzhong Ke
- Department of Epidemiology, Second Military Medical University, Shanghai, China.,Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Tao Lin
- Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Xiaolin Liu
- Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Kang Wu
- Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Xiaonan Ruan
- Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Yibo Ding
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Wenbin Liu
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Hua Qiu
- Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Xiaojie Tan
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Xiaonan Wang
- Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Xi Chen
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Zhitao Li
- Pudong New Area Center for Disease Control and Prevention, Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China
| | - Guangwen Cao
- Department of Epidemiology, Second Military Medical University, Shanghai, China
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