Abstract
Among high-income countries, awareness and use of e-cigarettes is lower in countries with more restrictive e-cigarette regulations. Little is known about e-cigarettes in middle-income countries, many of which like Mexico, ban e-cigarette sales and marketing. The current study determined the national-level prevalence and correlates of e-cigarette awareness and consumption in Mexico. Data were analyzed from a 2016 nationally representative survey. Prevalence of e-cigarette awareness, trial and current use was estimated separately for adolescents (n = 12,436), adult nonsmokers (n = 36,966), and adult smokers (n = 7347). For each group, crude and adjusted logistic models regressed e-cigarette outcomes on sociodemographic and smoking-related variables, adjusting for the sampling design and weights. Prevalence varied across subgroups for e-cigarette awareness (adolescents = 45.3%; adult nonsmokers = 33.9%; adult smokers = 54.3%), e-cigarette trial (adolescents = 6.5%; adult nonsmokers = 2.6%; adult smokers = 18.2%) and current use of electronic cigarettes (adolescents = 1.1%; adult nonsmokers = 0.3%; adult smokers = 4.5%). Among adolescents and adults, current smoking and higher smoking frequency were significantly associated with e-cigarette awareness, trial and use. Among adolescents and nonsmokers, awareness, trial and use of e-cigarette were significantly lower among females than males. Among adult smokers, however, females were more likely to use e-cigarettes than males (AOR = 1.80; 95% CI = 1.08–3.02). Higher education and greater wealth increased the likelihood of trial of e-cigarettes among adult nonsmokers and smokers. Despite the ban on the distribution and sales of e-cigarettes, a substantial number of Mexicans, have access to e-cigarettes. Decision makers and advocates should consider e-cigarette regulations as recommended by the WHO, at the same time Mexico must invest in the infrastructure needed to enforce these regulations.
Highlights
Use of electronic cigarettes (e-cigarettes) is rapidly increasing worldwide, previous studies of their uptake and use are primarily limited to high-income countries (HICs).[1,2,3]
Marketing of e-cigarettes often emphasized their being a safe alternative to conventional cigarettes and as an effective method for smoking cessation.[8,9,10,11]
Data from this study came from the National Survey of Drugs, Alcohol and Tobacco Use (ENCODAT), which were collected between June and November 2016
Summary
Use of electronic cigarettes (e-cigarettes) is rapidly increasing worldwide, previous studies of their uptake and use are primarily limited to high-income countries (HICs).[1,2,3] Ecigarettes are battery-operated devices that produce an aerosol that can contain different levels of nicotine, which is a highly addictive substance and can affect the neurological development of adolescents.[4,5,6,7] In addition, e-cigarette liquids contain flavorings that are potentially hazardous, especially for the respiratory system.[5]. A recent longitudinal study of Mexican adolescents found similar results;[19] more research is sorely needed to better understand the patterns of use and potential public health impact of e-cigarettes in low- and middle-income countries (LMICs)
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