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Adebisi YA, Bafail DA. Comparing self-rated health among exclusive e-cigarette users and traditional cigarette smokers: an analysis of the Health Survey for England 2019. Intern Emerg Med 2025; 20:441-452. [PMID: 39546077 PMCID: PMC11950125 DOI: 10.1007/s11739-024-03817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Accepted: 11/02/2024] [Indexed: 11/17/2024]
Abstract
The health implications of e-cigarette use compared to traditional cigarette smoking continue to attract significant public health interest. This study examines self-rated health (SRH) outcomes among exclusive e-cigarette users versus exclusive traditional cigarette smokers, using data from the Health Survey for England 2019. From an initial sample of 10,299 participants, the study focused on 8204 adults, excluding those aged 0-15. Further refinement to exclusive nicotine product users led to 274 e-cigarette users and 1017 cigarette smokers, after excluding dual users, never users, ex-users, non-responders, and users of other tobacco products such as pipes and cigars. SRH was derived from participants' responses to a question asking how they rated their general health, with five possible options: "very good", "good", "fair", "bad", and "very bad". For the purposes of this study, these responses were collapsed into two categories: "Good Health" (combining "very good" and "good") and "Poor Health" (combining "fair", "bad", and "very bad"). Consequently, 834 participants were classified as reporting good health, while 457 reported poor health. Binary logistic regression, adjusted for factors such as age, sex, ethnicity, residence, education, body mass index, alcohol use, age started smoking, physical or mental health conditions, and frequency of GP visits, revealed that exclusive e-cigarette users were significantly more likely to report good health compared to exclusive cigarette smokers, with an odds ratio (OR) of 1.59 (95% CI: 1.10 - 2.32, p = 0.014). As a sensitivity analysis, a generalized ordered logistic regression model was performed using the original five SRH categories. The adjusted model confirmed consistent results, with exclusive e-cigarette users showing higher odds of reporting better health across the full range of SRH outcomes (OR = 1.40, 95% CI: 1.08-1.82, p = 0.011). These findings suggest that exclusive e-cigarette users perceive their health more positively than traditional cigarette smokers, contributing useful insights to the discussions around harm reduction strategies.
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Affiliation(s)
| | - Duaa Abdullah Bafail
- Department of Clinical Pharmacology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Kundu A, Seth S, Felsky D, Moraes TJ, Selby P, Chaiton M. A Systematic Review of Predictors of Vaping Cessation Among Young People. Nicotine Tob Res 2025; 27:169-178. [PMID: 39031127 PMCID: PMC11750738 DOI: 10.1093/ntr/ntae181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 07/10/2024] [Accepted: 07/15/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND AND AIMS Understanding the factors influencing vaping cessation among young people is crucial for targeted interventions. This review aimed to summarize the individual and environmental factors that predict vaping cessation-related behaviors in the young population. METHODS We systematically searched five databases for studies investigating predictors of vaping cessation behaviors among young people aged 10-35 years. Studies that examined predictors of cessation of cigarettes, other tobacco products, cannabis vaping, and studies evaluating efficacy of cessation interventions were excluded. Quality in Prognosis Studies tool was used to assess risk of bias. RESULTS We found 24 studies analyzing predictors of intention to quit vaping (n = 15), quit attempts (n = 11), and vaping abstinence (n = 7). Most studies had low risk of bias, except for study attrition. We identified 107 predictors and grouped them into "probable," "possible," "insufficient evidence," "probably unrelated," and "inconsistent direction" categories. For "probable" predictors, we found 11 for intention to quit, eight for quit attempts and five for vaping abstinence. Overall, harm perception of vaping, current other tobacco products use, frequency of use, and level of nicotine dependence were common "probable" predictors across three outcomes, with low harm perception of vaping, dual use, and poly tobacco use associated with decreased intention to quit and quit attempts in younger population (~10-19 years). CONCLUSIONS Predictive modeling studies investigating vaping cessation-related behaviors among young people are still limited. Future research should specifically study the natural history of vaping in youth in different jurisdictions, populations, and age groups to expand our knowledge in this area. IMPLICATIONS We identified and categorized predictors of intention to quit vaping, quit attempts, and vaping abstinence among young people. While the "probable" predictors can inform public health and policymakers to plan targeted vaping cessation programs for high-risk populations, raising public harm perception of vaping and encouraging to quit other tobacco products might increase intention to quit and quit attempts among younger population. However, the "possible," "insufficient evidence" and "inconsistent direction" predictors need further testing by future prospective longitudinal research. Additionally, we emphasized the significance of appropriate study designs, conducting research across various jurisdictions, and different population groups to obtain comprehensive insights.
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Affiliation(s)
- Anasua Kundu
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Siddharth Seth
- Health Science, Queen’s University, Kingston, Ontario, Canada
| | - Daniel Felsky
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Theo J Moraes
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Chaiton
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Izquierdo-Condoy JS, Sosa KR, Salazar-Santoliva C, Restrepo N, Olaya-Villareal G, Castillo-Concha JS, Loaiza-Guevara V, Ortiz-Prado E. E-cigarette use among adolescents in Latin America: A systematic review of prevalence and associated factors. Prev Med Rep 2025; 49:102952. [PMID: 39817049 PMCID: PMC11733054 DOI: 10.1016/j.pmedr.2024.102952] [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: 08/19/2024] [Revised: 12/17/2024] [Accepted: 12/18/2024] [Indexed: 01/18/2025] Open
Abstract
Background Electronic cigarettes, introduced as a safer tobacco alternative, have unintentionally exposed millions of youths to nicotine and harmful chemicals. Adolescence, a key period for forming lifelong habits, has seen rising e-cigarette use, particularly in developing regions like Latin America, warranting thorough investigation. Objective To describe the prevalence and factors associated with e-cigarette use among adolescents in Latin America. Methods A systematic review was conducted according to PRISMA guidelines, covering studies published between 2003 and May 2024. Database searches included PubMed/Medline, Web of Science, Scopus, Google Scholar, Scielo, and LILACS. A total of 582 studies were identified, of which 14 met the inclusion criteria. Study data were synthesized and assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute checklist. Results The prevalence of e-cigarette among adolescents in six Latin American countries ranged from 2.6 % to 64.2 %, with a pooled mean prevalence of 18.9 %, and lifetime use higher than current use. Key associated factors included male sex, concurrent use of tobacco and other substances, social influences, and exposure to online advertising. A widespread lack of knowledge regarding e-cigarette risks, coupled with limited regulatory oversight, may be contributing to higher usage rates. Conclusion This review underscores critical gaps in data on adolescent e-cigarette use in Latin America and highlights the need for expanded research and targeted public health interventions. Nearly one-fifth of adolescents reported using e-cigarettes. Comprehensive prevention programs addressing factors associated with adolescent e-cigarette use in Latin America, involving diverse stakeholders and integrating education, school-based policies, social media campaigns, and policy restrictions, are strongly recommended.
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Affiliation(s)
| | - Kenny Ruiz Sosa
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
| | | | - Natalia Restrepo
- Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira, Colombia
| | | | | | | | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
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Sargsyan Z, Dekanosidze A, Hayrumyan V, Torosyan A, Cui Y, Grigoryan L, Alayan N, Petrosyan V, Bazarchyan A, Sturua L, Haardörfer R, Kegler MC, Berg CJ. Exposure to e-cigarette and heated tobacco product advertisements via digital, traditional media, and points-of-sale: An examination of associations with use intentions and perceived risk among adults in Armenia and Georgia. Tob Prev Cessat 2024; 10:TPC-10-46. [PMID: 39464386 PMCID: PMC11504294 DOI: 10.18332/tpc/191992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 08/02/2024] [Accepted: 08/05/2024] [Indexed: 10/29/2024]
Abstract
INTRODUCTION E-cigarette and heated tobacco product (HTP) marketing often leverages digital media and points-of-sale (POS) and advertises risk reduction, including in Armenia and Georgia where male cigarette use rates are high. METHODS Using 2022 survey data from Armenian and Georgian adults (n=1468, mean age=42.92 years, 51.4% female; and past-month use of e-cigarettes 3.2%, HTPs 2.7%, and cigarettes 31.6%), multivariable linear regression examined 4 outcomes - e-cigarette and HTP use intentions and perceived risk (1=not at all, to 7=extremely) - in relation to past-month e-cigarette or HTP advertisement exposure via digital media, traditional media, and POS, controlling for covariates (country, age, gender, education level, relationship status, children, past-month cigarette and e-cigarette/HTP use). RESULTS E-cigarette and HTP use intentions were low (mean score=1.47, SD=1.39 each), while perceived risk was high (mean score=5.83, SD=1.6, and mean score=5.87, SD=1.56, respectively). Past-month exposure to e-cigarette and HTP advertisements, respectively, were 12.9% and 11.2% via digital media, 6.1% and 4.8% traditional media, and 22.5% and 21.1% POS. For e-cigarettes, ad exposure via digital media was associated with greater use intentions (β=0.24; 95% CI: 0.03-0.44), ad exposure via traditional media (β= -0.32; 95% CI: -0.55 - -0.09) and POS (β= -0.30; 95% CI: -0.60 - -0.004) was associated with lower risk perceptions. For HTPs, ad exposure via digital media (β=0.35; 95% CI: 0.14-0.56) and POS (β=0.21; 95% CI: 0.04-3.63) was associated with greater use intentions, and ad exposure at POS was associated with lower risk perceptions (β= -0.23; 95% CI: -0.42 - -0.03). CONCLUSIONS Tobacco control efforts should monitor and regulate e-cigarette and HTP marketing, particularly via digital media which may effectively promote use, and via POS which may target and influence risk perceptions.
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Affiliation(s)
- Zhanna Sargsyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Ana Dekanosidze
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia
- Tbilisi State Medical University, Tbilisi, Georgia
| | - Varduhi Hayrumyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Arevik Torosyan
- National Institute of Health named after academician S. Avdalbekyan, Ministry of Health of the Republic of Armenia, Yerevan, Armenia
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, United States
| | - Lilit Grigoryan
- National Institute of Health named after academician S. Avdalbekyan, Ministry of Health of the Republic of Armenia, Yerevan, Armenia
| | - Nour Alayan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia
| | - Alexander Bazarchyan
- National Institute of Health named after academician S. Avdalbekyan, Ministry of Health of the Republic of Armenia, Yerevan, Armenia
| | - Lela Sturua
- Georgia National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, United States
| | - Michelle C. Kegler
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, United States
- George Washington Cancer Center, The George Washington University, Washington, United States
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Lund L, Andersen S, Ritz C, Bast LS. Predicting longitudinal changes in patterns of tobacco and nicotine product use among adolescents: A Latent Transition Analysis based on the X:IT study. Soc Sci Med 2024; 352:117029. [PMID: 38843676 DOI: 10.1016/j.socscimed.2024.117029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Understanding factors influencing the transition from non-use to tobacco and nicotine product initiation among adolescents is crucial for designing and implementing effective preventive strategies. This study explores transition patterns among 13-15-year-old adolescents in lower secondary school, focusing on the transition from non-use to tobacco and nicotine product initiation and the influence of individual, social, risk behavioral, and mental health factors on this transition. METHODS Based on data from a Danish smoking prevention trial between 2017 and 2019, this study employed questionnaire surveys at three time points: baseline (start of seventh grade, n = 1,990, response rate = 86.3%), eight-month follow-up (end of seventh grade, n = 1,666, response rate = 74,8%), and 20-month follow-up (end of eighth grade, n = 1,149, response rate = 70,6%). Tobacco and nicotine use indicators included current and lifetime use of cigarettes and lifetime use of e-cigarettes, smokeless tobacco, and hookah. A latent transition analysis was applied to identify longitudinal transition patterns across waves and to explore predictors of these patterns. RESULTS Three user classes emerged across all waves: none-use, lifetime e-cigarette and cigarette use, and poly-tobacco use. While the most prevalent class was the non-user class (71%-86%), the proportion of the lifetime e-cigarette and cigarette class increased over time (from 12% to 17%). Similarly, the poly-tobacco user class increased from 2% to 12%. The probability of transitioning from non-use to lifetime e-cigarette and cigarette use increased from 0.5% at baseline to 12% by the second follow-up, while the probability of transitioning from lifetime e-cigarette and cigarette use remained stable over time (12%-15%). Across all waves, elevated risk behavior predicted this transition. For instance, binge-drinking (OR = 3.76, 95% CI: 1.51-9.34), susceptibility to smoking (OR = 7.63, 95% CI: 3.68-16.83), and truancy (OR = 7.00, 95% CI: 1.98-24.59) influenced the transition from non-use at baseline to lifetime e-cigarette and cigarette use at first follow-up. Additionally, boys, adolescents with low socioeconomic status, low life satisfaction, and those with smoking friends or parents were more likely to transition from non-use to lifetime e-cigarette and cigarette use. CONCLUSION This study demonstrates that sociodemographic, social risk, behavioral, and mental health factors impact the transition from non-use to lifetime e-cigarette and cigarette use. The findings provide valuable insights for developing targeted preventive strategies focusing on these influencing factors.
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Affiliation(s)
- Lisbeth Lund
- National Institute of Public Health, University of Southern Denmark, Studiestræde, 61455, Copenhagen, Denmark.
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde, 61455, Copenhagen, Denmark.
| | - Christian Ritz
- National Institute of Public Health, University of Southern Denmark, Studiestræde, 61455, Copenhagen, Denmark.
| | - Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestræde, 61455, Copenhagen, Denmark.
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Erhabor J, Boakye E, Obisesan O, Osei AD, Tasdighi E, Mirbolouk H, DeFilippis AP, Stokes AC, Hirsch GA, Benjamin EJ, Rodriguez CJ, El Shahawy O, Robertson RM, Bhatnagar A, Blaha MJ. E-Cigarette Use Among US Adults in the 2021 Behavioral Risk Factor Surveillance System Survey. JAMA Netw Open 2023; 6:e2340859. [PMID: 37921768 PMCID: PMC10625038 DOI: 10.1001/jamanetworkopen.2023.40859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/17/2023] [Indexed: 11/04/2023] Open
Abstract
Importance After the initial disruption from the COVID-19 pandemic, it is unclear how patterns of e-cigarette use in the US have changed. Objective To examine recent patterns in current and daily e-cigarette use among US adults in 2021. Design, Setting, and Participants This cross-sectional study used data from the 2021 Behavioral Risk Factor Surveillance System (BRFSS) database. The BRFSS is the largest national telephone-based survey of randomly sampled adults in the US. Adults aged 18 years or older, residing in 49 US states (all except Florida), the District of Columbia, and 3 US territories (Guam, Puerto Rico, and the US Virgin Islands), were included in the data set. Data analysis was performed in January 2023. Main Outcomes and Measures The main outcome was age-adjusted prevalence of current and daily e-cigarette use overall and by participant characteristics, state, and territory. Descriptive statistical analysis was conducted, applying weights to account for population representation. Results This study included 414 755 BRFSS participants with information on e-cigarette use. More than half of participants were women (51.3%). In terms of race and ethnicity, 0.9% of participants were American Indian or Alaska Native, 5.8% were Asian, 11.5% were Black, 17.3% were Hispanic, 0.2% were Native Hawaiian or Other Pacific Islander, 62.2% were White, 1.4% were of multiple races or ethnicities, and 0.6% were of other race or ethnicity. Individuals aged 18 to 24 years comprised 12.4% of the study population. The age-standardized prevalence of current e-cigarette use was 6.9% (95% CI, 6.7%-7.1%), with almost half of participants using e-cigarettes daily (3.2% [95% CI, 3.1%-3.4%]). Among individuals aged 18 to 24 years, there was a consistently higher prevalence of e-cigarette use, with more than 18.6% reporting current use and more than 9.0% reporting daily use. Overall, among individuals reporting current e-cigarette use, 42.2% (95% CI, 40.7%-43.7%) indicated former combustible cigarette use, 37.1% (95% CI, 35.6%-38.6%) indicated current combustible cigarette use, and 20.7% (95% CI, 19.7%-21.8%) indicated never using combustible cigarettes. Although relatively older adults (aged ≥25 years) who reported current e-cigarette use were more likely to report former or current combustible cigarette use, younger adults (aged 18-24 years) were more likely to report never using combustible cigarettes. Notably, the proportion of individuals who reported current e-cigarette use and never using combustible cigarettes was higher in the group aged 18 to 20 years (71.5% [95% CI, 66.8%-75.7%]) compared with those aged 21 to 24 years (53.0% [95% CI, 49.8%-56.1%]). Conclusion and Relevance These findings suggest that e-cigarette use remained common during the COVID-19 pandemic, particularly among young adults aged 18 to 24 years (18.3% prevalence). Notably, 71.5% of individuals aged 18 to 20 years who reported current e-cigarette use had never used combustible cigarettes. These results underscore the rationale for the implementation and enforcement of public health policies tailored to young adults.
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Affiliation(s)
- John Erhabor
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
| | - Ellen Boakye
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
| | | | - Albert D. Osei
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland
| | - Erfan Tasdighi
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland
| | - Hassan Mirbolouk
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Andrew P. DeFilippis
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Andrew C. Stokes
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Glenn A. Hirsch
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colorado
| | - Emelia J. Benjamin
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
- Cardiovascular Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Carlos J. Rodriguez
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
- Albert Einstein College of Medicine, Bronx, New York, New York
| | - Omar El Shahawy
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Rose Marie Robertson
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Aruni Bhatnagar
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
- University of Louisville School of Medicine, Louisville, Kentucky
| | - Michael J. Blaha
- Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, Maryland
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
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Pettigrew S, Santos JA, Pinho-Gomes AC, Li Y, Jones A. Exposure to e-cigarette advertising and young people's use of e-cigarettes: A four-country study. Tob Induc Dis 2023; 21:141. [PMID: 37881174 PMCID: PMC10594952 DOI: 10.18332/tid/172414] [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: 07/16/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION The World Health Organization recommends banning all forms of e-cigarette advertising, promotion, and sponsorship. The aims of the present study were to: 1) examine young people's exposure to e-cigarette advertising across a wide range of media in four diverse countries; and 2) identify any association between the number of different types of media exposures and e-cigarette use. METHODS A cross-sectional online survey was administered to approximately 1000 people aged 15-30 years in Australia, China, India, and the United Kingdom (n=4107). The survey assessed demographic characteristics, e-cigarette and tobacco use, numbers of friends and family members who vape, and exposure to multiple forms of e-cigarette advertising (e.g. television, radio, print, and various types of social media). Descriptive analyses were conducted on those who had heard of e-cigarettes (n=3095, significance threshold p<0.001) and a logistic regression analysis was used to identify factors associated with e-cigarette ever use (significance threshold p<0.05). RESULTS The majority (85%) of respondents who had heard of e-cigarettes reported being exposed to e-cigarette advertising on at least one type of media, and the average number of types of media to which respondents were exposed was 5 (range: 0-17). The number of media types was significantly associated with ever use of e-cigarettes (OR=1.05; 95% CI: 1.02-1.08, p=0.001). CONCLUSIONS Despite advertising restrictions in place in all four countries, large majorities of young people reported being exposed to e-cigarette advertising. Social media and advertising on/around vape shops and other retailers appear to be key exposure locations. Urgent attention is needed to address these forms of exposure given their apparent association with e-cigarette use.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Joseph A. Santos
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Ana-Catarina Pinho-Gomes
- The George Institute for Global Health, London, United Kingdom
- School of Public Health, Imperial College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Yuan Li
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, Beijing, China
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Hwang J. Comparison of attempts and plans to quit tobacco products among single, dual, and triple users. Tob Induc Dis 2023; 21:113. [PMID: 37712078 PMCID: PMC10498502 DOI: 10.18332/tid/169663] [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: 03/27/2023] [Revised: 07/03/2023] [Accepted: 07/16/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Tobacco users are categorized as single, dual, and triple users based on the number of tobacco products (cigarettes, e-cigarettes, and heated tobacco products) used. This study addressed a literature gap by examining how adult Korean tobacco users' quit attempts/plans differed based on the user type, and the associated psychosocial and subjective health-related factors. METHODS We used a questionnaire to examine participants' self-reported health, stress, health concerns, health behavior, tobacco addiction, intentions/plans to quit, and demographic characteristics. Data were analyzed using chi-squared tests, one-way analysis of variance, and multiple linear regression. RESULTS Of the 1288 tobacco users, 55.4%, 28.3%, and 16.4% were single, dual, and triple users, respectively. Self-rated health and stress were lowest among single users and highest among triple users. Most user types had intentions/plans to quit, especially triple users. Quit attempts and plans increased with increasing health behaviors and time elapsed before first tobacco use in the morning, but decreased with higher stress and self-rated addiction. CONCLUSIONS Intentions/plans to quit tobacco use varied based on the type of tobacco user. Multiple users had higher self-rated health, plans to quit, and self-reported addiction; they considered themselves healthy or engaged in healthy behaviors to offset problems from tobacco use and used multiple tobacco products to quit smoking. Highly stressed users had fewer plans to quit and used tobacco for stress relief. Thus, the provision of accurate information about tobacco products and stress management is important to promote successful quitting.
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Affiliation(s)
- Jieun Hwang
- Department of Health Administration, College of Health and Welfare, Dankook University, Cheonan-si, Republic of Korea
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Wang J, Xie CC, Jia XX, Xu K, Gong ZY, Sun YQ, Gao JR, Ding Y, Huang ZY, Chen D. E-cigarette awareness and use, among adult residents in Shanghai, China. Tob Induc Dis 2023; 21:104. [PMID: 37581174 PMCID: PMC10401329 DOI: 10.18332/tid/169559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION The widespread popularity of e-cigarettes is considered an important public health concern. However, only some studies have investigated the prevalence of e-cigarette use in Shanghai, China. Research on the perceived harmfulness of e-cigarettes and public support for e-cigarette regulations in China is limited. This study aimed to estimate e-cigarette awareness, prevalence, and associated factors among adults in Shanghai, China. METHODS This study used data from a representative survey conducted in Shanghai, China, in 2019. The survey was conducted at 64 surveillance points in Shanghai, China, using a multistage, stratified, cluster-randomized sampling design, recruiting community-based Chinese adults aged ≥15 years. Based on the principles outlined in the Global Adult Tobacco Survey (GATS) China Project, data were collected by conducting face-to-face interviews in households. Of the 3200 selected households, 3060 people completed the individual survey. The overall response rate was 97.4%. RESULTS In all, 72.3% of the respondents had heard of e-cigarettes. The respondents who had used e-cigarettes at some point in their life, used them in the last 12 months, and used them currently were 5.8%, 2.6%, and 1.3%, respectively. Among adult residents who had heard of e-cigarettes, 38.2% thought they were less harmful than traditional cigarettes. The respondents who perceived e-cigarettes as more harmful than traditional cigarettes were less likely to have ever used e-cigarettes (AOR=0.2; 95% CI: 0.1-0.5, p=0.0015) and more likely to support incorporating e-cigarettes into the regulation of smoking control (AOR=3.9; 95% CI: 1.8-8.6, p=0.0008). CONCLUSIONS Our findings reveal that the awareness about e-cigarettes was high, and the prevalence of e-cigarette use was similar to the findings from previous studies in China. The harmful perception of e-cigarettes warrants further attention from public health practitioners.
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Affiliation(s)
- Jian Wang
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Chen-Chen Xie
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Xiao-Xian Jia
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Kun Xu
- Shanghai Development Promotion Centre of Undertakings for the Aged, Shanghai, China
| | - Zheng-Yang Gong
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Yuan-Qiao Sun
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
| | - Jing-Rong Gao
- Shanghai Development Promotion Centre of Undertakings for the Aged, Shanghai, China
| | - Yuan Ding
- Shanghai Municipal Center for Health Promotion, Shanghai, China
| | | | - De Chen
- Shanghai Municipal Center for Health Promotion, Shanghai, China
- Shanghai Association of Tobacco Control, Shanghai, China
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