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Alshareef HZ, Omaye ST. Toxicology of Commonly Found Ingredients in E-Cigarettes: A Brief Review. Health (London) 2021. [DOI: 10.4236/health.2021.1311100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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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Naeem MNM, Zain SMSM, Ng C, Noh MFM. Chemical Constituents in E-Cigarette Liquids and Aerosols. ACTA ACUST UNITED AC 2020. [DOI: 10.4236/jep.2020.119040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Meernik C, Baker HM, Kowitt SD, Ranney LM, Goldstein AO. Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review. BMJ Open 2019; 9:e031598. [PMID: 31619431 PMCID: PMC6797351 DOI: 10.1136/bmjopen-2019-031598] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Given the exponential increase in the use of e-cigarettes among younger age groups and in the growth in research on e-cigarette flavours, we conducted a systematic review examining the impact of non-menthol flavoured e-cigarettes on e-cigarette perceptions and use among youth and adults. DESIGN PubMed, Embase, PyscINFO and CINAHL were systematically searched for studies published and indexed through March 2018. ELIGIBILITY CRITERIA Quantitative observational and experimental studies that assessed the effect of non-menthol flavours in e-cigarettes on perceptions and use behaviours were included. Specific outcome measures assessed are appeal, reasons for use, risk perceptions, susceptibility, intention to try, initiation, preference, current use, quit intentions and cessation. DATA EXTRACTION AND SYNTHESIS Three authors independently extracted data related to the impact of flavours in tobacco products. Data from a previous review were then combined with those from the updated review for final analysis. Results were then grouped and analysed by outcome measure. RESULTS The review included 51 articles for synthesis, including 17 published up to 2016 and an additional 34 published between 2016 and 2018. Results indicate that non-menthol flavours in e-cigarettes decrease harm perceptions (five studies) and increase willingness to try and initiation of e-cigarettes (six studies). Among adults, e-cigarette flavours increase product appeal (seven studies) and are a primary reason many adults use the product (five studies). The role of flavoured e-cigarettes on smoking cessation remains unclear (six studies). CONCLUSION This review provides summary data on the role of non-menthol flavours in e-cigarette perceptions and use. Consistent evidence shows that flavours attract both youth and adults to use e-cigarettes. Given the clear findings that such flavours increase product appeal, willingness to try and initiation among youth, banning non-menthol flavours in e-cigarettes may reduce youth e-cigarette use. Longitudinal research is needed to examine any role flavours may play in quit behaviours among adults.
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Affiliation(s)
- Clare Meernik
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hannah M Baker
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah D Kowitt
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Leah M Ranney
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Adam O Goldstein
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Chan CMH, Ab Rahman J, Tee GH, Wee LH, Ho BK, Robson NZMH, Draman S, Ling Miaw Yn J, Kuang Hock L, Yusoff MF, Kartiwi M, Ab Rahman NS, Nik Mohamed MH. Perception of Harms and Benefits of Electronic Cigarettes Among Adult Malaysian Men: A Comparison by Electronic Cigarette Use and Smoking Status. Asia Pac J Public Health 2019; 31:32S-43S. [PMID: 31328531 DOI: 10.1177/1010539519860730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Little is known about the perceptions of harm and benefit associated with the use of e-cigarettes in Malaysia. This was a cross-sectional analysis of a nationally representative sample comprising 1987 males (≥18 years of age). Current, former, and never users of conventional cigarettes and/or e-cigarettes participated in a questionnaire study conducted via face-to-face interviews. The relationship between participant characteristics and perceptions of harm and benefit of e-cigarettes were determined with multivariable logistic regression. There were 950 current, 377 former, and 660 never users of e-cigarettes. Government employees (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.29-2.66, P = .001), private sector employees (OR = 1.67, 95% CI = 1.27-2.18, P = .001), and the self-employed people (OR = 1.68, 95% CI = 1.31-2.17, P = .001) were more likely to perceive e-cigarettes as more harmful than conventional cigarettes compared with respondents who were not wage earners. All current users in the form of e-cigarette users (OR = 7.87, 95% CI = 3.23-19.18), conventional cigarette smokers (OR = 1.80, 95% CI = 1.39-2.33), and dual users (OR = 8.59, 95% CI = 4.76-15.52) were more likely to perceive e-cigarettes as useful in quitting conventional cigarette smoking compared with former and never users. Our findings constitute an important snapshot into the perceptions of e-cigarette harms and benefits, which could inform targeted public health messaging strategies.
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Affiliation(s)
| | | | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- National University Malaysia, Kuala Lumpur, Malaysia
| | - Bee Kiau Ho
- Bandar Botanik Health Centre, Ministry of Health Malaysia, Klang, Selangor, Malaysia
| | | | - Shamsul Draman
- International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Jane Ling Miaw Yn
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Mira Kartiwi
- International Islamic University Malaysia, Kuala Lumpur, Malaysia
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Zain SMSM, Khair SKJ, Mohamad N, Noh MFM, Radhakrishnan DA. Nicotine Content in Electronic Cigarette Refill Solutions and Its Release in Aerosols. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/jep.2019.1010078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Perialathan K, Rahman AB, Lim KH, Adon Y, Ahmad A, Juatan N, Jaafar N. Prevalence and associated factors of ever use of electronic cigarettes: Findings from a hospitals and health clinics study based in Malaysia. Tob Induc Dis 2018; 16:55. [PMID: 31516452 PMCID: PMC6659488 DOI: 10.18332/tid/99258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 10/23/2018] [Accepted: 10/28/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are new smoking devices that have gained popularity recently. However, there is limited evidence on e-cigarette consumption in Malaysia. This study aims to determine the prevalence, risk factors and perception associated with e-cigarette use among those attending government hospitals and health clinics in Malaysia. METHODS A cross-sectional hospital-based study was conducted in seven public hospitals and health clinics in Malaysia, which were selected through a two-stage cluster sampling. A validated questionnaire was used to obtain data from the selected participants. Multivariable logistic regression was employed to determine the association between sociodemographics and perceptions of e-cigarette use. RESULTS Almost three-quarters (73.6%; n=923/1254) of participants were aware of e-cigarettes and 13.2% (n=122/923) reported having ever used e-cigarettes. The prevalence was significantly higher among males (18.1%), smokers (21.4%), and younger age group 18-34 years (30.2%). Ever users showed favourable perceptions towards e-cigarettes compared to non-users (23.3% vs 30.14%, p<0.001). Multivariable logistic regression revealed that current smokers, younger age group and those possessing a positive perception towards e-cigarettes were likely to be ever users of e-cigarettes. CONCLUSIONS The study showed that the awareness level of e-cigarettes was high amongst the population but the prevalence of ever e-cigarette user was moderate. Most of the ever e-cigarette users were male, current smokers, young adults and those with favourable perceptions towards e-cigarettes. Therefore, effective health educational activities regarding safe usage of e-cigarettes targeting those group identified in this study are warranted to reduce the negative outcomes from the use of this product.
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Affiliation(s)
| | - Abu B. Rahman
- Institute for Health Behavioural Research, Kuala Lumpur, Malaysia
| | - Kuang H. Lim
- Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Yusoff Adon
- Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Azman Ahmad
- Raja Permaisuri Bainun Hospital, Ipoh, Malaysia
| | - Nurashma Juatan
- Institute for Health Behavioural Research, Kuala Lumpur, Malaysia
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Zare S, Nemati M, Zheng Y. A systematic review of consumer preference for e-cigarette attributes: Flavor, nicotine strength, and type. PLoS One 2018; 13:e0194145. [PMID: 29543907 PMCID: PMC5854347 DOI: 10.1371/journal.pone.0194145] [Citation(s) in RCA: 155] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 02/26/2018] [Indexed: 12/13/2022] Open
Abstract
Objective Systematic review of research examining consumer preference for the main electronic cigarette (e-cigarette) attributes namely flavor, nicotine strength, and type. Method A systematic search of peer-reviewed articles resulted in a pool of 12,933 articles. We included only articles that meet all the selection criteria: (1) peer-reviewed, (2) written in English, and (3) addressed consumer preference for one or more of the e-cigarette attributes including flavor, strength, and type. Results 66 articles met the inclusion criteria for this review. Consumers preferred flavored e-cigarettes, and such preference varied with age groups and smoking status. We also found that several flavors were associated with decreased harm perception while tobacco flavor was associated with increased harm perception. In addition, some flavor chemicals and sweeteners used in e-cigarettes could be of toxicological concern. Finally, consumer preference for nicotine strength and types depended on smoking status, e-cigarette use history, and gender. Conclusion Adolescents could consider flavor the most important factor trying e-cigarettes and were more likely to initiate vaping through flavored e-cigarettes. Young adults overall preferred sweet, menthol, and cherry flavors, while non-smokers in particular preferred coffee and menthol flavors. Adults in general also preferred sweet flavors (though smokers like tobacco flavor the most) and disliked flavors that elicit bitterness or harshness. In terms of whether flavored e-cigarettes assisted quitting smoking, we found inconclusive evidence. E-cigarette users likely initiated use with a cigarette like product and transitioned to an advanced system with more features. Non-smokers and inexperienced e-cigarettes users tended to prefer no nicotine or low nicotine e-cigarettes while smokers and experienced e-cigarettes users preferred medium and high nicotine e-cigarettes. Weak evidence exists regarding a positive interaction between menthol flavor and nicotine strength.
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Affiliation(s)
- Samane Zare
- Department of Agricultural Economics, University of Kentucky, Lexington, Kentucky, United States of America
- * E-mail:
| | - Mehdi Nemati
- Department of Agricultural Economics, University of Kentucky, Lexington, Kentucky, United States of America
| | - Yuqing Zheng
- Department of Agricultural Economics, University of Kentucky, Lexington, Kentucky, United States of America
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Farsalinos KE, Le Houezec J. Electronic cigarette experimentation in the Malaysian city of Kuantan: Was there an association with the smoking status? J Pharm Bioallied Sci 2017; 8:347-348. [PMID: 28216962 PMCID: PMC5314837 DOI: 10.4103/0975-7406.199341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Konstantinos E Farsalinos
- Department of Cardiology, Onassis Cardiac Surgery Center, Kallithea, Greece; Department of Pharmacy, University of Patras, Patras, Greece E-mail:
| | - Jacques Le Houezec
- Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, England; CESP, University Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
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