Perception of E-cigarette Use among Adult Users in China: A Mixed-method Study.

Duan Zhao,Yangyujin Liu,Wang Fan,Pinpin Zheng,Dilshat S Urmi,Abu S Abdullah,Yantao Zuo

doi:10.3390/ijerph17082754

Abstract

The use of electronic cigarettes (ECs) is increasing rapidly in China, but the perception of these products and their health impact among Chinese users have received little research attention. This study collected semi-structured in-depth interview data from experienced adult EC (including heated tobacco products also named ECs on the Chinese market) users in the Shanghai area. The subjects were recruited from those who participated in a previous online survey on EC use. A thematic narrative approach was used to analyze the data. Thirty current EC users were interviewed for evaluation of their perception of EC use in a variety of categories, including reasons for using, concerns, social acceptance, satisfaction, and health impacts. Participants’ common reasons for using ECs were the ease of use and carrying, hygiene, no fire hazard, reduced smoke exposure, aiding quitting smoking, reduced health hazard, palatable flavor, being fashionable, and substituting cigarettes in non-smoking areas. Most (90%; 27/30) participants reduced (77%) or quit smoking (13%) after using ECs, and 80% were willing to recommend these products to others. Most (90%) of the participants reportedly noticed positive health changes after using ECs. Regulatory concerns were expressed by 33% participants. Participants predominately viewed ECs as a viable substitute for smoking, with substantial effects on tobacco harm reduction. These findings lend support to EC use as a promising opportunity for public health promotion in China through engaging smokers in smoking cessation attempts. However, overall public health benefits/risks of EC use, and its regulatory affairs need to be considered.

Highlights

Electronic cigarettes (ECs), which are hand-held electronic devices that produce inhalable vapor from liquid usually containing nicotine, have grown rapidly among adults as a substitute for traditional cigarettes around the world [1]
heated tobacco products (HTPs) are classified as tobacco products in some countries such as the U.S, they are marketed as a variation of ECs in other countries such as Korea [2]
Consistent with other reports [18,21], none of our participants were willing to quit ECs. While this may highlight their addictiveness to nicotine, as many were dual users, it underscored their positive attitudes towards ECs

Summary

Introduction

Electronic cigarettes (ECs), which are hand-held electronic devices that produce inhalable vapor from liquid (namely “e-liquid”) usually containing nicotine, have grown rapidly among adults as a substitute for traditional cigarettes around the world [1]. E.g., IQOS—“I quit original smoking”) have recently been reintroduced to the mass market. HTPs are classified as tobacco products in some countries such as the U.S, they are marketed as a variation of ECs in other countries such as Korea [2]. In China, both HTPs and heated liquid ECs are referred to as “dian zi yan” (i.e., electronic cigarettes) by sellers and consumers. Res. Public Health 2020, 17, 2754; doi:10.3390/ijerph17082754 www.mdpi.com/journal/ijerph

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