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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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Mai J, Lin L, Zhou L, Guan Q, Zhu W, Zhou W. Will personality traits affect the use of e-cigar among college students? A cross-sectional study in Guangdong Province, China. Front Public Health 2022; 10:1032606. [PMID: 36589985 PMCID: PMC9800422 DOI: 10.3389/fpubh.2022.1032606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Background The prevalence of e-cigar among adolescents and young adults around the world is increasing rapidly, which has a serious impact on the health of young people. This study assessed the prevalence of e-cigar among college students and to explore the relationship between e-cigar use and personality traits. Methods This study conducted an electronic questionnaire survey on college students who were from three undergraduate universities and three junior colleges in Guangdong Province from January 2022 to March 2022. The survey was conducted by stratified cluster sampling, and the respondents were 1362. Statistical descriptions are used to describe the demographic characteristics and personality traits of participants. Mann-Whitney U tests, and Chi-square tests were used to compare the differences between current e-cigar users and non e-cigar users. Two-step hierarchical Logistic regression was used to predict the associated factors with e-cigar use. Results The prevalence of current e-cigar users was 5.1%. Agreeableness showed statistically significant higher in non-users (Z = 2.585, P < 0.01). Moreover, gender (AOR = 0.312, 95%CI: 0.174-0.562), the relationship with mother (AOR = 5.887, 95%CI: 1.460-23.748), friends who use e-cigar (AOR = 3.808, 95%CI: 2.159-6.719), allowance per month (AOR = 2.482, 95%CI: 1.371-4.490), and agreeableness (AOR = 0.957, 95%CI: 0.918-0.997) were related to the use of e-cigar. Conclusion The level of agreeableness is associated with the use of e-cigar among college students. All these provided an important theoretical basis for future intervention.
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Lyu JC, Huang P, Ling PM. Electronic cigarette related topics with conflicting arguments
in Chinese newspapers. Tob Induc Dis 2022; 20:25. [PMID: 35342381 PMCID: PMC8895478 DOI: 10.18332/tid/145929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/20/2021] [Accepted: 01/18/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION While debates on e-cigarettes are mainly conducted in scientific fora, media are the most accessible information source for the public, shaping their perceptions of health issues. This study is the first to examine e-cigarette related topics with conflicting arguments presented in Chinese newspapers. METHODS The Chinese terms for ‘e-cigarettes’ were searched in a widely used Chinese news database Wisenews. Content analysis of the full text of 639 news articles was conducted to identify topics with conflicting arguments and examine whether the dominant argument in each topic changed across four time periods from 2004 to 2019. RESULTS Twelve e-cigarette related topics with conflicting arguments were identified. The most frequently reported topic was health impact of e-cigarettes, followed by impact of secondhand aerosol exposure, smoking cessation, relative health impact of e-cigarettes compared to cigarettes, and e-cigarette policies outside China. At the same time, the price was the least frequently reported topic. Overall, negative arguments outnumbered positive arguments in the study period. The dominant arguments within many topics changed across time periods; however, within the topics of relative health impact of e-cigarettes compared to cigarettes, taste/flavor, and economic prospects of the industry, positive arguments were more frequently reported in almost all periods. Within the topics of addiction, policies in China, and policies outside China, negative arguments were more frequently reported in virtually all periods. CONCLUSIONS Though overall the dominant argument about e-cigarettes and health was ‘e-cigarettes are harmful’, in the early time periods, e-cigarettes were reported as ‘harmless’ or even ‘healthy’. As China began to regulate e-cigarettes, the reporting on e-cigarettes more frequently included the ‘e-cigarettes are harmful’ argument. The consistent, more frequent reporting of ‘good e-cigarette taste/flavor’ has the potential to attract young people to e-cigarette products. The increased reporting on policies unfavorable to e-cigarettes aligned with the growing number of regulations restricting e-cigarettes.
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Affiliation(s)
- Joanne Chen Lyu
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, United States
| | - Peiyi Huang
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, United States
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Zhao D, Abdullah AS, Wen T, Chen X, Xiao X, Pan Z, He J, Urmi DS, Hao W, Lin H, Zheng P. Perceptions of e-cigarettes among smokers and non-smokers in households with children in rural China: A cross-sectional study. Tob Induc Dis 2021; 19:25. [PMID: 33850512 PMCID: PMC8033598 DOI: 10.18332/tid/133264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/10/2021] [Accepted: 02/11/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The perceived health benefits and effectiveness of electronic cigarettes (e-cigarettes) in quitting smoking may affect e-cigarette usage, however, research on the use of e-cigarettes among the Chinese, especially among the rural Chinse, is scarce. This study examined factors associated with perceptions of e-cigarette related harms, benefits, and addictiveness, among smoker and non-smoker households with children in rural China, to support the design of population-based interventions targeting rural Chinese households. METHODS In a cross-sectional study design, using a structured questionnaire, we collected data from the household members of children in two selected rural communities in China. Descriptive analyses were used to characterize respondents; χ2 test and Fisher’s exact probability test were used to compare the perceptions of e-cigarettes between different sociodemographic groups. Logistic regression was used to determine predictors for e-cigarette harms, benefits, and addictiveness, adjusting for demographic and other characteristics. RESULTS The overall participation rate was 81% (1211/1498). Of the participants, 668 (55%) were smokers and 543 (45%) were non-smokers; 53% knew about e-cigarettes. Participants from rural Dali (77% vs 59%), those who were ethnic minority (76% vs 59%), those who perceived increased COPD risks from smoking (mean score 4.37 vs 4.18) and concerned about harmful effects of secondhand smoke (SHS) exposure to children (mean score 4.48 vs 4.30) and adults (mean score 4.06 vs 3.87) were more likely to believe that e-cigarettes were less harmful (p<0.05). Participants with more knowledge about the harm of smoking were more likely to believe that e-cigarettes were helpful in quitting smoking (p<0.05). Of those participants who knew about e-cigarettes, females (19%) were significantly more likely to believe that e-cigarettes are addictive than males (10%). In the logistic regression analyses, believing e-cigarettes are helpful to quit smoking was the only variable associated with holding a higher knowledge about smoking and SHS exposure (OR=0.608; 95% CI: 0.450–0.820). CONCLUSIONS Our results showed that more than half of the rural household members who have a child at home were aware of e-cigarettes. Knowledge about health impacts of SHS exposure and perceptions about the benefits, harms and addictiveness of e-cigarette use varied among the participants, with a significant proportion of participants having wrong information. Public health campaigns to disseminate evidence-based information of e-cigarette benefits and harms are warranted. As knowledge about the harmfulness of smoking and SHS exposure was associated with perceived e-cigarette benefits, particular focus should be given to increasing knowledge about the health hazards related to smoking and SHS exposure.
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Affiliation(s)
- Duan Zhao
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Abu S Abdullah
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Duke Global Health Institute, Duke University, Durham, United States.,Boston Medical Center, Boston University School of Medicine, Boston, United States
| | - Tong Wen
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Xiaoxiao Chen
- Taizhou City Centers for Disease Control and Prevention, Taizhou, China
| | - Xia Xiao
- School of Public Health, Kunming Medical University, Kunming, China
| | - Zixian Pan
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Jingyi He
- Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai, China
| | - Dilshat S Urmi
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Wei Hao
- Taizhou City Centers for Disease Control and Prevention, Taizhou, China
| | - Haijiang Lin
- Taizhou City Centers for Disease Control and Prevention, Taizhou, China
| | - Pinpin Zheng
- Department of Preventive Medicine, School of Public Health, Fudan University, Shanghai, China
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Kim JY, Kang HS, Jung JW, Jung SY, Park HJ, Park JS, Park JH, Lee SH, Chun EM, Park DI, Park J, Choi HS. Nicotine Dependence and Stress Susceptibility in E-Cigarette Smokers: The Korea National Health and Nutrition Examination Survey 2013-2017. Tuberc Respir Dis (Seoul) 2021; 84:159-166. [PMID: 33401344 PMCID: PMC8010419 DOI: 10.4046/trd.2020.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background E-cigarettes are steadily gaining popularity in Korea. However, the characteristics of e-cigarette smokers, especially nicotine dependence and stress susceptibility, have not been evaluated in comparison to those of nonsmokers or combustible cigarette smokers in Korea. Methods In this study, 28,059 participants from the Korea National Health and Nutrition Examination Survey (2013–2017) were classified into the following three groups: non-smokers, smokers (current smokers and ex-smokers of combustible cigarettes only), and e-smokers (current smokers and ex-smokers of e-cigarettes regardless of combustible cigarette use). Results Among the participants, 16,980 (60.5%), 9,247 (33.0%), and 1,832 (6.4%) subjects were non-smokers, smokers, and e-smokers, respectively. E-smokers were younger, more educated, and had a higher household income than nonsmokers or smokers. The number of e-smokers who smoked within 5 minutes of waking up (31.5% vs. 19.8%, p<0.001) and who planned to quit smoking within 6 months (39.1% vs. 35.7%, p<0.05) was greater than that of smokers. E-smokers perceived stress as “very much” (7.0% vs. 4.4%, p<0.001) and “a lot” (29.1% vs. 20.5%, p<0.001) compared to non-smokers. Suicidal ideation (6.5% vs. 4.7%, p<0.001), plans (2.4% vs. 1.3%, p<0.001), and attempts (1.1% vs. 0.5%, p<0.001) were higher in e-smokers than in non-smokers. Depressive episodes in 1 year (14.2% vs. 11.4%, p<0.05) and suicidal plans (2.4% vs. 1.8%, p<0.05) were more frequent among e-smokers than among smokers. Conclusion E-smokers were younger, more educated, and had a higher income, but they were more dependent on nicotine and susceptible to stress than non-smokers and smokers. Smoking cessation counseling should be tailored according to the characteristics of e-smokers.
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Affiliation(s)
- Jae Yeol Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hye Seon Kang
- Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae-Woo Jung
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Sun Young Jung
- College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Hye Jung Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Sook Park
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Joo Hun Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sang Haak Lee
- Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Mi Chun
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Dong Il Park
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Jisook Park
- Department of Software Convergence, Seoul Women's University College of Interdisciplinary Studies for Emerging Industries, Seoul, Republic of Korea
| | - Hye Sook Choi
- Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea
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