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Liao LL, Chang LC, Lai IJ, Lee CK. College Students' E-health Literacy, Social Media Use, and Perceptions of E-cigarettes in Taiwan. J Community Health 2024; 49:52-60. [PMID: 37420015 DOI: 10.1007/s10900-023-01255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
This study aimed to examine the relationship between social media use, e-health literacy, and the risk and benefit perceptions of e-cigarettes among college students in Taiwan. A cross-sectional online survey was conducted with 1,571 Taiwanese college students, which included four questionnaires to assess participants' perceptions, social media use behavior, e-health literacy, and sociodemographic factors. The data were presented in terms of means, standard deviations, and percentages. Stepwise regression was used to identify factors associated with the participants' perceptions. The study found that 75.01% of the participants were exposed to e-cigarette information on social media, with 31.26% actively searching for it and 15.95% sharing it. Participants had a high e-cigarette risk perception, indicating low benefit perception, but acceptable e-health literacy. Factors such as current e-cigarette and tobacco use, e-health literacy, academic achievement, and sex significantly predicted e-cigarette risk perception, while sharing e-cigarette related information, sex, age, academic achievement, and current e-cigarette use significantly predicted its benefit perception. Thus, implementing effective e-health literacy programs to enhance college students' e-cigarette risk perception is recommended along with a proactive approach to tackle e-cigarette advertising messages on social media, minimizing their sharing behavior to decrease their perception of associated benefits.
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Affiliation(s)
- Li-Ling Liao
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Chun Chang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - I-Ju Lai
- Department of Nutrition, I-Shou University, Kaohsiung, Taiwan
| | - Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 70101, Taiwan.
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Chen G, Rahman S, Lutfy K. E-cigarettes may serve as a gateway to conventional cigarettes and other addictive drugs. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11345. [PMID: 38389821 PMCID: PMC10880776 DOI: 10.3389/adar.2023.11345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 02/24/2024]
Abstract
Electronic cigarettes (e-cigarettes) are devices that allow the user to inhale nicotine in a vapor, and are primarily marketed as a means of quitting smoking and a less harmful replacement for traditional cigarette smoking. However, further research is needed to determine if vaping nicotine via e-cigarettes can be effective. Conversely, nicotine has been considered a gateway drug to alcohol and other addictive drugs and e-cigarettes containing nicotine may have the same effects. Previous reports have shown that e-cigarette use may open the gate for the use of other drugs including conventional cigarettes, cannabis, opioids, etc. The increasing prevalence of e-cigarettes, particularly among youth and adolescents in the last decade have led to an increase in the dual use of e-cigarettes with alcohol, cannabis, and other illicit drug use like heroin and 3-4-methylenedioxymethamphetamine (MDMA). The advent of e-cigarettes as a device to self-administer addictive agents such as cocaine and synthetic cathinones may bring about additional adverse health effects associated with their concurrent use. This review aims to briefly describe e-cigarettes and their different generations, and their co-use with other addictive drugs as well as the use of the device as a tool to self-administer addictive drugs, such as cocaine, etc.
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Affiliation(s)
- Grace Chen
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, United States
| | - Kabirullah Lutfy
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
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Liu PI, Lin MN, Ho PS, Tsai JH, Yang YH, Wu KF, Chuang HY. Prediction and potential risk factors for electronic cigarette use behaviors among adolescents: a pilot study in Chiayi, Taiwan. Front Public Health 2023; 11:1140615. [PMID: 37397731 PMCID: PMC10311257 DOI: 10.3389/fpubh.2023.1140615] [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: 01/09/2023] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Electronic cigarette (e-cigarette) use among adolescents has become increasingly common; therefore, effectively reducing adolescent e-cigarette use is an urgent issue. We aimed to predict and identify potential factors related to adolescent e-cigarette use behaviors. Methods This cross-sectional study was conducted using anonymous questionnaires given to Taiwanese high school students in 2020. Approximately 1,289 adolescent students completed questions on e-cigarette use, personal characteristics, family environment, and substances used. We performed multivariate logistic regression analyses to assess the model's predictive performance in terms of the area under the receiver operating characteristic curve. Results We found that 9.3% of adolescent students used e-cigarettes. Tobacco smoking, close friends' reactions to e-cigarette use, and the use of other substances were independent risk factors for adolescent e-cigarette use. Furthermore, relative to tobacco nonuse, tobacco use and tobacco smoking dependence had odds ratios of 76.49 and 113.81, respectively. The predictive accuracy of adolescent e-cigarette use from personal characteristics, family environment, and substance use status was 73.13, 75.91, and 93.80%, respectively. Conclusion The present study highlights the need for early prevention of e-cigarette use among adolescents, particularly those with a history of using tobacco and other substances and those who have close friends with positive attitudes towards e-cigarette use.
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Affiliation(s)
- Ping-I Liu
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
- Department of Geriatric Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Ming-Nan Lin
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Pei-Shan Ho
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Ya-Hui Yang
- Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan
| | - Ke-Fei Wu
- Department of Business Management, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Hung-Yi Chuang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, and Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Jane Ling MY, Abdul Halim AFN, Ahmad D, Ahmad N, Safian N, Mohammed Nawi A. Prevalence and Associated Factors of E-Cigarette Use among Adolescents in Southeast Asia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3883. [PMID: 36900893 PMCID: PMC10001692 DOI: 10.3390/ijerph20053883] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 06/15/2023]
Abstract
The use of e-cigarettes in adolescents remains a major public health concern. Like other tobacco products, e-cigarettes pose health risks to adolescents. Understanding the magnitude of this problem and identification of its associated factors will serve as a guide for development of preventive interventions. This systematic review aims to identify and discuss current epidemiological data on the prevalence and associated factors of e-cigarette use among adolescents in Southeast Asia. The reporting of this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. We carried out a literature search through three databases (Scopus, PubMed, Web of Science) and targeted original English-language articles published between 2012 and 2021. A total of 10 studies were included in this review. The prevalence of current e-cigarette uses ranges from 3.3% to 11.8%. Several associated factors of e-cigarette use were identified, including sociodemographic factors, traumatic childhood experience, peer and parental influence, knowledge and perception, substance use, and accessibility of e-cigarettes. These factors should be addressed though multifaceted interventions which simultaneously target multiple factors. Laws, policies, programs, and interventions must be strengthened and tailored to the needs of adolescents at risk of using e-cigarettes.
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Affiliation(s)
| | | | | | | | | | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Tehrani H, Rajabi A, Ghelichi- Ghojogh M, Nejatian M, Jafari A. The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health 2022; 80:240. [PMID: 36415010 PMCID: PMC9682677 DOI: 10.1186/s13690-022-00998-w] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this systematic review study was to determine the national, regional, and global prevalence of electronic cigarettes (e-cigarettes) vaping. METHOD The articles were searched in July 2020 without a time limit in Web of Science (ISI), Scopus, PubMed, and Ovid-MEDLINE. At first, the titles and abstracts of the articles were reviewed, and if they were appropriate, they entered the second stage of screening. In the second stage, the whole articles were reviewed and articles that met the inclusion criteria were selected. In this study, search, selection of studies, qualitative evaluation, and data extraction were performed by two authors independently, and any disagreement between the two authors was reviewed and corrected by a third author. RESULTS In this study, the lifetime and current prevalence of e-cigarettes vaping globally were 23% and 11%, respectively. Lifetime and current prevalence of e-cigarettes vaping in women were 16% and 8%, respectively. Also, lifetime and current prevalence of e-cigarettes vaping in men were 22% and 12%, respectively. In this study, the current prevalence of e-cigarettes vaping in who had lifetime smoked conventional cigarette was 39%, and in current smokers was 43%. The lifetime prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 24%, 26%, 16%, and 25%, respectively. The current prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 10%, 14%, 11%, and 6%, respectively. CONCLUSIONS Based on the results of this study, it can be concluded that the popularity of e-cigarettes is increasing globally. Therefore, it is necessary for countries to have more control over the consumption and distribution of e-cigarettes, as well as to formulate the laws prohibiting about the e-cigarettes vaping in public places. There is also a need to design and conduct information campaigns to increase community awareness about e-cigarettes vaping.
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Affiliation(s)
- Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolhalim Rajabi
- Environmental Health Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mahbobeh Nejatian
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Martins BNFL, Normando AGC, Rodrigues-Fernandes CI, Wagner VP, Kowalski LP, Marques SS, Marta GN, Júnior GDC, Ruiz BII, Vargas PA, Lopes MA, Santos-Silva AR. Global frequency and epidemiological profile of electronic cigarette users: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:548-561. [PMID: 36182650 DOI: 10.1016/j.oooo.2022.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/19/2022] [Accepted: 07/26/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Electronic cigarette (e-cigarette) use is growing significantly worldwide, especially among young people. This product has been associated with renormalizing smoking and hindering quit attempts in smokers. Moreover, among nonsmokers, it can lead to subsequent cigarette smoking and nicotine dependence. The present study aimed to assess the epidemiological profile of e-cigarette users worldwide. STUDY DESIGN A systematic review was performed using 3 main electronic databases (Medline/PubMed, SCOPUS, and EMBASE). Studies were independently assessed by 2 reviewers based on established eligibility criteria. The risk of bias was assessed using the MAStARI critical appraisal instrument. RESULTS From 4,496 records, 43 were included. Among the 1,238,392 participants, 132,786 (10.72%) were e-cigarette users. The age range with the highest percentage of e-cigarette users was 18-24 years old, with 40,989 (30.86%) males, 34,875 (26.26%) females, and 33.6% being current cigarette smokers. The highest prevalence of users was 52.88% in Croatia and 49.62% in New Zealand. Other possible correlations were observed with e-cigarette use, such as a high level of education. CONCLUSION Overall, e-cigarette users tended to be male young adults with a higher level of education. The highest prevalence of use was found in Croatia. This systematic review provides valuable information to improve the development of appropriate intervention strategies targeting e-cigarette users for more accurate anti-smoking actions.
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Affiliation(s)
| | | | | | - Vivian Petersen Wagner
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of Sao Paulo Medical School and Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Sandra Silva Marques
- São Paulo State Reference Centre on Alcohol, Tobacco and Other Drugs, Secretary of Health, São Paulo, Brazil; State Coordination of the Tobacco Program, São Paulo, Brazil
| | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês São Paulo, São Paulo, Brazil
| | - Gilberto de Castro Júnior
- Clinical Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), São Paulo, São Paulo, Brazil
| | | | - Pablo Agustin Vargas
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil
| | - Marcio Ajudarte Lopes
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil.
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Kim J, Lee S, Chun J. An International Systematic Review of Prevalence, Risk, and Protective Factors Associated with Young People's E-Cigarette Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11570. [PMID: 36141845 PMCID: PMC9517489 DOI: 10.3390/ijerph191811570] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 06/06/2023]
Abstract
While the prevalence of young people's conventional cigarette use has decreased in many countries, the use of e-cigarettes has risen. To effectively counteract the growing popularity of e-cigarettes among young people internationally, researchers should know the exact prevalence as well as the protective and risk factors associated with vaping. Based on five eligibility criteria, 53 articles were chosen and analyzed by general characteristics, prevalence, sample characteristics, gender difference, protective factors, and risk factors. In this study, the international pooled prevalence of young people's lifetime e-cigarette use was 15.3%, the current use was 7.7%, and dual use was 4.0%. While the highest lifetime, current, and dual prevalence were found in Sweden, Canada, and the United Kingdom, respectively, the lowest prevalence was found in Germany, followed by South Korea and Sweden. Some protective and risk factors include perceived cost and danger of vaping, parental monitoring, internal developmental assets, cigarette use, family and peer smoking, exposure to online advertisements, and the presence of nearby retail stores. Based on this review, researchers and practitioners can develop different intervention programs and strategies for young smokers.
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Affiliation(s)
| | | | - JongSerl Chun
- Department of Social Welfare, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
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Struik LL, O'Loughlin EK, Riglea T, O'Loughlin JL. Predictors of past-year e-cigarette use among young adults. Prev Med Rep 2022; 29:101965. [PMID: 36161135 PMCID: PMC9502288 DOI: 10.1016/j.pmedr.2022.101965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/04/2022] [Accepted: 08/25/2022] [Indexed: 11/30/2022] Open
Abstract
Predictors of past-year e-cigarette use among young adults at age 30 were studied. Data was drawn from the Nicotine Dependence In Teens (NDIT) cohort. Male sex, friends smoke, tobacco and substance use, and impulsivity predicted use. Higher education and very good/excellent self-rated health were protective. These factors warrant consideration in public health efforts.
Understanding the underpinnings of e-cigarette use among young adults is critical to addressing increasing uptake. We identified predictors of past-year e-cigarette use among young adults in Montreal, Canada. Data on potential predictors were available for 714 young adults participating in the ongoing Nicotine Dependence in Teens Study at age 20 in 2007–08. Past-year e-cigarette use was measured at age 30 in 2017–20. Each potential predictor was studied in a separate multivariable logistic regression model controlling for age, sex, and educational attainment. Male sex, friends who smoke, cigarette smoking, use of other tobacco products, alcohol use, use of marijuana, and impulsivity predicted past-year e-cigarette use. Higher educational attainment and very good/excellent self-rated health were protective. Program and policy makers will need to consider these predictors of e-cigarette use in the design of clinical and public health interventions targeting e-cigarette use in young adults.
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Affiliation(s)
- Laura L. Struik
- School of Nursing, Department of Health and Exercise Sciences, University of British Columbia Okanagan, 1147 Research Road, Kelowna, British Columbia V1V1V7, Canada
- Corresponding author.
| | - Erin K. O'Loughlin
- Department of Exercise Sciences, University of Toronto, 55 Harbord Street, Toronto, Ontario M5S 2W6, Canada
- Carrefour de l’innovation et de l’évaluation en santé, University of Montreal Hospital Research Center, Tour Saint-Antoine, 850 Rue Saint-Denis, Montréal, Québec H2X 0A9, Canada
| | - Teodora Riglea
- Carrefour de l’innovation et de l’évaluation en santé, University of Montreal Hospital Research Center, Tour Saint-Antoine, 850 Rue Saint-Denis, Montréal, Québec H2X 0A9, Canada
| | - Jennifer L. O'Loughlin
- Carrefour de l’innovation et de l’évaluation en santé, University of Montreal Hospital Research Center, Tour Saint-Antoine, 850 Rue Saint-Denis, Montréal, Québec H2X 0A9, Canada
- Département de médecine sociale et préventive, École de santé Publique de l’Université de Montréal, 7101 ave du Parc, Montréal, QC H3N 1X9, Canada
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Althobaiti NK, Mahfouz MEM. Prevalence of Electronic Cigarette Use in Saudi Arabia. Cureus 2022; 14:e25731. [PMID: 35812546 PMCID: PMC9262416 DOI: 10.7759/cureus.25731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background: The electronic cigarette (e-cigarette) was aggressively promoted as a healthier alternative to tobacco smoking. Despite the fact that e-cigarettes gained popularity among youth and young adults, there are no national data assessing the prevalence of e-cigarette use in Saudi Arabia. Objective: The present study aims at establishing the prevalence and correlates of electronic cigarette use among adults in Saudi Arabia. Design and setting: A cross-sectional study was carried out to evaluate the prevalence of using electronic cigarettes in Saudi Arabia through a self-administered questionnaire. The data collected from the questionnaire were focusing on socio-demographic data as well as information on the type of smoking that adults are using. Data were represented in terms of frequencies and valid percentages for categorical variables. Statistical analysis was carried out using SPSS version 26. Results: A total of 3374 participants responded to this questionnaire. Around 26% of this cohort have tried electronic cigarettes at least once in their lives. Additionally, there was a statistically significant difference (p value <0.001) in using smokeless tobacco, where e-cigarette smokers had higher incidence of smokeless tobacco smoking. Also, e-cigarette smokers had significantly higher (p value=0.002) frequency of smoking tobacco. Moreover, e-cigarette smoking was significantly higher among males (p value <0.001), with higher educational levels (p value <0.001) and age group between 18 and 24 years old. Conclusion: Electronic cigarette use is more common among young adults and those who have previously tried tobacco smoking. Other randomized studies are urgent to explore the extent of harmful effects of electronic cigarettes smoking (e-smoking) in the Kingdom.
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Bašková M, Sovinová H, Csémy L, Baška T, Ochaba R. Does tobacco use among adolescents come out of style in Czechia and Slovakia? Findings from the Global Youth Tobacco Survey between 2002 and 2016. Cent Eur J Public Health 2022; 30:79-85. [PMID: 35876595 DOI: 10.21101/cejph.a6858] [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: 03/30/2021] [Accepted: 05/27/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study is to analyse Global Youth Tobacco Survey (GYTS) data on a prevalence of tobacco use, indicators of tobacco control and pro-tobacco activities in Czechia and Slovakia between 2002 and 2016. METHODS GYTS is a school-based survey of students aged 13-15 years carried out in Czechia and Slovakia in 2002/2003, 2007, 2011 and 2016. Standardized uniform questionnaires provided representative data. RESULTS Between 2002 and 2016 the current cigarette smoking declined both in Czechia and Slovakia (from 34.6% and 26.4% to 15.2% and 17.1%, respectively). Indicators of tobacco control activities either did not change (access to buy cigarettes by minors) or decreased (school-based and mass media interventions). Indicators of pro-tobacco activities declined (being ever offered by a free tobacco product and having something with a tobacco product brand logo on it). CONCLUSIONS Tobacco use is on decline and the situation becomes similar to the most of European countries. Preventive activities are only partially responsible for the process. Rather effect of global trends accelerated by widespread use of social media can play a role.
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Affiliation(s)
- Martina Bašková
- Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Hana Sovinová
- National Institute of Public Health, Prague, Czech Republic
| | - Ladislav Csémy
- National Institute of Mental Health, Klecany, Czech Republic
| | - Tibor Baška
- Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Robert Ochaba
- Department of Public Health, Faculty of Health Care and Social Work, Trnava University, Trnava, Slovak Republic
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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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Jane Ling MY, Ahmad N, Mohd Yusoff MF, Lim KH. Current e-cigarette use among in-school adolescents in West Malaysia: Examining the interactions between sociodemographic characteristics and lifestyle risk behaviours. PLoS One 2022; 17:e0263355. [PMID: 35100321 PMCID: PMC8803165 DOI: 10.1371/journal.pone.0263355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Adolescent e-cigarette use has increased dramatically. Most e-cigarette liquids contain nicotine, which can harm the developing adolescent brain. Local studies examining the risk factors of adolescent e-cigarette use and interactions between its risk factors are limited. This study was aimed at determining the prevalence of current e-cigarette use and its associated factors among in-school adolescents in West Malaysia. We also examined the possible sociodemographic characteristic, lifestyle risk behaviour and parental factor interactions that affect the probability of current e-cigarette use. Methods We conducted a cross-sectional study using data from the National Health and Morbidity Survey 2017. Respondents aged 13–18 years were included in the study. The data were analysed using STATA (v.15). Results The prevalence of current e-cigarette use was 9.1%. Male gender, older age, Malay ethnicity, schooling in urban area, current smoking, current alcohol use, current drug use, having parents that are not married and living together and parental tobacco product use were significantly associated with current e-cigarette use. There were significant interactions between: i) gender with age, ethnicity, current smoking, current alcohol use and current drug use, ii) ethnicity with current smoking and current alcohol use, iii) locality with ethnicity, current smoking and current alcohol use, iv) current drug use with age, ethnicity, current smoking and current alcohol use, v) parental marital status with gender, age and ethnicity, and vi) parental tobacco use with ethnicity and current smoking. Conclusion Our findings identify significant associations between sociodemographic characteristics, lifestyle risk behaviours and parental factors with current e-cigarette use. They also provide new insight into the interactions between these factors that affect the probability of current e-cigarette use among West Malaysian adolescents. Efforts to tackle e-cigarette use in Malaysian adolescents should target sociodemographic characteristics, lifestyle risk behaviours and parental factors such as smoking cessation intervention for parents.
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Affiliation(s)
- Miaw Yn Jane Ling
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norfazilah Ahmad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- * E-mail:
| | | | - Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Aqeeli AA, Makeen AM, Al Bahhawi T, Ryani MA, Bahri AA, Alqassim AY, El-Setouhy M. Awareness, knowledge and perception of electronic cigarettes among undergraduate students in Jazan Region, Saudi Arabia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:706-713. [PMID: 32974976 DOI: 10.1111/hsc.13184] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 08/24/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
The use of electronic cigarettes (e-cigarettes) has steadily grown over the past few years, rising in popularity amongst young adults, especially. Owing to the perception that e-cigarettes are less harmful than conventional cigarettes, some people have resorted to using them as a means of quitting cigarette smoking. This study aimed to assess the awareness, knowledge, perception and use of e-cigarettes among Jazan University students in Saudi Arabia. An observational cross-sectional study was conducted with 775 students. Using stratified random sampling to recruit study participants, the dataset tabling the use of e-cigarettes, as well as knowledge, perception and awareness was collected using a translated and culturally adapted structured Arabic questionnaire. Our results showed that 21.0% of the participants used e-cigarettes and 35.1% of them used them to quit smoking. E-cigarette use was mostly reported by students from the College of Medical Applied Sciences (31.7%). The overall knowledge score was 3.9, with a standard deviation of 1.3 for the score range from zero to seven. About half of the participants correctly identified e-cigarettes as not less addictive' than cigarettes. However, 70.2% of students failed to identify e-cigarettes as a source of second-hand exposure to nicotine. About two-thirds of the sample believed that e-cigarettes could adversely affect health. The perception of using e-cigarettes for smoking cessation was not significantly associated with e-cigarette use. In conclusion, the prevalence of e-cigarette use was similar to that reported in the literature. However, Jazan University students failed to identify the health risks associated with e-cigarette use. Therefore, a strategy to enhance students' awareness of the benefits and harms of e-cigarettes is needed.
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Affiliation(s)
- Abdulwahab A Aqeeli
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Anwar M Makeen
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Tariq Al Bahhawi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Majed A Ryani
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmed A Bahri
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmad Y Alqassim
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Boccio CM, Meldrum RC, Jackson DB. Adverse childhood experiences and adolescent nicotine and marijuana vaping: Findings from a statewide sample of Florida youth. Prev Med 2022; 154:106866. [PMID: 34740675 DOI: 10.1016/j.ypmed.2021.106866] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/26/2021] [Accepted: 10/30/2021] [Indexed: 11/17/2022]
Abstract
A wealth of research links exposure to adverse childhood experiences (ACEs) with negative outcomes including nicotine and marijuana use. In addition, an emerging line of research has documented associations between exposure to ACEs and vaping activity in American adults and international samples of adolescents. Very limited research, however, has explored whether a history of ACEs is linked with adolescent nicotine and marijuana vaping activity in an American sample. This study addresses this gap in the literature by employing multinomial logistic regression to examine whether cumulative exposure to ACEs is associated with adolescent nicotine vaping, dual mode use of nicotine, marijuana vaping, and dual mode use of marijuana in a sample of Florida high school students. Our findings reveal that greater cumulative exposure to ACEs (up to 5 ACEs) in adolescents leads to an increase in the likelihood of vaping nicotine and marijuana. In addition, greater cumulative exposure to ACEs (up to 6 ACEs) leads to an increase in the likelihood of using nicotine and marijuana through multiple delivery modes.
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Affiliation(s)
- Cashen M Boccio
- Department of Criminology & Criminal Justice, The University of Texas, San Antonio, USA.
| | - Ryan C Meldrum
- Department of Criminology and Criminal Justice, Florida International University, USA.
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, USA.
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Examining potential risk factors for early age of nicotine vaping initiation in a sample of Florida youth. Addict Behav 2021; 120:106962. [PMID: 33964584 DOI: 10.1016/j.addbeh.2021.106962] [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: 01/14/2021] [Revised: 03/17/2021] [Accepted: 04/22/2021] [Indexed: 11/22/2022]
Abstract
Previous research has examined risk factors for nicotine vaping in young adults and older adolescents. Even so, significantly less research has examined risk factors for initiating nicotine vaping in early adolescence. This paper addresses this gap in the literature by examining risk factors for initiating nicotine vaping in a sample of middle- and high-school students. In order to do so, we analyze data from the 2019 cohort of the Florida Youth Substance Abuse Survey (FYSAS). We employ multinomial logistic regression and logistic regression to examine potential risk factors for early age of nicotine vaping initiation. Our findings reveal that early age of nicotine vaping initiation is associated with cigarette use, alcohol use, having substance using peers, lifetime incidence of arrest, and lifetime incidence of school suspension. In conclusion, our findings reveal that early age of nicotine vaping initiation is associated with other forms of risky behavior in adolescence (i.e., substance use, misbehavior leading to arrest and/or school suspension). We discuss the implications of these findings for future research.
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Toxicology of flavoring- and cannabis-containing e-liquids used in electronic delivery systems. Pharmacol Ther 2021; 224:107838. [PMID: 33746051 DOI: 10.1016/j.pharmthera.2021.107838] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/11/2021] [Indexed: 12/15/2022]
Abstract
Electronic cigarettes (e-cigarettes) were introduced in the United States in 2007 and by 2014 they were the most popular tobacco product amongst youth and had overtaken use of regular tobacco cigarettes. E-cigarettes are used to aerosolize a liquid (e-liquid) that the user inhales. Flavorings in e-liquids is a primary reason for youth to initiate use of e-cigarettes. Evidence is growing in the scientific literature that inhalation of some flavorings is not without risk of harm. In this review, 67 original articles (primarily cellular in vitro) on the toxicity of flavored e-liquids were identified in the PubMed and Scopus databases and evaluated critically. At least 65 individual flavoring ingredients in e-liquids or aerosols from e-cigarettes induced toxicity in the respiratory tract, cardiovascular and circulatory systems, skeletal system, and skin. Cinnamaldehyde was most frequently reported to be cytotoxic, followed by vanillin, menthol, ethyl maltol, ethyl vanillin, benzaldehyde and linalool. Additionally, modern e-cigarettes can be modified to aerosolize cannabis as dried plant material or a concentrated extract. The U.S. experienced an outbreak of lung injuries, termed e-cigarette, or vaping, product use-associated lung injury (EVALI) that began in 2019; among 2,022 hospitalized patients who had data on substance use (as of January 14, 2020), 82% reported using a delta-9-tetrahydrocannabinol (main psychoactive component in cannabis) containing e-cigarette, or vaping, product. Our literature search identified 33 articles related to EVALI. Vitamin E acetate, a diluent and thickening agent in cannabis-based products, was strongly linked to the EVALI outbreak in epidemiologic and laboratory studies; however, e-liquid chemistry is highly complex, and more than one mechanism of lung injury, ingredient, or thermal breakdown product may be responsible for toxicity. More research is needed, particularly with regard to e-cigarettes (generation, power settings, etc.), e-liquids (composition, bulk or vaped form), modeled systems (cell type, culture type, and dosimetry metrics), biological monitoring, secondhand exposures and contact with residues that contain nicotine and flavorings, and causative agents and mechanisms of EVALI toxicity.
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Chudech S, Janmaimool P. University students' knowledge about and attitudes toward e-cigarette use and factors influencing students' e-cigarette use. HEALTH EDUCATION 2021. [DOI: 10.1108/he-11-2020-0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study aims to investigate university students' knowledge about and attitudes toward e-cigarette (EC) use. It will also examine whether students' EC use is associated with knowledge about and attitudes toward EC use. The study also aims to analyze the determinants of students' use of ECs. The effects of gender, smoking behavior and friends' and family members' smoking behaviors on students' use of ECs were analyzed.Design/methodology/approachCompleted questionnaire surveys were received from 1,362 students at King Mongkut's University of Technology Thonburi in Bangkok City, Thailand, in November and December 2019. Chi-square tests and an independent samples t-test were conducted to determine whether students' knowledge about ECs and attitudes toward EC use influenced their use of ECs. A logistic regression analysis was performed to identify significant factors affecting students' use of ECs.FindingsThe results revealed that students' EC use was associated with knowledge about ECs: Students with less knowledge about the harmful effects of ECs were more likely to use them. In addition, students who were EC users had more positive attitudes toward EC use than those who were not EC users. The results also revealed that male students, students who had also smoked tobacco cigarettes and students with friends who smoked tobacco cigarettes were more likely to use ECs. These results could suggest strategies to reduce the use of ECs among university students.Originality/valueThis study provides deep understanding about university students' knowledge about and attitudes toward EC use and their participation in EC use. The result clearly shows university students who are participating in EC use still have less knowledge about EC, thus, they have positive attitudes toward ECs. Gaining social acceptance from friends who use EC also influences students' decision to use EC. Therefore, EC use among students could significantly increase overall EC use.
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Krela-Kazmierczak I, Szymczak-Tomczak A, Tomczak M, Lykowska-Szuber L, Eder P, Kucharski MA, Stawczyk-Eder K, Waszak K, Karczewski J, Dobrowolska A. Is there a relation between vitamin D, interleukin-17, and bone mineral density in patients with inflammatory bowel disease? Arch Med Sci 2021; 17:662-674. [PMID: 34025836 PMCID: PMC8130475 DOI: 10.5114/aoms.2018.78009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 05/01/2018] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION In inflammatory bowel diseases (IBD), osteopenia and osteoporosis constitute a significant medical problem. Cytokines, especially IL-17, play an important role in the pathogenesis of IBD and osteoporosis. Vitamin D is a regulator of bone metabolism, and helps maintain immune system homeostasis. MATERIAL AND METHODS The research sample consisted of 208 persons: 83 patients (age 35 ±11.99 years) with Crohn's disease (CD); 86 patients (age 39.58 ±14.74 years) with ulcerative colitis (UC); and 39 persons (age 30.74 ±8.63 years) in the control group (CG). Clinical data on bone mineral density of the lumbar spine (L2-L4), bone mineral density of the femoral neck (FN), and body mass index (BMI) were collected. 25OHD and IL-17 serum concentrations were also measured. RESULTS Body mass index (kg/m2) results: in CD, 21.51 ±3.68; in UC, 23.31 ±4.38; and in CG, 24.57 ±3.45 (p < 0.01). Densitometry results for L2-L4 T-score SD: in CD -0.83 ±1.45; in UC -0.47 ±1.15; in CG 0.09 ±0.70. Densitometry results for FN T-score SD: in CD -0.62 ±1.26; in UC -0.29±1.17; in CG 0.41 ±1.03 25OHD (ng/ml) serum concentrations: in CD, 21.33±12.50; in UC, 22.04±9.56; in CG, 21.56±9.11 (ns). IL-17 (pg/ml) serum concentrations: in CD, 8.55±10.99; in UC, 11.67±12.97; in CG, 5.16±9.11 (ns). CONCLUSIONS Inflammatory bowel diseases patients and persons from the CG did not differ in vitamin D or IL-17 levels. Patients with a mild course of the disease had a higher vitamin D concentration and bone mineral density. In UC, higher vitamin D concentrations were associated with lower IL-17 concentrations. The IBD patients with a severe course of the disease had a lower body mass than those in the CG and the patients with a mild course of the disease.
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Affiliation(s)
- Iwona Krela-Kazmierczak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Aleksandra Szymczak-Tomczak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Tomczak
- Department of Psychology, Poznan University of Physical Education, Poznan, Poland
| | - Liliana Lykowska-Szuber
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin A. Kucharski
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Kamila Stawczyk-Eder
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Waszak
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Karczewski
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
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Rothrock AN, Andris H, Swetland SB, Chavez V, Isaak S, Pagane M, Romney J, Rothrock SG. Association of E-cigarettes with adolescent alcohol use and binge drinking-drunkenness: A systematic review and meta-analysis. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:684-698. [PMID: 32795246 DOI: 10.1080/00952990.2020.1771723] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: E-cigarette (ECIG) use has increased substantially in the past decade. Co-use of alcohol and ECIGS may have serious consequences in adolescents. Objectives: To evaluate the association of e-cigarettes (ECIGs) with alcohol use in adolescents. Methods: Searched databases included PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, and gray literature. Studies were included if they contained a non-E-cigarette group (NON-ECIG), an ECIG group, detailed rates of alcohol use, binge drinking, or drunkenness and included adolescents. Two independent reviewers extracted data using MOOSE guidelines. Evidence quality across studies was assessed using Cochrane GRADE methodology. Summary effects of ECIG vs. NON-ECIG use on any alcohol use and a composite of binge drinking/drunkenness were calculated using a random-effects model. Results: 28 of 3768 initially identified studies were included: 25 cross-sectional, 3 cohort studies, N = 458,357 total subjects (49.6% females). Pooling of data showed that ECIG users had a higher risk for any alcohol use compared to NON-ECIG users (Odds Ratio/OR 6.62, 95% confidence interval/CI 5.67-7.72) and a higher rate of binge drinking/drunkenness compared to NON-ECIG users (OR 6.73, 95% CI 4.5 - 10.07). The subset of high school ECIG users had higher rates of alcohol use (OR 8.17, 95% CI 5.95-11.2) and binge drinking/drunkenness (OR 7.98, 95% CI 5.98-10.63) compared to NON-ECIG users. Conclusion: ECIG users had a higher risk of alcohol use and binge drinking/drunkenness compared to NON-ECIG users. Our findings indicate that interventions to reduce ECIG use should be coupled with measures to reduce alcohol use in adolescents.Abbreviations: ECIG: e-cigarettes; NON-ECIG: non e-cigarettes.
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Affiliation(s)
| | - Halle Andris
- Lawton Chiles High School , Tallahassee, FL, USA
| | | | | | - Shira Isaak
- Winter Park High School , Winter Park, FL, USA
| | | | - Jake Romney
- Lake Mary Preparatory High School , Lake Mary, FL, USA
| | - Steven G Rothrock
- Department of Emergency Medicine, Dr. P Phillips Hospital, Orlando Health , Orlando, FL, USA
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Han CH, Chung JH. Factors associated with electronic cigarette use among adolescents asthma in the Republic Of Korea. J Asthma 2020; 58:1451-1459. [PMID: 32718189 DOI: 10.1080/02770903.2020.1802745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Despite the rapid increase in electronic cigarette (e-cigarette) smoking, little is known about the factors associated with their use, particularly in adolescents with asthma. Our study investigated the prevalence of, and factors associated with asthma. METHODS We analyzed data from the Korean Youth Risk Behavior Web-based Survey of 44,479 adolescents with physician-diagnosed asthma and 445,692 subjects without asthma. Sociodemographic factors, psychosocial factors, and e-cigarette smoking patterns were investigated by self-report questionnaires. Multiple logistic regression was used to investigate the factors associated with ever or current e-cigarette risks in adolescents with asthma, with adjustment for confounding factors. RESULTS Significantly more subjects had a smoking habit in the asthma group than in the non-asthma group. Among the adolescents with asthma, 4,420 (9.9%) smoked e-cigarettes (ever-users), and 1,962 (4.4%) smoked e-cigarettes within the last 30 days (current users). Multiple logistic regression showed that both ever and current e-cigarette use were significantly associated with male gender, higher family income, residence in an urban area, alcohol drinking, substance use experience, sexual experience, and friends' smoking. Current e-cigarette use was also significantly associated with high caffeine intake, no regular exercise, and experience of violence in adolescents with asthma. CONCLUSIONS E-cigarette smoking behavior was significantly more frequent in adolescents with asthma than in those without asthma, and multiple psychosocial factors were associated with e-cigarette smoking. Our results could inform e-smoking control programs and help identify adolescents with asthma at high risk of e-cigarette smoking, to ultimately prevent and reduce this behavior.
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Affiliation(s)
- Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary`s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
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Her W. How Is Use of Electronic Cigarettes Related to Conventional Cigarette Use? A Qualitative Study among Korean American Young Adults. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:308-320. [PMID: 32631207 DOI: 10.1080/19371918.2020.1785982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Given the growing popularity of e-cigarettes in the United States, there is a need to understand the relationship between conventional and electronic cigarette use among Korean American young adults. Thus, this study aimed to explore Korean American young adults' experience of electronic cigarettes and its association with use of conventional cigarettes. This study employed an exploratory qualitative design. Individual interviews were conducted with 15 Korean American young adults aged between 18 and 25 years who reported having smoked at least one conventional cigarette per day for the past 6 months. Interview data were subjected to thematic analysis in order to gain an in-depth understanding of the interconnection between e-cigarette and conventional cigarette use. Data analysis revealed three themes involving reasons for buying, using, and stopping use of e-cigarettes, each of which had several sub-themes. Study results suggest that experience of e-cigarettes was related to conventional cigarette use. Thus, the experience of e-cigarettes as well as conventional cigarettes should be considered in designing smoking cessation interventions for Korean American young adults.
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Affiliation(s)
- Wonbin Her
- Public Policy Research Institute, Pukyong National University , Busan, Republic of Korea
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Abdulrahman SA, Ganasegeran K, Loon CW, Rashid A. An online survey of Malaysian long-term e-cigarette user perceptions. Tob Induc Dis 2020; 18:26. [PMID: 32292316 PMCID: PMC7152783 DOI: 10.18332/tid/118720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/22/2020] [Accepted: 03/03/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The use of e-cigarettes (EC) has reached alarming proportions among Malaysians. On a national level, little is known about the profile and perceptions of Malaysian EC users. This study aimed to explore the prevalence of long-term EC usage and its associated factors among EC users in Malaysia. METHODS This nationwide online questionnaire survey was administered among 694 EC users across 13 states and 1 Federal Territory in Malaysia, between January and April 2018. A survey link was e-mailed to EC users that were recruited from an official national vape entity through their Facebook association page. We obtained information on respondents’ sociodemographic characteristics, smoking habits, long-term e-cigarette usage and perceptions of EC use. We estimated long-term EC user prevalence and fitted multivariate regression models to predict factors associated with long-term EC usage. Statistical significance was set at p<0.05. RESULTS Respondents were predominantly Malays (87.6%), aged >30 years (68.1%) and tertiary educated (71%). The majority were employed (93.1%) with a monthly household income of MYR 4000 or less (56.6%). About 84% were former smokers, while 10% were current smokers. The prevalence of long-term EC usage in this study was 82.3%. Most users believed that EC had helped them to cut down tobacco smoking (94.8%), reduced the urge to smoke (88.3%) and ultimately helped them to quit smoking (87.2%). Respondents aged >30 years and those who perceived that EC has helped them stop smoking were significantly more likely to be long-term EC users. CONCLUSIONS Most respondents engaged in EC use to quit smoking. They were more likely to be long-term EC users if they were older and perceived that EC has helped them to quit smoking. This information is valuable for targeted prevention, health promotion and policy regulations.
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Affiliation(s)
- Surajudeen A Abdulrahman
- Department of Public Health Medicine, RCSI & UCD Malaysia Campus, George Town, Malaysia.,Health Education England, Fulbourn, United Kingdom
| | | | - Chin W Loon
- Department of Environmental Health and Licensing, City Council of Penang Island, George Town, Malaysia
| | - Abdul Rashid
- Department of Public Health Medicine, RCSI & UCD Malaysia Campus, George Town, Malaysia
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Kapan A, Stefanac S, Sandner I, Haider S, Grabovac I, Dorner T. Use of Electronic Cigarettes in European Populations: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1971. [PMID: 32192139 PMCID: PMC7142603 DOI: 10.3390/ijerph17061971] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 12/28/2022]
Abstract
The increasing popularity of electronic cigarettes in past decades has aroused public health concern. This study aims to review the literature on the prevalence of e-cigarette use among the general adult and young populations in Europe. We searched Medline and Google Scholar from September 2019, and included "prevalence of e-cigarettes", "electronic cigarettes" or "e-cigarettes", and "electronic nicotine delivery system" or "vaping". The prevalence of current e-cigarette use ranged from 0.2% to 27%, ever-use ranged from 5.5% to 56.6% and daily use ranged from 1% to 2.9%. Current smokers of conventional cigarettes showed the highest prevalence for the use of e-cigarettes, ranging from 20.4% to 83.1%, followed by ex-smokers, with ranges from 7% to 15%. The following socio-demographic factors were associated with a higher chance of using e-cigarettes: male sex and younger age groups; results for economic status were inconclusive. In European countries, there is a higher prevalence of e-cigarette use among males, adolescents and young adults, smokers of conventional cigarettes, and former smokers.
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Affiliation(s)
- A. Kapan
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Vienna 1090, Austria; (S.S.); (I.S.); (S.H.); (I.G.); (T.E.D.)
| | - S. Stefanac
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Vienna 1090, Austria; (S.S.); (I.S.); (S.H.); (I.G.); (T.E.D.)
- Institute of Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna 1090, Austria
| | - I. Sandner
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Vienna 1090, Austria; (S.S.); (I.S.); (S.H.); (I.G.); (T.E.D.)
| | - S. Haider
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Vienna 1090, Austria; (S.S.); (I.S.); (S.H.); (I.G.); (T.E.D.)
| | - I. Grabovac
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Vienna 1090, Austria; (S.S.); (I.S.); (S.H.); (I.G.); (T.E.D.)
| | - T.E. Dorner
- Department of Social and Preventive Medicine, Centre of Public Health, Medical University of Vienna, Vienna 1090, Austria; (S.S.); (I.S.); (S.H.); (I.G.); (T.E.D.)
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Rodríguez-Bolaños R, Arillo-Santillán E, Barrientos-Gutiérrez I, Zavala-Arciniega L, Ntansah CA, Thrasher JF. Sex Differences in Becoming a Current Electronic Cigarette User, Current Smoker and Current Dual User of Both Products: A Longitudinal Study among Mexican Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E196. [PMID: 31892159 PMCID: PMC6981723 DOI: 10.3390/ijerph17010196] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/22/2019] [Accepted: 12/23/2019] [Indexed: 02/05/2023]
Abstract
This study aimed to assess sex differences in predictors for becoming a current exclusive electronic cigarette (e-cigarette) user, current exclusive smoker, or current dual user (concurrent smoking and e-cigarette use). This longitudinal study included 2399 females and 2177 males who had tried neither cigarettes nor e-cigarettes at baseline and attended 57 middle schools in the three largest cities in Mexico. We estimated multinomial logistic models stratified by sex. At follow-up, the prevalence of current exclusive e-cigarette use was 6.4% for males and 5.5% for females; current exclusive smoking was similar among males (3.6%) and females (3.5%); dual use was 2.4% females and 1.8% males. In the adjusted model, current e-cigarette use among females was associated with baseline current drinking (ARR = 1.85; p < 0.05), having a job (ARR = 1.99; p < 0.05), higher technophilia (ARR = 1.27; p < 0.05), and higher positive smoking expectancies (ARR = 1.39; p < 0.05). Among males, only having friends who smoke cigarettes at baseline was a significant predictor of current exclusive e-cigarette use at follow-up (ARR = 1.44; p < 0.05). For both sexes, current exclusive smoking at follow-up was associated with baseline current drinking (male ARR = 2.56; p < 0.05; female ARR = 2.31; p < 0.05) and, among males, only with having a parent who smoked (ARR = 1.64; p < 0.05). For both sexes, dual use at follow-up was associated with baseline current drinking (male ARR = 3.52; p < 0.005; female ARR = 2.77; p < 0.05); among females, with having paid work (ARR = 2.50; p < 0.001); and among males, with parental smoking (ARR = 3.20; p < 0.05). Results suggested both common and different risk factors by sex, suggesting that interventions may need to consider targeting sex differences.
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Affiliation(s)
- Rosibel Rodríguez-Bolaños
- Population Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico; (E.A.-S.); (J.F.T.)
| | - Edna Arillo-Santillán
- Population Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico; (E.A.-S.); (J.F.T.)
- School of Demography, Australian National University, Canberra 2601, Australia
| | - Inti Barrientos-Gutiérrez
- Center for Evaluation and Survey Research, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico;
| | | | - Charity A. Ntansah
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - James F. Thrasher
- Population Health Research Center, Mexican National Institute of Public Health, Av. Universidad 655 Col. Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico; (E.A.-S.); (J.F.T.)
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
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Lewek P, Woźniak B, Maludzińska P, Smigielski J, Kardas P. E-cigarette use and its predictors: Results from an online cross-sectional survey in Poland. Tob Induc Dis 2019; 17:79. [PMID: 31772557 PMCID: PMC6856825 DOI: 10.18332/tid/113093] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/05/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Since the invention of electronic cigarettes (ECs) in 2003, their use has spread worldwide; however, little is known about the profiles of EC users. Understanding the motivators for using ECs enables more accurate prediction of their use and more effective direction of pro-health activities. Our objective was to identify the factors that may influence the decision to use ECs and their possible adverse effects according to the experiences of EC users. METHODS A cross-sectional online survey was administered between 1 July 2016 and 1 January 2017 among 1288 Polish-speaking users of social networks and EC forums. To explore associations between current EC use and other factors, multivariate binary logistic regression analyses were performed. RESULTS The final analysis included 1142 survey participants: mean age 25.9 years (± 11.1), 85.6% were male, 50.3% had secondary education, 98.2% were Polish citizens, and 81.0% were current EC users. Male gender, lower education, aged ≤40 years, former cigarette smoking, previous attempts to quit smoking, perception of lack of harmful effects of ECs, perception of ECs as being tastier and cheaper than cigarettes, awareness of the advantages of ECs and their use as a smoking cessation aid were all statistically significant factors increasing the risk of EC use. The majority of study participants claimed that ECs are less addictive or not addictive compared to cigarettes (62.6%) and less harmful or not harmful (89.5%) compared to cigarettes. The most common reported side effects of ECs were dryness in the mouth (8.3%), itching in the throat (4.5%) and nausea (1.9%). CONCLUSIONS Males aged ≤40 years with a lower level education were more likely to use ECs in the studied Polish population. The perception that ECs are less harmful than regular cigarettes is a factor increasing the odds of EC use; however, although ECs have few adverse effects, they nevertheless exist.
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Affiliation(s)
- Pawel Lewek
- Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | | | | | - Janusz Smigielski
- Social and Technical Department, State Higher Vocational School, Konin, Poland
| | - Przemyslaw Kardas
- Department of Family Medicine, Medical University of Lodz, Lodz, Poland
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Predictors of E-Cigarette Use Susceptibility-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203935. [PMID: 31623178 PMCID: PMC6843563 DOI: 10.3390/ijerph16203935] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 11/17/2022]
Abstract
Identification of the youth at risk of e-cigarette use is crucial for development of effective prevention strategies. The current study aims at evaluation of predictors of susceptibility to e-cigarette initiation and experimentation among adolescents. This cross-sectional study included 1693 students (non-current users of e-cigarettes) attending 21 schools in Piotrkowski district (a socially disadvantaged rural area in central Poland). The regression models were applied so as to study factors linked to susceptibility to e-cigarette use among never users (n = 1054) and ever users (n = 639) of e-cigarettes, with susceptibility defined as the absence of a firm decision not to use these products. A high proportion of the youth was susceptible to e-cigarette use (68% of never and 78% of ever e-cigarette users). The adjusted model confirmed the following risk factors: smoking parents and friends (never users: OR = 3.0; p < 0.001; OR = 2.0; p < 0.05; ever users: OR = 2.2; OR = 2.2; p < 0.01), alcohol consumption (never users: moderate drinking OR = 2.9; p < 0.001; binge drinking OR = 2.2; p < 0.01; ever users: moderate drinking OR = 4.2; p < 0.001), cigarette smoking (never users: OR = 14.1; ever users: OR = 11.3; p < 0.001), and perception that e-cigarettes are less harmful than traditional cigarettes (never users: OR = 1.8; p < 0.001). The youth whose mothers had a medium and high educational level (never users: OR = 2.7; p < 0.01; OR = 2.7; p < 0.05; ever users: OR = 5.4; OR = 4.4; p < 0.001), those who perceived girls who use e-cigarettes as more attractive (never users: OR = 4.1; p < 0.001; ever users: OR = 2.9; p < 0.01), and secondary school students (ever users: OR = 5.6; p < 0.001) had higher odds of susceptibility to e-cigarette use. The youth who had more money per month were less susceptible to e-cigarette experimentation (OR = 0.4; p < 0.001). A multi-level intervention approach, considering vulnerable populations, is required to prevent the youth from e-cigarette initiation and experimentation.
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Brożek GM, Jankowski M, Lawson JA, Shpakou A, Poznański M, Zielonka TM, Klimatckaia L, Loginovich Y, Rachel M, Gereová J, Golonko J, Naumau I, Kornicki K, Pepłowska P, Kovalevskiy V, Raskiliene A, Bielewicz K, Krištúfková Z, Mróz R, Majek P, Lubanski J, Kaleta D, Pinkas J, Zejda JE. The Prevalence of Cigarette and E-cigarette Smoking Among Students in Central and Eastern Europe-Results of the YUPESS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132297. [PMID: 31261697 PMCID: PMC6651674 DOI: 10.3390/ijerph16132297] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/12/2019] [Accepted: 06/26/2019] [Indexed: 01/22/2023]
Abstract
Electronic cigarettes (e-cigarettes) are an alternative to traditional tobacco cigarette smoking. The aim of this study was to assess the prevalence of cigarette smoking and e-cigarette use among university students from Central and Eastern Europe and to investigate personal characteristics associated with cigarette and e-cigarette smoking. A questionnaire-based cross-sectional survey was performed between 2017–2018 among university students in five European countries: Belarus, Lithuania, Poland, Russia, and Slovakia. The questionnaire included 46 questions related to the frequency and habits of traditional cigarettes and e-cigarettes use. Completed questionnaires were obtained from 14,352 students (8800 medical; aged 20.9 ± 2.4 years) with an overall response rate of 72.2%. Two-thirds of the respondents had smoked a traditional tobacco cigarette and 43.7% had used an e-cigarette. Overall current smoking status included 12.3% traditional cigarette smokers, 1.1% e-cigarette users, and 1.8% were dual users with the remainder being non-smokers. Smoking status differed between the research centres (p < 0.001). Females were less likely to try either cigarettes (OR = 0.83) or e-cigarettes (OR = 0.62) and were less likely to be current cigarette (OR = 0.64), e-cigarette (OR = 0.34), or dual users (OR = 0.33) than males. Perception of e-cigarettes significantly differed between smokers and non-smokers (p < 0.001). Among university students, cigarettes are more popular than e-cigarettes.
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Affiliation(s)
- Grzegorz Marek Brożek
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland
| | - Mateusz Jankowski
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland.
| | - Joshua Allan Lawson
- Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, 104 Clinic Place, PO Box 23, Saskatoon, SK S7N 2Z4, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Andrei Shpakou
- Department of Sports Medicine and Rehabilitation, Yanka Kupala State University of Grodno, 22 Ozheshko Str, 230023 Grodno, Belarus
| | - Michał Poznański
- Department of General and Oncological Pulmonology, Norbert Barlicki Memorial Teaching Hospital No. 1, Medical University of Lodz, Kopcińskiego 22 Str, 90-153 Lodz, Poland
| | - Tadeusz Maria Zielonka
- Department of Family Medicine, Warsaw Medical University, Banacha Street 1a, 02-097 Warsaw, Poland
| | - Ludmila Klimatckaia
- Department of Social Pedagogy and Social Work, Krasnoyarsk State Pedagogical University named after V.P. Astafiev, A. Lebedeva 89 Str, Krasnoyarsk 660017, Russia
| | - Yelena Loginovich
- Institute of Biology Systems and Genetic Research, Lithuanian University of Health Sciences, MLK, Eivenių 4Str, LT-50103 Kaunas, Lithuania
| | - Marta Rachel
- Department of Human Physiology and Pathophysiology, Faculty of Medicine, University of Rzeszów, Kopisto 2a Str, 35-359 Rzeszow, Poland
- Department of Allergology and Cystic Fibrosis, Clinical Provincial Hospital No. 2, Lwowska 60 Str, 35-301 Rzeszów, Poland
| | - Justína Gereová
- Department of Epidemiology, Faculty of Public Health, Slovak Medical University in Bratislava, Limbová 14 Str, 833 03 Bratislava, Slovak Republic
| | - Justyna Golonko
- Student's Scientific Society at 2nd Department of Lung Diseases and Tuberculosis, Medical University of Bialystok, Żurawia 14 Str, 15-540 Bialystok, Poland
| | - Ihar Naumau
- Department of General Hygiene and Ecology, Grodno State Medical University, Gorkogo 80 Str, 230009 Grodno, Belarus
| | - Kamil Kornicki
- Department of General and Oncological Pulmonology, Norbert Barlicki Memorial Teaching Hospital No. 1, Medical University of Lodz, Kopcińskiego 22 Str, 90-153 Lodz, Poland
| | - Paulina Pepłowska
- Department of Family Medicine, Warsaw Medical University, Banacha Street 1a, 02-097 Warsaw, Poland
| | - Valeriy Kovalevskiy
- Department of Childhood Psychology, Krasnoyarsk State Pedagogical University named after V.P. Astafiev, A. Lebedeva 89 Str, Krasnoyarsk 660017, Russia
| | - Asta Raskiliene
- Institute of Biology Systems and Genetic Research, Lithuanian University of Health Sciences, MLK, Eivenių 4Str, LT-50103 Kaunas, Lithuania
| | - Krzysztof Bielewicz
- Department of Human Physiology and Pathophysiology, Faculty of Medicine, University of Rzeszów, Kopisto 2a Str, 35-359 Rzeszow, Poland
| | - Zuzana Krištúfková
- Department of Epidemiology, Faculty of Public Health, Slovak Medical University in Bratislava, Limbová 14 Str, 833 03 Bratislava, Slovak Republic
| | - Robert Mróz
- 2nd Department of Lung Diseases and Tuberculosis, Medical University of Bialystok, Żurawia 14 Str, 15-540 Bialystok, Poland
| | - Paulina Majek
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland
| | - Jakub Lubanski
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, Zeligowskiego 7/9 Str, 90-752 Łódź, Poland
| | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, Kleczewska 61/63 Str, 01-826 Warsaw, Poland
| | - Jan Eugeniusz Zejda
- Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Medykow 18 Str, 40-752 Katowice, Poland
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Du Y, Shih M, Shah MD, Weber MD, Lightstone AS. Prevalence and sociodemographic disparities in ever E-cigarette use among adults in Los Angeles County. Prev Med Rep 2019; 15:100904. [PMID: 31194002 PMCID: PMC6545394 DOI: 10.1016/j.pmedr.2019.100904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 11/29/2022] Open
Abstract
E-cigarette use has increased rapidly among U.S. adults. Few studies have examined the prevalence and risk factors of e-cigarette use among adults in the United States. We conducted descriptive analyses to identify characteristics of ever e-cigarette users among adults (18 years and older) living in Los Angeles (LA) County, the most populous county in the U.S., using data from the 2015 LA County Health Survey. We used logistic regression to examine independent factors associated with ever e-cigarette use. Age-adjusted prevalence of ever e-cigarette use was 8.4%. A significant interaction between conventional cigarette smoking status and gender was found (p < 0.05), and several factors were identified as associated with ever e-cigarette use in models stratified by gender. Various social and demographic factors are associated with ever e-cigarette use and should be incorporated into evidence-based interventions. In LA County, 11.6% of males and 5.7% of females reported ever using e-cigarettes. The prevalence of ever e-cigarette use was 18.5% among young adults (18–24 years). Factors associated with ever e-cigarette use varied by gender. Concurrent use of other substances was associated with ever e-cigarette use.
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Affiliation(s)
- Yajun Du
- Los Angeles County Department of Public Health, Office of Health Assessment & Epidemiology, Los Angeles, CA 90012, United States of America
| | - Margaret Shih
- UnitedHealthcare, Minnetonka, MN, United States of America
| | - Megha D Shah
- Los Angeles County Department of Public Health, Office of Health Assessment & Epidemiology, Los Angeles, CA 90012, United States of America
| | - Mark D Weber
- Los Angeles County Department of Public Health, Tobacco Control and Prevention Program, Los Angeles, CA 90010, United States of America
| | - Amy S Lightstone
- Los Angeles County Department of Public Health, Office of Health Assessment & Epidemiology, Los Angeles, CA 90012, United States of America
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Javadi-Paydar M, Kerr TM, Harvey EL, Cole M, Taffe MA. Effects of nicotine and THC vapor inhalation administered by an electronic nicotine delivery system (ENDS) in male rats. Drug Alcohol Depend 2019; 198:54-62. [PMID: 30878767 PMCID: PMC6467722 DOI: 10.1016/j.drugalcdep.2019.01.027] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/23/2019] [Accepted: 01/26/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS, e-cigarettes) are increasingly used for the self-administration of nicotine by various human populations, including previously nonsmoking adolescents. Studies in preclinical models are necessary to evaluate health impacts of ENDS including the development of nicotine addiction, effects of ENDS vehicles, flavorants and co-administered psychoactive substances such as Δ9-tetrahydrocannabinol (THC). This study was conducted to validate a rat model useful for the study of nicotine effects delivered by inhalation of vapor created by ENDS. METHODS Male Sprague-Dawley rats (N = 8) were prepared with radio telemetry devices for the reporting of temperature and activity. Experiments subjected rats to inhalation of vapor generated by an electronic nicotine delivery system (ENDS) adapted for rodents. Inhalation conditions included vapor generated by the propylene glycol (PG) vehicle, Nicotine (1, 10, 30 mg/mL in the PG) and THC (12.5, 25 mg/mL). RESULTS Nicotine inhalation increased spontaneous locomotion and decreased body temperature of rats. Pretreatment with the nicotinic cholinergic receptor antagonist mecamylamine (2 mg/kg, i.p.) prevented stimulant effects of nicotine vapor inhalation and attenuated the hypothermic response. Combined inhalation of nicotine and THC resulted in apparently independent effects which were either additive (hypothermia) or opposed (activity). CONCLUSIONS These studies provide evidence that ENDS delivery of nicotine via inhalation results in nicotine-typical effects on spontaneous locomotion and thermoregulation in male rats. Effects were blocked by a nicotinic antagonist, demonstrating mechanistic specificity. This system will therefore support additional studies of the contribution of atomizer/wick design, vehicle constituents and/or flavorants to the effects of nicotine administered by ENDS.
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Affiliation(s)
| | - Tony M. Kerr
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
| | - Eric L. Harvey
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
| | - Maury Cole
- La Jolla Alcohol Research, Inc., La Jolla, CA, USA
| | - Michael A. Taffe
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA,Correspondence: Michael A. Taffe, Department of Neuroscience, The Scripps Research Institute, SP30-2400 10550 North Torrey Pines Road, La Jolla, CA 92037, Phone: +1.858.784.7228 Fax: +1.858.784.7405
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Smith DM, Gawron M, Balwicki L, Sobczak A, Matynia M, Goniewicz ML. Exclusive versus dual use of tobacco and electronic cigarettes among adolescents in Poland, 2010-2016. Addict Behav 2019; 90:341-348. [PMID: 30508744 DOI: 10.1016/j.addbeh.2018.11.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 10/05/2018] [Accepted: 11/24/2018] [Indexed: 11/19/2022]
Abstract
Globally, electronic cigarette (e-cigarette) use among adolescents has increased, along with concerns about potential health implications from exclusive and concurrent tobacco and e-cigarette use (i.e., "dual use"). This study used data from a cross-sectional survey administered to 5708 students aged 15-19 in secondary and technical schools throughout two regions of Poland. Data from 2010-2011 (n = 1760); 2013-2014 (n = 1970) and 2015-2016 (n = 1978) were analyzed to assess changes in use of cigarettes and e-cigarettes from 2010-2016, and correlates of exclusive and dual use, daily use, and intensity of product use from 2013-2016. In this sample, e-cigarette trial and past 30-day exclusive e-cigarette use significantly increased over time (2010-2011: 2%; 2013-2014: 8%; 2015-2016: 11% (p < .05)). Dual use increased from 2010-2011 (4%) to 2013-2014 only (23%, p < .05); and remained stable from 2013-2014 to 2015-2016 (24%, p = .60). Most dual users reported using cigarettes before trying e-cigarettes (82% in 2013-2014, 76% in 2015-2016). Analyses comparing dual users to exclusive users showed significant differences in frequency and intensity of product use, similar findings were observed within dual users. Following the introduction of e-cigarettes, both total tobacco use and total cigarette use increased. Among youth in Poland, e-cigarettes do not seem to replace conventional cigarettes, but instead contribute to a more diverse array of available products from which youth can experiment.
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Affiliation(s)
- Danielle M Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
| | - Michal Gawron
- Department of General and Analytical Chemistry, Division of Laboratory Medicine, School of Pharmacy, Medical University of Silesia, Jagiellońska 4, 41-200 Sosnowiec, Poland
| | - Lukasz Balwicki
- Department of Public Health and Social Medicine, Medical University of Gdansk, Zwycięstwa 42A, 80-210 Gdansk, Poland
| | - Andrzej Sobczak
- Department of General and Analytical Chemistry, Division of Laboratory Medicine, School of Pharmacy, Medical University of Silesia, Jagiellońska 4, 41-200 Sosnowiec, Poland; Institute of Occupational Medicine and Environmental Health, Kościelna 13, 41-200 Sosnowiec, Poland
| | - Monika Matynia
- Department of Public Health and Social Medicine, Medical University of Gdansk, Zwycięstwa 42A, 80-210 Gdansk, Poland
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
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Fakunle DO, Eck R, Milam AJ, Thorpe RJ, Furr-Holden DM. E-Cigarettes in Baltimore Alcohol Outlets: Geographic and Demographic Correlates of Availability. FAMILY & COMMUNITY HEALTH 2019; 41:205-213. [PMID: 30134335 PMCID: PMC6107309 DOI: 10.1097/fch.0000000000000200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is limited research on e-cigarette availability despite increased use. E-cigarette availability within Baltimore alcohol outlets was analyzed for disparities among residential neighborhoods. Data were obtained via field surveys of alcohol outlets, and then spatially merged with sociodemographic data; 18.8% of alcohol outlets had any e-cigarette availability. Regression models showed greater odds ratios for e-cigarette availability when cigarettes, cigars, or hookah paraphernalia were sold, and lower odds ratios when alcohol outlets had an on-site consumption license. Outlets with e-cigarette availability were in predominantly lower-income, nonwhite neighborhoods. It is important to assess exposure of another potentially damaging substance among perpetually disadvantaged populations.
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Affiliation(s)
- David O Fakunle
- School of Community Health & Policy, Morgan State University, Baltimore, Maryland (Dr Fakunle); Departments of Health, Behavior & Society (Drs Eck and Thorpe) and Mental Health (Drs Fakunle and Milam), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and Department of Prevention Science and Public Health, Michigan State University College of Human Medicine, Flint (Dr Furr-Holden)
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Puteh SEW, Manap RA, Hassan TM, Ahmad IS, Idris IB, Sham FM, Lin ABY, Soo CI, Mohamed RMP, Mokhtar AI, Zakaria H, Lee J, Nordin ASA, Ariaratnam S, Yusoff MZM. The use of e-cigarettes among university students in Malaysia. Tob Induc Dis 2018; 16:57. [PMID: 31516454 PMCID: PMC6659562 DOI: 10.18332/tid/99539] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 10/25/2018] [Accepted: 11/02/2018] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION E-cigarette use is an emerging phenomenon with increasing recognition and acceptance globally. This study aims to create a profile of e-cigarette users among university students in Malaysia. METHODS The study was conducted using a cross-sectional research involving six universities in Malaysia. A semi-structured questionnaire was distributed to 1302 randomly selected students, who either smoked cigarettes and/or e-cigarettes. The 2011 version of Global Adult Tobacco Surveys (GATS) tool was used to record the respondents' sociodemographic data. RESULTS The study revealed that 74.9% of the respondents smoked e-cigarettes; 40.3% used both cigarettes and e-cigarettes (dual users), and 34.5% were exclusive e-cigarette users. The exclusive use of e-cigarettes was related to gender (OR=0.18, 95% CI: 0.09-0.39). Also, male respondents were the majority users (95%). Of the respondents, 75.2 % were Malays, 98.0% single and most believed they have no health problems (92.1%). Further findings revealed the occurrence of adverse effects, dizziness 14.4%, cough 14.1%, and headaches 12.4%. Overall, 57.8% of the respondents used e-cigarettes as a smoking cessation tool, while others consider e-cigarettes a self-image enhancing tool or as part of social activities. CONCLUSIONS Further research on the use of e-cigarettes should be conducted on a large number of respondents in other settings to augment the findings of this study, and also guide policy making on and prevention practice of e-cigarette use, among the general student population in Malaysia.
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Affiliation(s)
- Sharifa Ezat Wan Puteh
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Roslina Abdul Manap
- Respiratory Units, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Tidi Maharani Hassan
- Respiratory Units, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Izzah Syazwani Ahmad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Idayu Badilla Idris
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Fariza Md Sham
- Department Da’wah and Leadership Studies, Faculty of Islamic Studies, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Andrea Ban Yu Lin
- Respiratory Units, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Chun Ian Soo
- Respiratory Units, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Rashidi Mohamed Pakri Mohamed
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
- University Malaya Centre of Addiction Sciences (UMCAS), University Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Irdha Mokhtar
- Department Da’wah and Leadership Studies, Faculty of Islamic Studies, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Hazli Zakaria
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Jing Lee
- Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Amer Siddiq Amer Nordin
- University Malaya Centre of Addiction Sciences (UMCAS), University Malaya, Kuala Lumpur, Malaysia
| | - Suthahar Ariaratnam
- Department of Psychological and Behavioural Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Selayang Campus, Batu Caves, Selangor, Malaysia
| | - Mohd Zaliman Mohd Yusoff
- Department of Software Engineering, College of Information Technology, Universiti Tenaga Nasional (UNITEN), Kajang, Malaysia
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33
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Zavala-Arciniega L, Reynales-Shigematsu LM, Lozano P, Rodríguez-Andrade MÁ, Arillo-Santillán E, Thrasher JF. Patterns of awareness and use of electronic cigarettes in Mexico, a middle-income country that bans them: Results from a 2016 national survey. Prev Med 2018; 116:211-218. [PMID: 30261244 PMCID: PMC6276365 DOI: 10.1016/j.ypmed.2018.09.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 09/10/2018] [Accepted: 09/22/2018] [Indexed: 12/23/2022]
Abstract
Among high-income countries, awareness and use of e-cigarettes is lower in countries with more restrictive e-cigarette regulations. Little is known about e-cigarettes in middle-income countries, many of which like Mexico, ban e-cigarette sales and marketing. The current study determined the national-level prevalence and correlates of e-cigarette awareness and consumption in Mexico. Data were analyzed from a 2016 nationally representative survey. Prevalence of e-cigarette awareness, trial and current use was estimated separately for adolescents (n = 12,436), adult nonsmokers (n = 36,966), and adult smokers (n = 7347). For each group, crude and adjusted logistic models regressed e-cigarette outcomes on sociodemographic and smoking-related variables, adjusting for the sampling design and weights. Prevalence varied across subgroups for e-cigarette awareness (adolescents = 45.3%; adult nonsmokers = 33.9%; adult smokers = 54.3%), e-cigarette trial (adolescents = 6.5%; adult nonsmokers = 2.6%; adult smokers = 18.2%) and current use of electronic cigarettes (adolescents = 1.1%; adult nonsmokers = 0.3%; adult smokers = 4.5%). Among adolescents and adults, current smoking and higher smoking frequency were significantly associated with e-cigarette awareness, trial and use. Among adolescents and nonsmokers, awareness, trial and use of e-cigarette were significantly lower among females than males. Among adult smokers, however, females were more likely to use e-cigarettes than males (AOR = 1.80; 95% CI = 1.08-3.02). Higher education and greater wealth increased the likelihood of trial of e-cigarettes among adult nonsmokers and smokers. Despite the ban on the distribution and sales of e-cigarettes, a substantial number of Mexicans, have access to e-cigarettes. Decision makers and advocates should consider e-cigarette regulations as recommended by the WHO, at the same time Mexico must invest in the infrastructure needed to enforce these regulations.
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Affiliation(s)
- Luis Zavala-Arciniega
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Paula Lozano
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | | | - Edna Arillo-Santillán
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | - James F Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico; Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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34
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Breitbarth AK, Morgan J, Jones AL. E-cigarettes-An unintended illicit drug delivery system. Drug Alcohol Depend 2018; 192:98-111. [PMID: 30245461 DOI: 10.1016/j.drugalcdep.2018.07.031] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/12/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022]
Abstract
Since the introduction of electronic cigarettes (e-cigarettes) in 2003, the technology has advanced allowing for greater user modifications, with users now able to control voltage, battery power, and constituents of the e-cigarette liquid. E-cigarettes have been the subject of a growing body of research with most research justifiably focused on the chemical makeup and risk analysis of chemicals, metals, and particulates found in e-cigarette liquids and vapor. Little research to date has focused on assessing the risks associated with the drug delivery unit itself and its potential for use as an illicit drug delivery system. In light of this, a range of illicit drugs was researched focusing on pharmacodynamics, usual method of administration, the dosage required for toxicity, toxic effects, and evidence of existing use in e-cigarettes in both literature and online illicit drug forums. A systematic literature search found evidence of current use of e-cigarettes to vape almost all illicit drug types analyzed. This presents both a potential population health risk and a management issue for clinicians. It also raises the issue of policing illicit drugs due to potential altered characteristic smells and storage within e-cigarette fluids. E-cigarettes are a viable illicit drug delivery system with evidence both inside and outside of the formal medical literature detailing their potential use for drug delivery of a wide range of illicit and legal drugs.
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Affiliation(s)
| | - Jody Morgan
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Alison L Jones
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
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35
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Chen YL, Wu SC, Chen YT, Hsiao PC, Yu YH, Ting TT, Chen CY, Tu YK, Huang JH, Yang HJ, Li CY, Strong C, Yen CF, Yen CF, Chen WJ. E-Cigarette Use in a Country With Prevalent Tobacco Smoking: A Population-Based Study in Taiwan. J Epidemiol 2018; 29:155-163. [PMID: 30175730 PMCID: PMC6414808 DOI: 10.2188/jea.je20170300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The different profiles of e-cigarette users in different age groups have seldom been investigated, particularly in populations facing a high prevalence of cigarette smoking. This study aims to examine the prevalence and correlates of e-cigarette use separately for adolescents and adults in nationally representative samples in Taiwan. METHODS Among 17,837 participants in the 2014 National Survey of Substance Use in Taiwan, 4445 were aged 12 to 17 years and 13,392 were aged 18 to 64 years. Individuals' lifetime tobacco use was divided into four groups: non-use, exclusive e-cigarette use, exclusive cigarette use, and dual use. Questions on sociodemographic features, use and problematic use of tobacco, alcohol, and other drugs, and psychosocial distress, among others, were administered using a computer-assisted self-interview on tablet computers. RESULTS Among lifetime users of e-cigarette (2.2% for adults and 0.8% for adolescents), 4.5% for adults and 36.6% for adolescents were exclusive e-cigarette users. From use of exclusive e-cigarettes to use of exclusive cigarettes to dual use, those usage groups were related to an increasing trend of adjusted odds ratios for use of other psychoactive substances, particularly problematic use of alcohol or drugs, and with more depressive symptoms. Two correlates were specific to e-cigarette use: alcohol use had stronger relationships with e-cigarette use among adolescents, and younger adults (18-34) were more likely to try e-cigarettes compared to older adults. CONCLUSIONS These results provide essential information regarding e-cigarette use in the general population, and future prevention strategies should account for its specific correlates in young people.
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Affiliation(s)
- Yi-Lung Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
| | - Shang-Chi Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
| | - Yen-Tyng Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University.,Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Po-Chang Hsiao
- Genetic Epidemiology Core, Center of Genomic Medicine, National Taiwan University
| | - Ya-Hui Yu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
| | - Te-Tien Ting
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University.,School of Big Data Management, Soochow University
| | - Chuan-Yu Chen
- Department of Public Health, College of Public Health, National Taiwan University.,Institute of Public Health, National Yang-Ming University.,Center of Neuropsychiatric Research, National Health Research Institutes
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University.,Department of Public Health, College of Public Health, National Taiwan University
| | - Jiun-Hau Huang
- Department of Public Health, College of Public Health, National Taiwan University.,Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University
| | - Hao-Jan Yang
- Department of Public Health, College of Health Care and Management, Chung Shan Medical University
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital & School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University
| | - Chia-Feng Yen
- Department of Public Health, College of Medicine, Tzu Chi University
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University.,Genetic Epidemiology Core, Center of Genomic Medicine, National Taiwan University.,Department of Public Health, College of Public Health, National Taiwan University
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36
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Balwicki L, Smith D, Balwicka-Szczyrba M, Gawron M, Sobczak A, Goniewicz ML. Youth Access to Electronic Cigarettes in an Unrestricted Market: A Cross-Sectional Study from Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071465. [PMID: 29997350 PMCID: PMC6068881 DOI: 10.3390/ijerph15071465] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 11/29/2022]
Abstract
Background: Electronic cigarette (e-cigarette) use among youths in Poland has become very popular. The aim of this study was to identify the potential points of access to these products by students aged 16–17 years old before implementation of sales restrictions to minors in Poland in November 2016. Methods: A school-based, cross-sectional survey was administered in 2015–2016 in 21 secondary/technical schools across two regions of Poland. Analyses focused on 341 students aged 16–17 years old who reported their past 30-day use of e-cigarettes. Pearson Chi-square analyses were utilized to examine the associations between access-related items, e-cigarette use and demographics. Results: Among youth e-cigarette users, the most common access to their first e-cigarette was from a friend (38%), followed by purchasing from vape shops (26%). Similar patterns emerged when the students were asked about their access to the currently used e-cigarette. Most youths reported no difficulty in purchasing cartridges/e-liquid containing nicotine (90%). The majority of users (52%) reported buying such products in vape shops. Conclusions: Prior to implementing age-related sales restrictions, youth access to e-cigarettes and paraphernalia did not pose any significant barriers. Poland’s introduction of a new age limit on e-cigarette sales may help to limit the number of youths who purchase e-cigarettes from vape shops.
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Affiliation(s)
- Lukasz Balwicki
- Department of Public Health and Social Medicine, Medical University of Gdansk, Zwyciestwa 42A, 80-210 Gdansk, Poland.
| | - Danielle Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
| | | | - Michal Gawron
- Department of General and Analytical Chemistry, Division of Laboratory Medicine, School of Pharmacy, Medical University of Silesia, 41-200 Sosnowiec, Poland.
| | - Andrzej Sobczak
- Department of General and Analytical Chemistry, Division of Laboratory Medicine, School of Pharmacy, Medical University of Silesia, 41-200 Sosnowiec, Poland.
- Institute of Occupational Medicine and Environmental Health, 41-200 Sosnowiec, Poland.
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
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37
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Getachew B, Payne JB, Vu M, Pillai D, Shah J, Levine H, Berg CJ. Perceptions of Alternative Tobacco Products, Anti-tobacco Media, and Tobacco Regulation among Young Adults: A Qualitative Study. Am J Health Behav 2018; 42:118-130. [PMID: 29973316 PMCID: PMC6818245 DOI: 10.5993/ajhb.42.4.11] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives With increased alternative tobacco product (ATP) use and lagging public health action, we explored perceptions of ATPs, anti-tobacco messaging, and tobacco regulation among young adults. Methods Semi-structured interviews were conducted with 60 Georgia college students aged 18-25 using: (1) cigarettes, little cigars/cigarillos (LCCs), smokeless tobacco, or e-cigarettes ≥15 days of the past 30; or (2) hookah ≥10 of the past 30 days (due to lower frequency of use). Of 99 participants recruited, 80 consented, and 60 participated. Results Participants were on average 21.01 years old (SD = 2.07), 56.7% women, and 65.0% black; 56.7% reported current use of cigarettes, 43.3% LCCs, 26.7% smokeless tobacco, 45.0% e-cigarettes, and 41.7% hookah. Cigarettes were perceived as most harmful to health and most addictive. E-cigarettes and hookah were generally regarded as lowest risk. Many indicated that ATP risk information was limited or inaccessible and that most anti-tobacco campaigns were irrelevant to ATPs. Participants requested more research and dissemination of evidence regarding ATP risks and need for ATP regulation. Conclusions In light of low risk perceptions regarding ATPs among young adults, research, anti-tobacco campaigns, and regulation must address their known and potential risks.
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38
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Perceptions and Reasons Regarding E-Cigarette Use among Users and Non-Users: A Narrative Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061190. [PMID: 29882828 PMCID: PMC6025300 DOI: 10.3390/ijerph15061190] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/30/2018] [Accepted: 05/30/2018] [Indexed: 12/17/2022]
Abstract
This paper aims to provide an in-depth understanding of the attractiveness of e-cigarettes for several different groups. For this purpose, perceptions of and reasons for e-cigarette use were systematically reviewed as reported by e-cigarette users, cigarette smokers, dual users, and non-users, among both adults and youth. MEDLINE® and Scopus were used to search for relevant articles, and references of included studies were also investigated. Two reviewers screened all titles and abstracts independently, blinded to authors and journal titles (Cohen’s Kappa = 0.83), resulting in 72 eligible articles. Risk perceptions, perceived benefits, and reasons for e-cigarette use were categorized in themes and sub-themes. Risk perceptions included harmfulness in general, and specific health risks. Perceived benefits included improved taste and smell, and safety for bystanders. Reasons for use included (health) benefits, curiosity, smoking cessation, and friends using e-cigarettes. The findings highlight that there is a variety of perceptions and reasons mentioned by adult and youth e-cigarette users, cigarette smokers, dual users, and non-users. As such, this overview provides valuable information for scientists, public health professionals, behavior change experts, and regulators to improve future research, risk communication, and possibilities to effectively regulate e-cigarettes.
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39
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Yoong SL, Stockings E, Chai LK, Tzelepis F, Wiggers J, Oldmeadow C, Paul C, Peruga A, Kingsland M, Attia J, Wolfenden L. Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta-analysis of country level data. Aust N Z J Public Health 2018. [PMID: 29528527 DOI: 10.1111/1753-6405.12777] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To describe the prevalence and change in prevalence of electronic nicotine delivery systems (ENDS) use in youth by country and combustible smoking status. METHODS Databases and the grey literature were systematically searched to December 2015. Studies describing the prevalence of ENDS use in the general population aged ≤20 years in a defined geographical region were included. Where multiple estimates were available within countries, prevalence estimates of ENDS use were pooled for each country separately. RESULTS Data from 27 publications (36 surveys) from 13 countries were included. The prevalence of ENDS ever use in 2013-2015 among youth were highest in Poland (62.1%; 95%CI: 59.9-64.2%), and lowest in Italy (5.9%; 95%CI: 3.3-9.2%). Among non-smoking youth, the prevalence of ENDS ever use in 2013-2015 varied, ranging from 4.2% (95%CI: 3.8-4.6%) in the US to 14.0% in New Zealand (95%CI: 12.7-15.4%). The prevalence of ENDS ever use among current tobacco smoking youth was the highest in Canada (71.9%, 95%CI: 70.9-72.8%) and lowest in Italy (29.9%, 95%CI: 18.5-42.5%). Between 2008 and 2015, ENDS ever use among youth increased in Poland, Korea, New Zealand and the US; decreased in Italy and Canada; and remained stable in the UK. CONCLUSIONS There is considerable heterogeneity in ENDS use among youth globally across countries and also between current smokers and non-smokers. Implications for public health: Population-level survey data on ENDS use is needed to inform public health policy and messaging globally.
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Affiliation(s)
- Sze Lin Yoong
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales
| | - Emily Stockings
- National Drug and Alcohol Research Centre, UNSW Australia, New South Wales
| | - Li Kheng Chai
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Christopher Oldmeadow
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Armando Peruga
- Centro de Epidemiología y Políticas de Salud (Center for Epidemiology and Health Policies), Facultad de Medicina/CAS, Universidad del Desarrollo, Región Metropolitana, Chile
| | - Melanie Kingsland
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - John Attia
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter Medical Research Institute, New South Wales
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, New South Wales.,Hunter New England Population Health, Hunter New England Local Health District, New South Wales.,Hunter Medical Research Institute, New South Wales
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40
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Lindström M, Rosvall M. Addictive behaviors, social and psychosocial factors, and electronic cigarette use among adolescents: a population-based study. Public Health 2018; 155:129-132. [DOI: 10.1016/j.puhe.2017.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/10/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022]
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41
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Hartwell G, Thomas S, Egan M, Gilmore A, Petticrew M. E-cigarettes and equity: a systematic review of differences in awareness and use between sociodemographic groups. Tob Control 2017; 26:e85-e91. [PMID: 28003324 PMCID: PMC5739861 DOI: 10.1136/tobaccocontrol-2016-053222] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 10/10/2016] [Accepted: 10/26/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess whether electronic cigarette (e-cigarette) awareness, 'ever use' and current use vary significantly between different sociodemographic groups. DESIGN Systematic review. DATA SOURCES Published and unpublished reports identified by searching seven electronic databases (PubMed, MEDLINE, Web of Science, EMBASE, Global Health, PsycINFO, CINAHL Plus) and grey literature sources. STUDY SELECTION Systematic search for and appraisal of cross-sectional or longitudinal studies that assessed e-cigarette awareness, 'ever use' or current use, and included subgroup analysis of 1 or more PROGRESS Plus sociodemographic groups. No geographical or time restrictions imposed. Assessment by multiple reviewers, with 17% of full articles screened meeting the selection criteria. DATA EXTRACTION Data extracted and checked by multiple reviewers, with quality assessed using an adapted tool developed by the Joanna Briggs Institute. DATA SYNTHESIS Results of narrative synthesis suggest broadly that awareness, 'ever use' and current use of e-cigarettes may be particularly prevalent among older adolescents and younger adults, males, people of white ethnicity and-particularly in the case of awareness and 'ever use'-those of intermediate or high levels of education. In some cases, results also varied within and between countries. CONCLUSIONS E-cigarette awareness, 'ever use' and current use appear to be patterned by a number of sociodemographic factors which vary between different countries and subnational localities. Care will therefore be required to ensure neither the potential benefits nor the potential risks of e-cigarettes exacerbate existing health inequalities.
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Affiliation(s)
- Greg Hartwell
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, NIHR School for Public Health Research, London, UK
| | - Sian Thomas
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, NIHR School for Public Health Research, London, UK
| | - Matt Egan
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, NIHR School for Public Health Research, London, UK
| | - Anna Gilmore
- Department for Health, University of Bath, UK Centre for Tobacco and Alcohol Studies (UKCTAS), Bath, UK
| | - Mark Petticrew
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, NIHR School for Public Health Research, London, UK
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42
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Rodriguez E, Parrón T, Alarcón R. Percepciones y uso del cigarrillo electrónico en estudiantes universitarios. Arch Bronconeumol 2017; 53:650-652. [DOI: 10.1016/j.arbres.2017.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/03/2017] [Accepted: 03/20/2017] [Indexed: 11/28/2022]
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43
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Akre C, Suris JC. Adolescents and young adults' perceptions of electronic cigarettes as a gateway to smoking: a qualitative study in Switzerland. HEALTH EDUCATION RESEARCH 2017; 32:448-454. [PMID: 28931165 DOI: 10.1093/her/cyx054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 07/27/2017] [Indexed: 06/07/2023]
Abstract
Electronic cigarettes (ECs) acting as a gateway to smoking traditional cigarettes (TCs) is a growing public health concern of EC use among youths. To gather the opinions and perceptions of adolescents and young adults (AYAs) on whether and how EC can act as a gateway to smoking TC among youths. A qualitative method included 42 AYAs. Participants identified a significant risk of EC acting as a gateway to TC use, several factors contributing to this phenomenon such as a facilitated transition to smoking or its perception as a harmless toy. Participants considered an even greater gateway threat regarding very young adolescents. A minority did not identify the gateway risk and some believed that it was nicotine-dependent. This potential gateway effect brought forth several recommendations: health professionals should screen adolescents (even very young ones) for EC use and inform consumers of the potential gateway effect; this possible effect should be acknowledged to end the harmless perception many might have; there is an urge for better preventive and regulatory policies directed at protecting adolescents and children who never smoked and support those who have quit.
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Affiliation(s)
- Christina Akre
- Institut Universitaire de Médecine Sociale et Préventive, Lausanne University Hospital, Biopole 2, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Joan-Carles Suris
- Institut Universitaire de Médecine Sociale et Préventive, Lausanne University Hospital, Biopole 2, Route de la Corniche 10, 1010 Lausanne, Switzerland
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44
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Copeland AL, Peltier MR, Waldo K. Perceived risk and benefits of e-cigarette use among college students. Addict Behav 2017; 71:31-37. [PMID: 28242533 DOI: 10.1016/j.addbeh.2017.02.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 12/23/2022]
Abstract
Recent data demonstrates that the use of e-cigarettes is growing, especially among college students and young adults. This trend is increasingly problematic, as many of these individuals report never using traditional tobacco cigarettes, but nevertheless are using e-cigarettes. The present study sought to develop the Risks and Benefits of E-cigarettes (RABE) questionnaire to assess the perceptions about e-cigarette use among college students. College students (N=734) completed the RABE via online survey. Principal components analysis yielded two reliable scales representing perceptions about e-cigarette use. Based on the two-factor solution, subscales were named according to item content. The resulting 30 items demonstrated excellent internal consistency (Risks scale α=0.92; Benefits scale α=0.89). Subsequent confirmatory factor analysis generally supported the 2-factor structure. As an initial measure of construct validity, scale scores were compared across smoking status groups. Smoking status groups were defined by the following: "e-cigarette users" were current daily users of e-cigarettes, "conventional smokers" were daily traditional cigarette users, and "dual users" were individuals who used both e-cigarettes and traditional cigarettes daily. Scale scores for perceived Benefits of e-cigarette use differed significantly across groups (p<0.001), whereby students who reported using e-cigarettes or traditional cigarettes reported benefits associated with e-cigarette use. Scale scores for perceived Risks of e-cigarette use across smoking status groups did not significantly differ. The present results indicate that the RABE is a reliable instrument to measure college student's perceived risks and benefits of e-cigarettes.
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Affiliation(s)
- Amy L Copeland
- Department of Psychology, Louisiana State University, United States.
| | | | - Krystal Waldo
- Department of Psychology, Louisiana State University, United States
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45
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Noland M, Rayens MK, Wiggins AT, Huntington-Moskos L, Rayens EA, Howard T, Hahn EJ. Current Use of E-Cigarettes and Conventional Cigarettes Among US High School Students in Urban and Rural Locations: 2014 National Youth Tobacco Survey. Am J Health Promot 2017; 32:1239-1247. [PMID: 28731384 DOI: 10.1177/0890117117719621] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Adolescent tobacco use is higher in rural than in urban areas. While e-cigarette use is increasing rapidly among this age group, differences in prevalence between rural versus urban populations for this relatively novel product have not been explored. The purpose is to investigate whether location of school (rural-urban) is associated with e-cigarette use and dual use (defined as the use of both e-cigarettes and conventional cigarettes) among high school students. DESIGN Cross-sectional survey obtained using a stratified, 3-stage cluster sample design. SETTING United States. PARTICIPANTS A nationally representative sample of US high school students (N = 11 053) who completed the 2014 National Youth Tobacco Survey (NYTS); slightly more than half were urban (54%). MEASURES The NYTS measures tobacco-related knowledge, attitudes, and use behavior and demographics of students in the United States. ANALYSIS Weighted logistic regression assessed the relationships of urban-rural location with current e-cigarette use and dual use, adjusting for demographic factors, perceived risk, and social norms. RESULTS There were clear differences in patterns of adolescent e-cigarette and cigarette use in rural versus urban areas. Social norms and perceptions may play a role in understanding these differences. CONCLUSION Urban youth current cigarette smokers were nearly twice as likely as rural cigarette smokers to also use e-cigarettes. Reasons for urban-rural differences need to be taken into account when designing prevention programs and policy changes.
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Affiliation(s)
- Melody Noland
- 1 Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- 2 Tobacco Policy Research Division, BREATHE, College of Nursing and College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Amanda T Wiggins
- 2 Tobacco Policy Research Division, BREATHE, College of Nursing and College of Public Health, University of Kentucky, Lexington, KY, USA
| | | | - Emily A Rayens
- 4 Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Tiffany Howard
- 5 Department of Health Promotion and Administration, College of Health Sciences, Eastern Kentucky University, Richmond, KY, USA
| | - Ellen J Hahn
- 2 Tobacco Policy Research Division, BREATHE, College of Nursing and College of Public Health, University of Kentucky, Lexington, KY, USA
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Measuring youth beliefs about the harms of e-cigarettes and smokeless tobacco compared to cigarettes. Addict Behav 2017; 70:7-13. [PMID: 28160661 DOI: 10.1016/j.addbeh.2017.01.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/11/2017] [Accepted: 01/24/2017] [Indexed: 11/23/2022]
Abstract
This study examined validity of direct and indirect measures of perceived harm of e-cigarettes and smokeless tobacco (SLT) compared to cigarettes. On direct measures, people compare one product to another, whereas on indirect measures, people rate each product separately and the researcher compares these ratings. Data from youth in Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2014) were analyzed (N=13,651 youth aged 12-17years). The study included direct measures of perceived harm of e-cigarettes and SLT compared to cigarettes, and indirect measures were created by comparing ratings of the products. Weighted multinomial logistic regressions tested criterion validity by assessing whether direct and indirect measures were associated with criterion variables, including use of e-cigarettes and SLT. Youth were more likely to rate e-cigarettes as less harmful than cigarettes on the indirect measure (67.3%) than the direct measure (50.2%). The same pattern held for ratings of SLT as less harmful than cigarettes (indirect: 29.7%; direct: 11.7%). Direct measures explained unique variance in product use criterion variables even after adjusting for indirect measures, as did indirect measures after adjusting for direct measures. However, the criterion variables were more often associated with the direct measures than the indirect measures. Results offer preliminary support for using both direct and indirect measures when assessing youth's perceived relative harm of various types of products. However, if researchers cannot include both direct and indirect measures in a study, associations with product use criterion variables support prioritizing direct measures.
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Park S, Lee H, Min S. Factors associated with electronic cigarette use among current cigarette-smoking adolescents in the Republic of Korea. Addict Behav 2017; 69:22-26. [PMID: 28110154 DOI: 10.1016/j.addbeh.2017.01.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/25/2016] [Accepted: 01/02/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Despite a rapid increase in electronic cigarette (e-cigarette) use and substantial dual use of cigarettes and e-cigarettes among adolescents, little is currently known about adolescent e-cigarette use. Thus, this study aimed to investigate (a) rates of e-cigarette use and (b) significant factors associated with e-cigarette use among current cigarette users in adolescence. METHODS We analyzed secondary data collected from a nationally representative sample of Korean adolescents. Our study sample included 6307 current smokers. Our dependent variable was e-cigarette use and consisted of three categories (nonuse, former use, and current use); independent variables included demographics, perceived stress, parental and friends' smoking, three characteristics of cigarette smoking, and other health risk behaviors. Descriptive statistics was used for the first aim; multinomial logistic regression analysis was performed for the second aim. RESULTS Of current cigarette users, 20% smoked e-cigarettes in their lifetime but not within the past 30days (former users), and 42% smoked e-cigarettes in their lifetime and within the past 30days (current users). Both former and current e-cigarette use were significantly associated with male gender, higher grades, higher weekly allowance, residence in urban areas, friends' smoking, daily smoking, a higher number of cigarettes smoked, and quit attempts. In addition, current e-cigarette use was significantly associated with at-risk drinking, lifetime drug use, and lifetime sexual intercourse. CONCLUSIONS E-cigarette use should be included in intervention strategies for smoking prevention and cessation. Strict regulations should be implemented in order to prohibit easy access to e-cigarettes and forbid advertising of e-cigarettes as well.
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Affiliation(s)
- Grace Kong
- Yale School of Medicine, New Haven CT, USA.
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Breland A, Soule E, Lopez A, Ramôa C, El-Hellani A, Eissenberg T. Electronic cigarettes: what are they and what do they do? Ann N Y Acad Sci 2017; 1394:5-30. [PMID: 26774031 PMCID: PMC4947026 DOI: 10.1111/nyas.12977] [Citation(s) in RCA: 232] [Impact Index Per Article: 33.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Electronic cigarettes (ECIGs) use electricity to power a heating element that aerosolizes a liquid containing solvents, flavorants, and the dependence-producing drug nicotine for user inhalation. ECIGs have evolved rapidly in the past 8 years, and the changes in product design and liquid constituents affect the resulting toxicant yield in the aerosol and delivery to the user. This rapid evolution has been accompanied by dramatic increases in ECIG use prevalence in many countries among adults and, especially, adolescents in the United States. The increased prevalence of ECIGs that deliver nicotine and other toxicants to users' lungs drives a rapidly growing research effort. This review highlights the most recent information regarding the design of ECIGs and their liquid and aerosol constituents, the epidemiology of ECIG use among adolescents and adults (including correlates of ECIG use), and preclinical and clinical research regarding ECIG effects. The current literature suggests a strong rationale for an empirical regulatory approach toward ECIGs that balances any potential ECIG-mediated decreases in health risks for smokers who use them as substitutes for tobacco cigarettes against any increased risks for nonsmokers who may be attracted to them.
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Affiliation(s)
| | - Eric Soule
- Virginia Commonwealth University, Richmond, Virgina
| | - Alexa Lopez
- Virginia Commonwealth University, Richmond, Virgina
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Abstract
BACKGROUND Information on e-cigarettes among youth in the Russian Federation is lacking. OBJECTIVE We examined prevalence of and factors associated with youth e-cigarette use in the Russian Federation. METHODS A cross-sectional, anonymous survey, conducted among 716 (females 51.5%) high school students in three cities (i.e., Ufa, Sterlitamak, Karagaevo) within the Republic of Bashkortostan, Russian Federation in 2015, assessed e-cigarette use and its correlates (i.e., sex, age, ethnicity, family structure, parents' highest degrees, antisocial behaviors, stress coping strategies, lifetime cigarette, hookah, alcohol, and marijuana use). RESULTS Lifetime use of e-cigarettes was 28.6% and past-30-day use was 2.2%. Multilevel modeling showed that belonging to Tatar/Bashkir ethnicity relative to Russian ethnicity (OR = 1.60) and lifetime use of cigarettes (OR = 21.64), hookah (OR = 4.21), and alcohol (OR = 1.90) was associated with greater odds of lifetime use of e-cigarettes. Furthermore, use of social support coping strategies (i.e., utilizing parents for support) were associated with lower odds of lifetime use of e-cigarettes (OR = 0.94). CONCLUSIONS Despite high lifetime e-cigarette use, past-30-day use was low. Greater knowledge of the reasons for e-cigarette discontinuation through continued surveillance is needed in the Russian Federation. Social coping strategies involving parents may inform e-cigarette use prevention.
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Affiliation(s)
- Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Bulat Idrisov
- Section of General Internal Medicine, Boston Medical Center, Boston University, Boston, Massachusetts, USA
- Department of Preventive Medicine, Bashkir State Medical University, Ufa, Russian Federation
| | - Artur Galimov
- Department of Preventive Medicine, Bashkir State Medical University, Ufa, Russian Federation
| | - Radik Masagutov
- Department of Psychiatry and Narcology, Bashkir State Medical University, Ufa, Russian Federation
| | - Steve Sussman
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
- Department of Psychology, University of Southern California, Los Angeles, California, USA
- School of Social Work, University of Southern California, Los Angeles, California, USA
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