Abstract
Background: In the context of declining smoking rates in Estonia, this study aims to analyze the recent trends in e-cigarette use and its associations with smoking status and sociodemographic factors. Methods: Nationally representative data from biennial cross-sectional health surveys in 2012–2018 (n = 9988) were used to describe the prevalence of smoking and e-cigarette use by smoking status in Estonia. Multivariate logistic regression analysis was used to describe the sociodemographic patterns of e-cigarette use in three subgroups: the general population, smokers, and ex-smokers. Results: The prevalence of current smoking decreased from 45.4% in 2012 to 31.5% in 2018 among men and from 26.6% to 20.0% among women. At the same time, e-cigarette use in the general population had increased to 3.7% among men and to 1.2% among women. The increase in the prevalence of e-cigarette use was statistically significant among men in the general population, smokers, and ex-smokers, but non-significant among women. In addition to period effects, e-cigarette use was patterned by age, gender, and education. Conclusion: In 2002–2018, the e-cigarette use had increased but smoking had decreased in Estonia. A timely and targeted tobacco policy may alleviate the harm of e-cigarette use from the public health perspective.
Highlights
Estonian tobacco legislation has witnessed several significant changes over the past decades that have had a positive effect on overall smoking rates
The decline in smoking rates was statistically significant for both genders
The overall prevalence of e-cigarette use increased from 1.4% in 2012 to 3.7%
Summary
Estonian tobacco legislation has witnessed several significant changes over the past decades that have had a positive effect on overall smoking rates. Since the implementation of the Tobacco Act in 2001 and its later revisions [1], the prevalence of current smoking among 16–64 year old adults had decreased during 2000–2016 from 53.5% to 39.3% among men and from 28.3% to 22.3% among women [2]. Electronic nicotine delivery systems (ENDS), commonly known as e-cigarettes, have become increasingly popular in recent years [5]. As they do not involve inhaling and exhaling the fumes of burning plant material, their use is not considered de jure as smoking and are not included when calculating prevalence estimates for smoking [3]. In the context of declining smoking rates in Estonia, this study aims to analyze the recent trends in e-cigarette use and its associations with smoking status and sociodemographic factors. Multivariate logistic regression analysis was used to describe the sociodemographic patterns of e-cigarette use in three subgroups: the general population, smokers, and ex-smokers
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