Adolescents and E-cigarettes in India: A Qualitative Study of Perceptions and Practices

Choose life, not vapes: empowering teens to make healthier choices - a cross sectional study

OBJECTIVES

The tobacco epidemic is more than just a health concern. It is a socioeconomic one with far-reaching effects. Smoking being the most common mode of tobacco use worldwide, has an impact on human life and well-being. Hence, this study aimed to seek the knowledge and awareness of adolescents about e-cigarettes and spread awareness about the harmful effects of vapig so as to reduce the ongoing rise in cigarette consumption among these individuals.

METHODS

A questionnaire-based cross-sectional survey was conducted among 100 teenage children of urban schools in Delhi NCR of age group 14-17 years which collected information on teenage vaping practices, views about vaping, and their accessibility to vaping items. The data were analyzed using the Statistical Program for Social Sciences - SPSS version 25 through frequency and percent, graphs, Bar chart and Chi-squared test.

RESULTS

A total 100 participants took part in the survey out of which of 59 were males and 41 were females. A significant proportion of the participants (94 %) possessed knowledge of e-cigarettes, and 14 % had actually used them at some point. Most of the participants were aware of the disposable variety of e-cigarettes and most of them thought that e-cigarettes were less addictive.

CONCLUSIONS

A significant portion of educated young adults who have never vaped are susceptible to using e-cigarettes in the future. It is also discovered that e-cigarettes are still available and being promoted in spite of the restrictions. In addition to good health education for minors, more stringent enforcement of current rules and monitoring could help prevent larger uptake in the future.

Knowledge, Attitude, and Practice of College Students Toward E-cigarettes: A Study From the Northern Part of Karnataka, India

INTRODUCTION

E-cigarettes, also known as electronic cigarettes or vape pens, are battery-powered devices that deliver nicotine, flavorings, and other chemicals to users in the form of an aerosol. It revolutionized the landscape of nicotine consumption, marketed as a safer alternative to traditional cigarettes. Since then, e-cigarettes have become popular among young adults and adolescents. There has always been a conflict in the risks versus benefits of e-cigarettes over the decade, which has created a gap in knowledge in the population. This study aimed to attain the knowledge, attitude, and practice of students from a semi-urban background to understand the level of education needed among the young population of our country.

METHODS

This online survey was conducted among 411 students of Shri BM Patil Medical College Hospital and Research Centre (BLDE) (DU), College, Vijayapura, Karnataka. The survey consisted of 21 MCQ questionnaires to assess students' knowledge, attitude, and practice toward e-cigarettes. Later, the data was analyzed using SPSS version 28.

RESULTS

The study included a diverse group of 411 participants, with a majority being males (63%) and the rest females (37%). The age distribution highlighted a young demographic, with 93% of participants aged between 18 and 34. The study revealed a high level of awareness about e-cigarettes, with 90% of participants being familiar with them. Friends and social media emerged as the primary sources of information, accounting for 52% and 40%, respectively. While 48% of the participants believed e-cigarettes to be non-addictive, only 19% recognized their addictive potential, with the rest being unsure. A majority, 45%, did not see e-cigarette users as superior to traditional smokers, while 15.5% held the opposite view. While 58% of e-cigarette users found them to be stress-relieving, 33% did not, highlighting a subjective aspect of e-cigarette use.

CONCLUSION

The study offers critical insights into the knowledge, attitudes, and practices regarding e-cigarettes among medical students in northern Karnataka. While awareness is high, there is a notable gap in accurate understanding of e-cigarettes' safety and addictive nature. The findings emphasize the need for enhanced education and awareness campaigns to correct misconceptions about e-cigarettes.

Knowledge, Attitudes, and Practices of University Students Regarding the Impact of Smokeless Tobacco, Areca Nut, E-cigarette Use on Oral Health

BACKGROUND

 The prevalence of smokeless tobacco, areca nut, and e-cigarette use among university students has raised concerns regarding their potential impact on oral health. Assessing students' knowledge, attitudes, and practices toward these substances is necessary. Understanding these factors can inform targeted interventions and policies promoting oral health among this population. This study aims to investigate the awareness levels, attitudes, and behaviors of university students regarding smokeless tobacco, areca nut, and e-cigarette use and their potential effects on oral health. Identifying gaps in knowledge and misconceptions will help guide educational initiatives and public health interventions tailored to the needs of university students.

METHODOLOGY

 The study employed a designed questionnaire, comprising 20 closed-ended queries, administered via the Google Forms platform. This survey was disseminated among college students in Chennai to gather insights for the study.

RESULTS

Of the 500 college students included in the study, almost 85.5% (427) were aware of the harmful effects of smokeless tobacco on oral health. Additionally, 74.6% (373) recognized that chewing areca nut contributes to poor oral health, while 59.8% (299) acknowledged the negative impact of e-cigarette use.

CONCLUSIONS

The present study concluded that 11.1% (6) used smokeless tobacco, 18.9% (94) chewed areca nut, and 1.9% (10) used areca nut along with tobacco. Regarding e-cigarettes, 3.9% (19) indulged in vaping as a substitute for smoking regular cigarettes and 12.1% (61) used it along with tobacco cigarettes. It was also noted that 27.8% (139) were trying to quit and 12.6% (63) have tried but could not succeed. Therefore, although there was awareness of the ill effects of these deleterious habits on oral health and the increased risk of oral cancer, there remains a need to educate individuals and provide support for quitting these habits. Our study will provide insights into the present scenario of the awareness of the association between oral health and tobacco/areca nut consumption among college students in Chennai city.

A Systematic Literature Review on the Composition, Health Impacts, and Regulatory Dynamics of Vaping

This comprehensive review deals with the multifaceted aspects of electronic cigarettes (e-cigarettes), examining their composition, health implications, regulatory challenges, and market dynamics. E-cigarettes, also known as vaping devices, function by warming a solution of liquid containing flavors, nicotine, and various other compounds to produce an aerosol for users to inhale. This review underscores the evolution and widespread adoption of e-cigarettes since their introduction in 2003, highlighting their appeal as alternatives to traditional tobacco smoking. The essential parts of e-cigarettes are the battery, heating element, e-liquid (or e-juice), and mouthpiece. Propylene glycol and vegetable glycerin are common ingredients in e-liquids, along with nicotine and other flavors. Concerns over the health impacts of e-cigarettes have grown, particularly in light of incidents like the e-cigarette or vaping-associated lung injury outbreak in 2019 linked to vaping-associated lung injuries. Evidence suggests that while e-cigarettes may pose fewer risks than conventional cigarettes, they are not without health consequences, including potential respiratory and cardiovascular effects. Regulatory efforts worldwide have struggled to keep pace with the rapid evolution of e-cigarettes, exacerbated by their diverse flavors and marketing strategies that appeal to youth. The review discusses global regulatory responses, including bans and restrictions, to curb youth uptake and address public health concerns. Furthermore, the rise of a black market for e-cigarettes poses additional challenges to effective regulation and tobacco control efforts. In conclusion, while e-cigarettes offer potential harm reduction benefits for adult smokers seeking alternatives to traditional tobacco products, their widespread availability and evolving landscape necessitate vigilant regulatory oversight to protect public health, especially among youth. Future research should continue to explore the long-term health impacts and efficacy of e-cigarettes as smoking elimination aids, informing evidence-based policies and interventions.

Prevalence, regional patterns and socio-demographic factors associated with poly-tobacco use in India: A secondary data analysis

BACKGROUND

Tobacco use is associated with early, intermediate and long-term complications throughout the life course. With an influx of newer products containing nicotine, poly-tobacco use is slowly emerging as a public health concern, that is defined as existing tobacco users currently using two or more tobacco or nicotine products. While many studies have investigated single use tobacco, there is a paucity of research on regional patterns and socio-demographic factors associated with poly-tobacco use in India.

OBJECTIVES

To assess prevalence of poly-tobacco use and determine the socio-demographic factors associated with poly-tobacco use in India.

METHODS

Data from the Global Adult Tobacco Survey 2 (GATS, 2016-17) was analysed, which included information on tobacco use among people aged >15 years. The pattern of current tobacco status was described using descriptive statistics. Multiple logistic regression models were estimated to determine factors associated with poly-tobacco use.

RESULTS

The prevalence of poly-tobacco use in India was found to be 9.8%. Among the current tobacco users, the prevalence was 33%. Significant socio-demographic factors associated with poly-tobacco use included younger age, male gender, religion and backward caste. North-eastern region reported highest prevalence of poly-tobacco use in the country, followed by the central region.

CONCLUSION

The number of poly-tobacco users in India is considerably high and a matter of concern, more so in north east and central regions of the country. There is a need to create awareness about dangerous effects of all types of tobacco products and strengthen implementation of tobacco control policies with special focus on regions with high burden.

Electronic nicotine delivery system: a narrative review on growing threat to tobacco control and health of the young Indian population

The electronic cigarette (EC) was developed as an alternative to cigarette smoking. In less than a decade, the prevalence of past-month EC usage increased from 1.5 to 27.5 % among US high-school students. In the coming years, Asia-Pacific countries will have the highest sales of electronic nicotine/non-nicotine delivery systems (ENDS/ENNDS) after Western Europe. Based on the World Health Organization and Indian Council of Medical Research recommendations, India approved a complete ban on EC in 2019. Even though it has been three years since the ban, EC is still being sold in India's grey markets, where marketing is not regulated. In this narrative review, we discuss that vaping is not just a harm reduction strategy for tobacco smoking cessation but poses a serious threat to India's existing tobacco control efforts as well as the health of the country's young people.