Abstract

INTRODUCTIONThe use of electronic cigarettes (e-cigarettes) in adults is increasing globally, and similar trends may be observed in the young population. Our objective was to estimate the awareness and use of e-cigarettes among the students from two comprehensive universities in Shanghai, China, and to identify the factors that may influence their decision to use e-cigarettes and their possible adverse effects.METHODSAn online cross-sectional survey was conducted among the students of Shanghai Jiao Tong University and Fudan University. A total of 869 students (412 males and 457 females), mean age 21.09 years (SD=2.44), were recruited in 2018. Multivariate binary logistic regression analyses were performed to explore the associations between ever e-cigarette use and influencing factors.RESULTSOf the responding students, 88.4% were aware of e-cigarettes, 4.6% had used e-cigarettes at least once in their lifetime, and 1.7% were current e-cigarettes users. Males and smokers were more likely to use e-cigarettes (ever used e-cigarettes even once) than females (OR=3.51; 95% CI: 1.69–7.27; p=0.001) and non-smokers (OR=28.58; 95% CI: 14.03–58.20; p<0.001). University students were easily motivated to use e-cigarettes when their peers also used them, and the risk ratio was 4.15 (95% CI: 2.11–8.19) compared with if their peers never used e-cigarettes. The major factors found to motivate university students to use e-cigarettes were the belief that e-cigarettes were less harmful or not harmful (55.0%) and the perception that e-cigarettes were helpful to quit smoking (37.5%). The survey also indicated that 72.4% of the respondents heard about e-cigarettes from television advertisements, 42.7% from websites online, and 41.2% from their parents and friends.CONCLUSIONSUniversity students who were males, cigarette smokers and whose peers used e-cigarettes were more likely to use e-cigarettes. The use of traditional cigarettes should be controlled strictly in order to reduce the likelihood of e-cigarette use among university students.

Highlights

  • The use of electronic cigarettes (e-cigarettes) in adults is increasing globally, and similar trends may be observed in the young population

  • The International Tobacco Control (ITC) China survey showed that the percentage of smokers who had heard of e-cigarettes increased from 29.0% to 60.0%, and those who had tried e-cigarettes from 2.0% to 11.0%, in the period 2009 to 20145

  • Participants and procedure A cross-sectional survey was developed among undergraduates and graduate students who studied in Shanghai Jiao Tong University and Fudan University, two top universities in Shanghai, in the summer semester of 2018

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Summary

Introduction

The use of electronic cigarettes (e-cigarettes) in adults is increasing globally, and similar trends may be observed in the young population. The International Tobacco Control (ITC) China survey showed that the percentage of smokers who had heard of e-cigarettes increased from 29.0% to 60.0%, and those who had tried e-cigarettes from 2.0% to 11.0%, in the period 2009 to 20145. According to the China Adult Tobacco Survey 2015, 52.3% of the population aged 15–24 years were aware of e-cigarettes and 4.1% had tried e-cigarettes, which were both higher than in other age groups[6]. Young adults are more likely to be aware of and use e-cigarettes if current trends in e-cigarette advertising continue[10]; common e-cigarette advertising is designed to imply safety and smoking cessation, and incorporates health claims not supported by medical evidence[11,12]

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