Awareness Of E-cigarettes Research Articles

Everything you wanted to know about e-cigarettes and vaping but were afraid to ask: a guide for mental health clinicians

SUMMARYMental health clinicians are expected to offer support and advice to patients to promote smoking cessation. Alongside this is the relatively new and increasingly popular phenomenon of electronic cigarette use. The absence of any long-term evidence regarding safety is recognised and clinicians' awareness of e-cigarettes may be limited to personal experience or media publications, leading to uncertainty in their confidence discussing e-cigarettes with patients, both in general and as an aid to quitting smoking. This article provides a historical and contemporary overview of e-cigarettes and vaping. The reader will gain an understanding of e-cigarette usage, risks and benefits, the current position on use of e-cigarettes in mental health settings, and tips on how to take an e-cigarette/vaping history and how to offer advice about use. This is achieved in the context of recent publications and national recommendations. Although the focus is primarily on the mental health patient, the article is of benefit to all health and social care professionals to help them develop an understanding of e-cigarettes as a tobacco-smoking cessation or harm-reduction aid.LEARNING OBJECTIVESAfter reading this article you will be able to: •provide a balanced overview of e-cigarette use•understand the risk reduction approach in the use of e-cigarettes versus tobacco smoking in people with mental illness•demonstrate the principles of taking a vaping history.DECLARATION OF INTERESTS.G. was chief investigator for the Smoking Cessation Intervention for Severe Mental Ill Health Trial (SCIMITAR) (HTA 11/136/52) and is supported by the National Institute for Health Research (NIHR) Yorkshire and Humber Collaboration for Leadership in Applied Health Research and Care (CLAHRC YH). S.K. received an NIHR grant to part fund her research time for SCIMITAR. This article evolved from the SCIMITAR study.

Electronic cigarette use in China: Awareness, prevalence and regulation.

INTRODUCTIONE-cigarettes were invented in China, and most of the world’s e-cigarettes have been produced in China. However, awareness and use of e-cigarettes in China are lower than in Europe and America. Against the backdrop of the increasing use of e-cigarettes, the supervision of e-cigarettes in China has been almost non-existent.METHODSA literature search was carried out in five popular Chinese and English databases. These databases were PubMed, EMBASE, the Cochrane Library, China national knowledge infrastructure (CNKI), and Wan-fang database.RESULTSTwenty-one studies were identified, and a comprehensive analysis of e-cigarette awareness ratio was conducted for different regions of China and according to gender, age group, and smoking status. We also examined e-cigarette use and associated risk factors, and the relationship between e-cigarette use and smoking cessation. In 2015, the prevalence of ‘ever use’ and ‘current use’ of e-cigarettes in China were 3.1% and 0.5%, respectively. The review indicates that the awareness ratio of e-cigarettes was about 66% in Hong Kong, whereas the ratio for Tianjin was lower (43.6%). Online sales were the main channel for selling e-cigarettes to 80% of the users. Awareness of e-cigarettes has been increasing in China. Awareness was higher in men compared to women in all age groups. Nevertheless, e-cigarette use in China was lower than in developed countries. E-cigarette users were more likely to try to quit smoking, but the relationship between e-cigarette use and smoking cessation is still unclear. Governance is necessary for e-cigarette use and marketing effort.CONCLUSIONSThis study investigated the awareness and use of e-cigarettes in China and the existing regulations for e-cigarette use and marketing. The lack of regulations for e-cigarette use and the unrestricted practice encourage the increase in adoption of e-cigarettes and misconceptions of the benefits of using e-cigarettes. Hence, it is crucial that the government of China prioritize the establishment and implementation of regulations for e-cigarette use and marketing.

Perceptions and use of electronic cigarettes among young adults in China.

INTRODUCTIONLittle is known about the perception and use of e-cigarettes by the Chinese, particularly the young people. This study reveals the awareness, attitudes, and use of e-cigarettes among young adults in China, examines the relationship between smoking behavior and e-cigarette perception and use, and demonstrates the phenomenon of e-cigarette gifting.METHODSWe used results from a mobile app-based survey conducted in November 2015 that included 10477 young Chinese adults aged between 19 and 29 years. Bivariate tests were conducted to analyze perception and use of e-cigarettes by respondents of different smoking status. Multivariate logistic regressions were applied to examine the correlates of e-cigarette use and perception and e-cigarette gifting behavior, particularly the factors of tobacco smoking status and quitting behavior.RESULTSAmong the surveyed young adults, 88.40% were aware of e-cigarettes, and nearly a quarter of all respondents had used e-cigarettes by the time of our survey. Multivariate regression results demonstrated that current smokers with quitting experience were more likely to be aware of and to use e-cigarettes than current smokers with no quitting experience. Smokers with quitting experience also were more inclined to promote e-cigarettes to others by either recommending them or giving them as gifts.CONCLUSIONSE-cigarettes have gained popularity among young adults in China and smokers, especially those who had tried quitting, were more likely to have known and used e-cigarettes. More empirical research on the relationship between e-cigarette use and smoking cessation is warranted to better inform a potential regulatory framework in China.

E-cigarettes and Smoking Cessation in the United States According to Frequency of E-cigarette Use and Quitting Duration: Analysis of the 2016 and 2017 National Health Interview Surveys.

The purpose of this study was to examine the association between electronic cigarette (e-cigarette) use and smoking cessation among US adults. Duration of smoking cessation was taken into consideration because e-cigarette awareness and use were low in the United States before 2010. A pooled analysis of the 2016 and 2017 National Health Interview Surveys on current (N = 9935) and former smokers (N = 14 754) was performed. Adjusted prevalence ratios (aPRs), for sociodemographic factors, were calculated. Current e-cigarette use was reported by 10.5% (95% CI = 9.8% to 11.3%) of current smokers and 4.5% (95% CI = 4.0% to 5.0%) of former smokers. Prevalence was high in former smokers of less than 1 year (16.8%, 95% CI = 13.9% to 20.2%), 1-3 years (15.0%, 95% CI = 13.0% to 17.3%), and 4-6 years (10.5%, 95% CI = 8.6% to 12.7%), and very low in former smokers of more than 6 years (0.7%, 95% CI = 0.5% to 0.9%). Similar patterns were observed for daily e-cigarette use. Current e-cigarette use was negatively associated with being a former smoker when quit duration was ignored (aPR = 0.64, 95% CI = 0.59 to 0.69) but was positively associated with being a former smoker of less than 1 year (aPR = 1.44, 95% CI = 1.12 to 1.84) and 1-3 years (aPR = 1.21, 95% CI = 1.03 to 1.42). Daily e-cigarette use was not associated with being a former smoker when quit duration was ignored but was positively associated with being a former smoker of less than 1 year (aPR = 3.44, 95% CI = 2.63 to 4.49), 1-3 years (aPR = 2.51, 95% CI = 2.13 to 2.95), and 4-6 years (aPR = 1.84, 95% CI = 1.49 to 2.26). Daily e-cigarette use is strongly associated with recent smoking cessation (≤6 years) among US adults. Frequency of e-cigarette use and smoking cessation duration are important parameters when analyzing the effects of e-cigarettes in population surveys. There is controversy on whether e-cigarettes promote or prevent smoking cessation. This study presents a detailed analysis of the association between e-cigarette use and smoking cessation in the United States considering frequency of e-cigarette use and duration of smoking cessation. The latter was considered appropriate because e-cigarette awareness and use were low in the United States before 2010. Daily e-cigarette use is strongly associated with recent (≤6 years) smoking cessation in the United States. Both frequency of e-cigarette use and duration of smoking cessation are important factors in determining the effects of e-cigarettes in population studies.

Youth and young adult exposure to and perceptions of news media coverage about e-cigarettes in the United States, Canada and England

News media coverage has the potential to shape awareness and perceptions of e-cigarettes, but little is known about youth and young adult exposure to e-cigarette news. We analyzed news exposure measures on Wave 1 of the ITC Youth Tobacco and E-cigarette Survey, conducted in Canada, England, and the U.S. Web-based surveys were completed by 16–19-year-olds in July/August 2017 (n = 12,064). The prevalence of exposure to e-cigarette news and its perceived valence is provided. Logistic regression was used to model the odds of news exposure, and the association between news exposure and e-cigarette harm perceptions, susceptibility, and quitting intentions. Overall, 17.1% of young people reported hearing or seeing e-cigarette news at least ‘sometimes’ in the past 30 days. The majority of those exposed (n = 2052) perceived the content of the news stories to be mostly negative (35.7%) or mixed (34.8%) about e-cigarettes, versus mostly positive (19%). Perceived exposure to mostly negative e-cigarette stories was lower among past 30-day e-cigarette users and youth in England. Participants exposed to mostly negative e-cigarette news were more likely to perceive that e-cigarettes cause at least some harm and, among past 30 day users, have intentions to quit e-cigarettes in the next month. Exposure to mostly positive news was associated with higher odds of e-cigarette susceptibility among never triers. Young people report exposure to e-cigarette news with varied perceptions of its valence. E-cigarette news exposure may shape e-cigarette harm perceptions and use intentions, as well as reflect existing beliefs and product interest.

E-cigarette use among medical students at Qassim University: Knowledge, perception, and prevalence.

Background:The popularity of e-cigarettes is increasing rapidly worldwide and advertisements for such products are becoming ubiquitous in the media. Health concerns and smoking cessation are the most commonly reported reasons for traditional tobacco smokers to shift to e-cigarettes. As a result, the global market for e-cigarettes is on the rise. However, they are still a potential cause for many diseases.Methods:This is a cross-sectional study carried out at Qassim University in Buraydah, Saudi Arabia. A prevalidated questionnaire was distributed to medical students in April 2018 to evaluate the experience, knowledge, and awareness of e-cigarettes among the participants.Results:About one in ten students confirmed having smoked an e-cigarette. There was no significant relationship between e-cigarette users and demographic factors, such as gender, academic level, or age. However, the study showed a significant association between e-cigarette smoking and having an e-cigarette smoker among family members or friends. Most students 71.9% were not sure whether e-cigarettes were approved by the Food and Drug Administration (FDA) for smoking cessation. Only 23.3% of those surveyed believed that e-cigarettes can help in smoking cessation, whereas only 11% said that they would recommend it for a patient. On the contrary, 49.6% agreed that e-cigarettes are addictive. In response to another question, 92% reported receiving no education in medical school about e-cigarettes.Conclusion:Our study showed that medical students lacked knowledge about e-cigarettes. Therefore, more studies are needed to raise awareness about e-cigarettes, especially since the habit of using e-cigarettes is invading our society.

Awareness, Knowledge, Attitude and Practices of E-Cigarettes among Undergraduate Dental Students

Awareness, Knowledge, Attitude and Practices of E-Cigarettes among Undergraduate Dental Students

Patterns of awareness and use of electronic cigarettes in Mexico, a middle-income country that bans them: Results from a 2016 national survey

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.

Perception and Current Use of E-cigarettes Among Youth in China.

This study provides nationally representative estimates of electronic cigarette (e-cigarette) use among youth in China and explores the factors associated with awareness and use of e-cigarettes and the relationship between e-cigarette and conventional tobacco use. This study examined data from the Global Youth Tobacco Survey, which was completed by 155 117 middle school students (51.8% boys and 48.2% girls) in China, and employed a multistage stratified cluster sampling design. For data analysis, SAS 9.3 complex survey procedures were used, and logistic regression was used to explore factors associated with e-cigarette use and the relationship between e-cigarette and conventional tobacco use. About 45.0% of middle school students had heard of e-cigarettes, but only 1.2% reported using e-cigarettes in the last 30 days. Among never-smokers, e-cigarette users were more likely to intend to use a tobacco product in the next 12 months than nonusers (adjusted odds ratio [OR] = 6.970, 95% confidence interval [CI] = 4.474% to 10.857%), and more likely to say that they would enjoy smoking a cigarette (adjusted OR = 14.633, 95% CI = 11.328% to 18.902%). E-cigarette use was associated with previous experimentation with cigarette smoking (OR = 3.2), having noticed tobacco advertising in the past 30 days (OR = 2.7), having close friends who smoke (OR = 1.4), and thinking tobacco helps people feel more comfortable in social situations (OR = 3.3) and makes young people look more attractive (OR = 1.3). E-cigarette use among youth in China remains low but awareness is high. E-cigarette use was associated with increased intentions to use tobacco. Enhanced prevention efforts are needed targeting e-cigarette use among youth. This study is the first nationally representative survey of e-cigarette use among youth in China. It found that among middle school students, prevalence of e-cigarette use is 1.2% and prevalence of e-cigarette awareness is 45.0%. Chinese youths use e-cigarettes as a tobacco product rather than an aid to quitting. Among never-smokers, e-cigarette users were more likely to have intentions to use a tobacco product in the next 12 months, more likely to use a tobacco product offered by their best friends and enjoy smoking a cigarette than nonusers.

A Descriptive Longitudinal Study of Changes in Vape Shop Characteristics and Store Policies in Anticipation of the 2016 FDA Regulations of Tobacco Products, Including E-Cigarettes.

After proposing the “Deeming Rule” in 2014, the U.S. Food and Drug Administration (FDA) began regulating the manufacturing, marketing, and sales of electronic cigarette (e-cigarette) products as tobacco products in 2016. The current study conducted vape shop store observations and surveyed Los Angeles–area shop employees (assessing their beliefs, awareness, and perceptions of e-cigarettes and related FDA regulations) at two time points one year apart to better understand what vape shop retailers would do given FDA’s soon-to-be-enacted Deeming Rule. The study also compared retailer beliefs/awareness/actions and store characteristics immediately after the Deeming Rule proposal versus a year after the Rule had been proposed, right before its enactment. Two data collection waves occurred before the Deeming Rule enactment, with Year 1 surveying 77 shops (2014) and Year 2 surveying 61 shops (2015–2016). Between the data collection points, 16 shops had closed. Among the shops that were open at both time points, the majority (95% in Year 1; 74% in Year 2) were aware of some FDA regulations or other policies applying to vape shops. However, overall awareness of FDA regulations and state/local policies governing e-cigarettes significantly decreased from Year 1 to Year 2. At both time points, all shops offered customers free puffs of nicotine-containing e-liquids (prohibited by the then upcoming Deeming Rule). Perceptions of e-cigarette safety also significantly decreased between the years. Exploring vape shop retailer perceptions and store policies (i.e., free puffs/samples displays, perceptions of e-cigarette safety, etc.) over time will help the FDA assess the needs of the vape shop community and develop more effective retailer education campaigns and materials targeted to increase compliance with the newly enacted regulations.

Awareness and Use of E-cigarettes and Vaping Behaviors among Korean Adult Smokers: ITC 2016 Korean Study

Awareness and Use of E-cigarettes and Vaping Behaviors among Korean Adult Smokers: ITC 2016 Korean Study

Electronic cigarette awareness and use among students at the Federal University of Mato Grosso, Brazil.

ABSTRACTObjective:To analyze the prevalence of electronic cigarette (e-cigarette) awareness and experimentation among university students, as well as the characteristics associated with that awareness. Methods:This was a cross-sectional study, conducted in 2015, in which 489 university students at the Federal University of Mato Grosso (Cuiabá campus), Brazil, were interviewed with the use of a specific questionnaire. We estimated the prevalence of e-cigarette awareness and use, as well as analyzing the major characteristics associated with that awareness and use. Results:The prevalence of e-cigarette awareness was 37%, and the rate of e-cigarette experimentation was 2.7%. Awareness of e-cigarettes was found to be associated with marital status, work status, the level of parental education, and the presence or absence of smokers in the family. Conclusions:A high proportion of university students were aware of e-cigarettes. Although the prevalence of those who had experimented with e-cigarettes was low, there is concern that there could be an increase in the use of these types of device. There is a need for measures targeting university students, in order to build awareness of and prevent e-cigarette use.

Awareness and use of electronic cigarettes: Perceptions of health science programme students in Malaysia

Objectives: In recent years, electronic nicotine delivery systems (ENDS) or e-cigarettes appear to be gaining in popularity despite controversy over their health effects and public health impacts. This paper is the first in Malaysia to assess sociodemographic and behavioural characteristics associated with ENDS awareness, perceptions and use among students enrolled in health science programmes. Design: Online self-reported use and perceptions of ENDS were assessed using a cross-sectional design. Setting: The study was conducted at the International Medical University, Malaysia. Method: An anonymous Internet-based, cross-sectional survey was conducted among a cohort of 404 undergraduate students at International Medical University, Malaysia, in September 2016. Data were collected over a period of 6 weeks. A 31-question web-based survey was developed to assess sociodemographic and behavioural characteristics associated with ENDS awareness, perceptions and use. Logistic regression analysis was performed to assess the impact of a set of predictors on e-cigarette use. Results: Almost 95% of respondents were aware of e-cigarettes, 13.8% reported ever-use and students had varied perceptions towards e-cigarettes. Characteristics associated with greater likelihood of ever-use included gender, ethnicity and parents educational level. Other correlates included prior conventional cigarette smoking, prior hookah smoking, parents’ tobacco use and higher sensation-seeking behaviour total score. Conclusion: In this sample of young adults, e-cigarette awareness was high and ever-use was evident especially among ever cigarette smokers. Nearly half of ever-users had not used an e-cigarette in the past 30 days of the survey and mostly reported flavoured over unflavoured e-cigarette use. These findings highlight the importance of e-cigarette surveillance and health promotion interventions targeting young adults.

E-cigarette awareness, perceived harmfulness, and ever use among U.S. adults.

The overarching aims of this study are to (a) estimate and update knowledge on rates and predictors of awareness, perceived harmfulness, and ever use of e-cigarettes among U.S. adults and (b) to utilize that information to identify risk-factor profiles associated with ever use. Data were collected from the 2015 Health Information National Trends Survey (N=3738). Logistic regression was used to explore relationships between sociodemographics (gender, age, race/ethnicity, sexual orientation, educational attainment, income, and census region), current use of other tobacco products (conventional cigarettes, cigars, and smokeless tobacco), ever use of alternative products (hookah, pipes, roll-your-own cigarettes, and snus) and e-cigarette awareness, perceived harm, and ever use. Classification and regression tree (CART) modeling was used to examine risk-factor profiles of e-cigarette ever use. Results showed that most respondents were aware of e-cigarettes (83.6%) and perceived them to be not at all or moderately harmful (54.7%). Prevalence of e-cigarette ever use was 22.4%. Current cigarette smoking and ever use of alternative tobacco products were powerful predictors of use. Other predictors of use of e-cigarettes were age, race/ethnicity, and educational attainment. Awareness and perceived harm were significant predictors among particular smoker subgroups. Fifteen risk profiles were identified across which prevalence of e-cigarette use varied from 6 to 94%. These results underscore the need to continue monitoring patterns of e-cigarette use. They also provide new knowledge regarding risk-profiles associated with striking differences in prevalence of e-cigarette use that have the potential to be helpful when considering the need for or impact of e-cigarette regulatory policies.

Trends in Awareness, Use of, and Beliefs About Electronic Cigarette and Snus Among a Longitudinal Cohort of US Midwest Young Adults.

Few longitudinal studies have examined how awareness, use of, and beliefs about electronic cigarettes (e-cigarettes) and snus change over time. We assessed these trends in a cohort of young adults from the US Midwest. Data were from the Minnesota Adolescent Community Cohort (MACC) Study, collected annually during 2010-2013 when participants were 21-29 years old (n = 2622). Participants were asked if they had heard of and ever used e-cigarettes and snus, and the number of days they used these products in the past 30 days. Beliefs about whether these products are less harmful than cigarettes, less addictive than cigarettes, and could help people quit smoking were assessed. Repeated measures multiple linear and logistic regression models, adjusting for demographics, peer smoking and smoking status, were used to assess trends. Compared to 2010-2011, participants in 2012-2013 were five times more likely to be aware of e-cigarettes, report ever used them, and report using them in the past 30-days. Increases in e-cigarette use were observed in all smoking status. Participants were also increasingly likely to believe that e-cigarettes are less harmful than combustible cigarettes and could help people quit smoking. There was only a modest increase in awareness of and ever using snus, as well as believing snus is less harmful than combustible cigarettes. These trends did not differ by smoking status. The increasingly favorable beliefs about e-cigarettes may explain the increasing prevalence of their use particularly among young adults, both among smokers and nonsmokers. Awareness and use of e-cigarettes have increased substantially over the past few years, and positive beliefs of e-cigarettes have also become more prevalent among young adults. Meanwhile, little changes in awareness, use of, and beliefs about snus among young adults. Given the potential of these products to have both positive and negative impact on public health depending on who use them and how they are used, strategically communicating the risks associated with e-cigarettes and snus use may help minimize the burden of tobacco use at the population level.

E-Cigarettes: Harmless substitute to conventional smoking or a devil in disguise?

Smoking tobacco through cigarette use kills around six million people each year worldwide and is one of the biggest public health threats the world has been facing. Electronic-cigarette (E-cigarette) use is marketed as being a healthier substitute to traditional cigarette smoking and is also used as a smoking cessation tool. It is commonly believed that e-cigarette use might be a harmless substitute to conventional smoking and has no long term debilitating side-effects. E-cigarettes were introduced in 2007 and they seem to be getting day by day and the prevalence of their use has rapidly increased. Awareness and trial use of e-cigarettes has almost doubled in most countries from 2008 to 2012. Since late 2013, there have been different varieties of e-cigarettes. Some are with nicotine, while others are nicotine-free. E-cigarettes are becoming an emerging public health concern as they gain popularity worldwide. The health concerns are due to the ingredients found in the e-cigarettes. FDA has reported that e-cigarettes may contain carcinogens and toxic chemicals, such as nitrosamines and diethylene glycol, which can cause harmful effects on humans. There is a need for more in-depth studies on not only the constitution of e-cigarette products, but also to ascertain whether these produce significant harmful health effects to their users in the short term or in the long run. Till then, the users need to be wary of the potential threat these e-cigarettes may pose.

Racial/ethnic differences in electronic cigarette knowledge, social norms, and risk perceptions among current and former smokers

Psychosocial factors that may affect electronic cigarette (e-cigarette) initiation or maintenance among racial/ethnic minorities are not well-understood. This study examined racial/ethnic differences in e-cigarette knowledge, risk perceptions, and social norms among current and former smokers. Individuals with a tobacco smoking history and an awareness of e-cigarettes (N=285) were recruited from the community from June to August 2014. Telephone-administered surveys assessed demographics, smoking status, and e-cigarette knowledge, risk perceptions, and normative beliefs. Analyses of covariance and multinomial logistic regression tested associations by race/ethnicity. Controlling for sociodemographics and smoking status, White participants scored significantly higher on e-cigarette knowledge, compared to both Hispanics and African Americans/Blacks. Knowledge was lower among African Americans/Blacks compared to Hispanics. Compared to both Whites and Hispanics, African American/Black participants held lower perceptions regarding e-cigarette health risks and were less likely to view e-cigarettes as addictive. Normative beliefs did not differ by race/ethnicity. In conclusion, e-cigarette knowledge, health risk perceptions, and perceived addictiveness differed by race/ethnicity. The variation in e-cigarette knowledge and beliefs among smokers and former smokers has implications for use, and potentially, dual use. Understanding these relationships in unrepresented populations can inform future research and practice.

Trends in E-Cigarette Awareness and Perceived Harmfulness in the U.S.

Electronic cigarettes (e-cigarettes) are gaining in popularity as an alternative to regular cigarettes, as they are viewed as potentially less harmful. However, it remains unclear how awareness about e-cigarettes is permeating through the general U.S. This study seeks to extend previous research and examine trends in e-cigarette awareness and perceived harmfulness, and their association with smoking-cessation efforts. Data from three cycles (2012, 2013, and 2014) of the Health Information National Trends Survey were combined into a single data set. Controlling for survey year, multivariate logit models were used to determine the association between demographic characteristics and e-cigarette awareness, perceived harmfulness, quit attempts, and quit intentions. Data were analyzed in 2015. Awareness of e-cigarettes increased from 77.1% in 2012 to 94.3% in 2014. Controlling for demographic characteristics, e-cigarette awareness significantly increased in both 2013 and 2014, relative to 2012. Perception that e-cigarettes were less harmful than regular cigarettes declined from 50.7% in 2012 to 43.1% in 2014. Among smokers, no relationship was observed between e-cigarette awareness and past-year quit attempts or quit intentions, but those that viewed e-cigarettes as less harmful were less likely to have a past-year quit attempt. These analyses reveal a continued increase in overall public awareness of e-cigarettes and shifting harm perceptions relative to regular cigarettes. New regulatory oversight by the U.S. Food and Drug Administration may have major effects on both dimensions, which are worth continued monitoring.

E-Cigarette Awareness, Use, and Harm Perception among Adults: A Meta-Analysis of Observational Studies.

ObjectiveThe aim of this study is to systematically review the published literature on the awareness, previous and current use, and harm perceptions of electronic cigarettes (e-cigarettes) among adults.MethodsA search of the most current literature using the PubMed and Scopus database to identify articles published since 2003 yielded a total of 28 relevant articles.ResultsThe pooled prevalence of awareness, previous use, current use of e-cigarettes and perceived healthier of e-cigarettes than regular cigarettes (healthier perception) among adults were 61.2% (95% confidence interval (CI): 51.5–70.8%), 16.8% (95% CI: 14.0–19.6%), 11.1% (95% CI: 9.2–13.1%), and 52.6% (95% CI: 42.5–62.6%), respectively, using a random effects model. The subgroup analysis showed that pooled estimates were highest in the group of current smokers of regular cigarettes, except that the highest pooled rate of current use was seen in the group of former smokers of regular cigarettes (the corresponding rates were 71.9% (95% CI: 57.5–86.3%), 27.2% (95% CI: 18.8–35.6%), 16.8% (95% CI: 7.2–26.3%), and 63.1% (95% CI: 52.1–74.1%)), and the lowest pooled rates were in the group of non-smokers, except for the rate of healthier perception in the users of e-cigarettes (and the corresponding rates were 46.8% (95% CI: 26.8–66.8%), 2.5% (95% CI: 1.1–5.6%), 1.2% (95% CI: 0.4–2.1%), and 37.9% (95% CI: -0.5–76.3%)). The cumulative meta-analysis found that awareness increased over time, while the prevalence of previous use, current use, and healthier perception first experienced an increase followed by a decrease and remained stable thereafter.ConclusionsE-cigarette awareness has been increasing, and e-cigarette use and perceived health risks are nearly invariable between 2009 and 2014. Given the substantial heterogeneity in the prevalence rate estimates, there is a need for more accurate and comparable prevalence estimates for e-cigarettes across the world.

Changes in Electronic Cigarette Use from 2013 to 2015 and Reasons for Use among Finnish Adolescents.

Electronic cigarettes are quite a new potential source of nicotine addiction among youth. More research is needed, particularly on e-liquid use and socioeconomic factors as potential determinants. We studied changes from 2013 to 2015 in adolescent e-cigarette awareness and ever-use, types of e-liquids, and determinants in Finland. In 2015, we studied weekly use and reasons for ever-use. Data were from two national surveys of 12–18-year-old Finns (2013, n = 3535, response rate 38%; 2015, n = 6698, 41%). Descriptive statistics and logistic regression analysis were used. Awareness and ever-use of e-cigarettes increased significantly from 2013 to 2015 in all age and gender groups. Ever-use increased from 17.4% to 25%, with half having tried nicotine e-liquids. In 2015, weekly use was rare (1.5%). Daily cigarette smoking was the strongest determinant (OR 51.75; 95% CI 38.18–70.14) for e-cigarette ever-use, as for e-cigarette weekly use, but smoking experimentation and ever-use of snus (Swedish type moist snuff) and waterpipes alongside parental smoking and poor academic achievement also increased the odds for ever-use. The most common reason behind e-cigarette ever-use was the desire to try something new. To conclude, adolescent e-cigarette ever-use is increasing, and also among never-smokers. Tobacco-related factors are stronger determinants for e-cigarette use than socioeconomic factors.