Perceptions Of Electronic Cigarettes Research Articles

“Tobacco-free nicotine” electronic cigarette perceptions and use among adolescents and adults in five New England states

IntroductionMore brands are using tobacco-free nicotine (TFN) in electronic cigarettes (e-cigarettes) and these products are becoming increasingly popular. The term TFN and claims about its properties can mislead consumers about the harms and addictiveness of TFN e-cigarettes, which may increase initiation of these products among non-smokers or influence current smokers’ decisions to adopt TFN e-cigarettes as a harm reduction measure. MethodsWe conducted an observational, cross-sectional survey of 777 adolesc aged 13–17 and 655 current adult cigarette smokers residing in Massachusetts, Connecticut, New Hampshire, Rhode Island, or Vermont about their TFN e-cigarette awareness, use, perceptions, and susceptibility. We examined the association between prior awareness of TFN and use, perceptions, and susceptibility. ResultsOne-third of adolescents and adults reported being aware of TFN. TFN e-cigarette use was less common than tobacco-derived nicotine (TDN) e-cigarette use among adolescents (8.9 % vs. 30.5 %) and adults (21.1 % vs. 79.4 %). Compared to unaware adolescents, adolescents who were aware of TFN more frequently reported being more likely to use TFN compared to TDN e-cigarettes and that TFN e-cigarettes are more addictive than those containing TDN. Aware adult smokers more frequently reported that TFN e-cigarettes are more addictive than TDN e-cigarettes, TFN e-cigarettes cause some harm, TDN e-cigarettes cause little harm, and that TFN and TDN e-cigarettes are equally harmful than those who were unaware previously. ConclusionPublic health education campaigns are needed to educate consumers about the harms and addictiveness of TFN e-cigarettes.

Effects of “Tobacco Free” Language in Warning Labels on Perceptions of Electronic Cigarettes and Nicotine Pouches among Young Adult Men: A Randomized Trial

Background: Manufacturers of Puff Bar electronic cigarettes (e-cigarettes) and Fre nicotine pouches claim that their products contain synthetic nicotine. The packages for Puff Bar and Fre have modified versions of the warning labels required by the Food and Drug Administration (FDA) for tobacco products, which specify that Puff Bar and Fre products contain “tobacco free” or “non-tobacco” nicotine, respectively. We evaluated whether exposure to these “tobacco free” warning labels was associated with differing perceptions about the products. Method: N = 239 young adult men who were enrolled in a cohort study completed a short online experiment. Participants were randomly assigned to view either packages of Puff Bar and Fre nicotine pouches with the standard FDA warning or packages with the standard FDA warning + the tobacco free descriptor. We compared harm and addictiveness perceptions and products’ perceived substitutability for cigarettes and smokeless tobacco (SLT) by exposure to a “tobacco free” warning. Results: Viewing a Puff Bar package with a “tobacco free” warning label was associated with increased perceived substitutability of the product for cigarettes and smokeless tobacco (p’s<.05). Viewing a Fre package with a “non-tobacco” warning label was associated with thinking the product was less harmful than SLT (p<.01). Conclusions: “Tobacco free” descriptors in warning labels for e-cigarettes and nicotine pouches affect young adults’ perceptions of the products. To date, it is unclear whether the FDA will continue to permit “tobacco free” descriptors in warning labels. As e-cigarettes and nicotine pouches are increasingly marketed with “tobacco free” language, urgent action is needed.

Portrayal of electronic cigarettes in the news

Portrayal of electronic cigarettes in the news

Beliefs and perceptions of electronic cigarettes among medical staff in respiratory departments of Fujian Province, China, in 2021.

Due to the popularity of e-cigarettes, more and more patients ask about e-cigarettes, and it is particularly important to understand doctors' beliefs and perceptions on e-cigarettes. The aim was to evaluate the belief and perception of electronic cigarettes among medical staff in the respiratory department of medical institutions located in Fujian Province. The electronic questionnaires were conveyed to the medical staff of the respiratory department in Fujian Province during March to April 2021. Descriptive statistics were calculated for all questions, and the relationship between relevant factors and the perception of e-cigarette-related statements was analyzed by logistic regression analysis. Among 1028 medical staff in the respiratory departments of Fujian Province, 90.5% of medical staff agreed that electronic cigarettes are harmful to the human body; 61.4% of medical staff agreed that e-cigarettes cannot be regarded as a type of smoking cessation treatment; 71.7% of medical staff agreed that e-cigarettes could be a 'gateway' to other tobacco use; and 69.2% of medical staff agreed that electronic cigarettes are in 'Three No' states. The multivariate logistic regression analysis showed that the respondents' perception of 'e-cigarettes cannot be regarded as a type of smoking cessation treatment' were related to gender, professional title and whether they participated in the cessation clinic. The medical staff of the respiratory department in Fujian Province put more emphasis on the adverse effects of e-cigarettes on health, but lack the cognition of the effect of e-cigarette smoking cessation. In order to better carry out smoking cessation work, it is necessary to strengthen the training of respiratory medical staff at all levels of medical institutions on e-cigarette knowledge.

Use and Perceptions of Electronic Cigarettes among Young Chinese Generation: Expanding the Theory of Planned Behaviour

The Theory of Planned Behaviour (TPB) is recognized as powerful predictive model to explain consumer purchase behaviour. However, there have been relatively few studies that determine the role of TPB’s constructs in e-cigarettes decision-making process. Moreover, the TPB ignores the impulsive motivation (i.e., hedonism) and unconscious motivation (i.e., habit) and perceived knowledge in the literature. This study adopted a quantitative method based on a survey with 293 young respondents using e-cigarettes. The proposed hypotheses were empirically tested with SPPS and AMOS. This study revealed that perceived knowledge positively influenced attitude, subjective norm (SN), and perceived behavioural control (PBC) respectively. The results showed a positive relationship between attitude, SN, PBC and intention, and intention positively influenced actual e-cigarettes use behaviour. The results also demonstrated how consumers’ hedonic motivation and habit influence intention. Lastly, the theoretical and practical implications and limitations were discussed.

Intention to quit smoking according to smoking preferences and perceptions of electronic cigarettes among university students in South Korea.

This study aimed to alleviate unhealthy smoking habits among university students and provide the basic data necessary for public health-oriented approaches such as developing regulations and policies on electronic cigarettes by analyzing the relationship between university students’ smoking preferences, perceptions of electronic cigarettes, and intention to quit smoking.This study involved 567 college students and conducted frequency and chi-squared analyses of the general characteristics, smoking preferences, and perceptions of electronic cigarettes. This study also performed logistic regression analysis to analyze the relationship between intention to quit smoking stratified by smoking preferences and the perceptions about electronic cigarettes. SPSS version 25.0 was used for data analysis.This study showed that electronic cigarette smokers were approximately 6.4 to 10.8 times more likely to think that electronic cigarettes positively affect smoking cessation attitude than nonsmokers. This study showed that regular cigarette smokers were approximately 1.7 to 2.2 times and other smoker 3.3 to 3.9 times more likely to think that electronic cigarettes positively affect smoking cessation attitude than nonsmokers. Those who perceived harmless to the human body, capable of reducing the frequency of smoking, and less harmful than tobacco were approximately 2.6 to 2.9, 11.6 to 12.8, and 3.3 to 3.7 times more likely have intention to quit smoking, respectively.Regular health education, advertising awareness of health hazards, and public health science-oriented approaches and policies for smoking cessation support services are needed to create awareness on electronic cigarettes among university students.

Changes in Family Physicians' Perceptions of Electronic Cigarettes in Tobacco Use Counseling Between 2016 and 2019.

IntroductionGiven the recent reports of e-cigarette, or vaping, product use-associated lung injury (EVALI) and harm of e-cigarettes, the authors evaluated changes in the use and perception of e-cigarettes as tobacco use cessation tools in 2019 relative to 2016. The authors also evaluated the sources family physicians most commonly use to receive information regarding e-cigarettes.MethodsA cross-sectional online survey of 248 community family physicians in Kansas was conducted from October 2019 to December 2019. An 11-item questionnaire measured the participants’ perceptions of recommending e-cigarettes to patients for tobacco cessation. A mixed method approach was used to collect, analyze, and interpret the data. Standard descriptive statistics, Likelihood-Ratio/Fisher’s exact tests, and immersion-crystallization methods were used to analyze the data.ResultsThe response rate was 59.3% (147/248). The proportion of the family physicians who did not recommend e-cigarettes for tobacco use cessation was significantly higher in 2019 than in 2016 (86% vs. 82%; χ2 [1, n = 261] = 12.31; p < 0.01). Several reasons regarding respondents’ perceptions of e-cigarettes as tobacco use cessation tools were reported. The medical literature and news media were the top sources where family physicians accessed e-cigarettes information.ConclusionMost family physicians did not recommend e-cigarettes for tobacco cessation. Opinions regarding the efficacy and safety of e-cigarettes were influenced by information sources. Future, larger studies would be beneficial to further determine family physicians’ beliefs and practices regarding e-cigarettes as tobacco use cessation products.

Perceptions of electronic cigarettes among ethno-culturally diverse Latino adults in four US urban centers

ABSTRACT Objective The aim of this study was to examine perceptions including knowledge, attitudes, and beliefs about e-cigarettes among ethno-culturally diverse Latino adults living in the US, a rapidly growing minority group for which we know little about their e-cigarette perceptions. Design A total of 25 focus groups with Latinos (n = 180; ages 18–64 years) were conducted in 2014. E-cigarettes users and non-users were recruited via purposive sampling techniques. Participants completed brief questionnaires on sociodemographic factors and tobacco use. Focus group discussions were conducted in English and Spanish, audio-recorded, and transcribed. Data were analyzed using thematic analysis procedures. Results Participants were of diverse Latino backgrounds. Over one-third (35%) reported current cigarette smoking and 8% reported current e-cigarette or hookah use. Nonsmokers reported experimenting with e-cigarettes and hookah during social occasions. Participants’ perceptions towards e-cigarettes were generally formed in comparison to conventional cigarettes. Perceived benefits of using e-cigarettes included their utility as a smoking cessation aid, higher social acceptability, and lower harm compared to conventional cigarettes. Negative perceptions of e-cigarettes included lower overall satisfaction compared to conventional cigarettes and high content of toxins. Socio-cultural factors (e.g. gender roles, familismo, and simpatía) also influenced perceptions of e-cigarette of study participants. Conclusions Overall, Latino adults knew relatively little about the potential health risks associated with e-cigarette use. The limited knowledge about and misinformation of e-cigarettes among this rapidly growing minority group have important public health implications. Findings may inform culturally tailored health communication campaigns, which are much needed among underserved US Latino populations in light of low effectiveness of tobacco control and regulatory efforts.

Awareness, knowledge and perception of electronic cigarettes among undergraduate students in Jazan Region, Saudi Arabia.

The use of electronic cigarettes (e-cigarettes) has steadily grown over the past few years, rising in popularity amongst young adults, especially. Owing to the perception that e-cigarettes are less harmful than conventional cigarettes, some people have resorted to using them as a means of quitting cigarette smoking. This study aimed to assess the awareness, knowledge, perception and use of e-cigarettes among Jazan University students in Saudi Arabia. An observational cross-sectional study was conducted with 775 students. Using stratified random sampling to recruit study participants, the dataset tabling the use of e-cigarettes, as well as knowledge, perception and awareness was collected using a translated and culturally adapted structured Arabic questionnaire. Our results showed that 21.0% of the participants used e-cigarettes and 35.1% of them used them to quit smoking. E-cigarette use was mostly reported by students from the College of Medical Applied Sciences (31.7%). The overall knowledge score was 3.9, with a standard deviation of 1.3 for the score range from zero to seven. About half of the participants correctly identified e-cigarettes as not less addictive' than cigarettes. However, 70.2% of students failed to identify e-cigarettes as a source of second-hand exposure to nicotine. About two-thirds of the sample believed that e-cigarettes could adversely affect health. The perception of using e-cigarettes for smoking cessation was not significantly associated with e-cigarette use. In conclusion, the prevalence of e-cigarette use was similar to that reported in the literature. However, Jazan University students failed to identify the health risks associated with e-cigarette use. Therefore, a strategy to enhance students' awareness of the benefits and harms of e-cigarettes is needed.

Welsh Primary Schoolchildren's Perceptions of Electronic Cigarettes: A Mixed Methods Study.

There are concerns that the growing popularity of e-cigarettes promotes experimentation among children. Given the influence of the early years on attitude and habit formation, better understanding of how younger children perceive vaping before experimentation begins is needed, to prevent uptake and inform tobacco control strategies. We explored Welsh primary schoolchildren’s (aged 7–11) awareness of e-cigarettes relative to tobacco smoking, their understanding of the perceived risks and benefits and their intentions and beliefs about vaping. Data was collected using a mix of methods in June and July 2017 from 8 purposively selected primary schools across Wales. Four hundred and ninety-five children (52% female) aged 7 years (n = 165), 9 years (n = 185) and 11 years (n = 145) completed a class-administered booklet encompassing a draw and write exercise and survey. Ninety-six children participated in 24 peer discussion groups comprised of 2 boys and 2 girls from each year group. Data were analysed independently and findings triangulated. Survey analyses used frequencies, descriptive statistics and chi-squared tests. Content analysis was undertaken on the draw and write data and peer discussion groups were analysed thematically. Study findings highlight that primary schoolchildren have general awareness of e-cigarettes. Vaping was perceived to be healthier than smoking and there was some recognition that e-cigarettes were used for smoking cessation. Understanding of any health harms was limited. Few children intended to smoke or vape in the future but almost half thought it was okay for grownups. Children’s perceptions were influenced by exposure through family and friends. Findings suggest a need for e-cigarette education in primary schools, to highlight the associated risks of e-cigarette experimentation including the potential for tobacco initiation.

E-cigarette use and its predictors: Results from an online cross-sectional survey in Poland.

INTRODUCTIONSince the invention of electronic cigarettes (ECs) in 2003, their use has spread worldwide; however, little is known about the profiles of EC users. Understanding the motivators for using ECs enables more accurate prediction of their use and more effective direction of pro-health activities. Our objective was to identify the factors that may influence the decision to use ECs and their possible adverse effects according to the experiences of EC users.METHODSA cross-sectional online survey was administered between 1 July 2016 and 1 January 2017 among 1288 Polish-speaking users of social networks and EC forums. To explore associations between current EC use and other factors, multivariate binary logistic regression analyses were performed.RESULTSThe final analysis included 1142 survey participants: mean age 25.9 years (± 11.1), 85.6% were male, 50.3% had secondary education, 98.2% were Polish citizens, and 81.0% were current EC users. Male gender, lower education, aged ≤40 years, former cigarette smoking, previous attempts to quit smoking, perception of lack of harmful effects of ECs, perception of ECs as being tastier and cheaper than cigarettes, awareness of the advantages of ECs and their use as a smoking cessation aid were all statistically significant factors increasing the risk of EC use. The majority of study participants claimed that ECs are less addictive or not addictive compared to cigarettes (62.6%) and less harmful or not harmful (89.5%) compared to cigarettes. The most common reported side effects of ECs were dryness in the mouth (8.3%), itching in the throat (4.5%) and nausea (1.9%).CONCLUSIONSMales aged ≤40 years with a lower level education were more likely to use ECs in the studied Polish population. The perception that ECs are less harmful than regular cigarettes is a factor increasing the odds of EC use; however, although ECs have few adverse effects, they nevertheless exist.

Electronic Cigarette Perceptions and Knowledge Among Pediatric Residents

Electronic Cigarette Perceptions and Knowledge Among Pediatric Residents

Electronic Cigarette Perceptions and Knowledge Among Pediatric Residents

Purpose: This study aims to assess the current perception and knowledge of electronic cigarettes (e-cigarettes) among pediatric and medicine-pediatric residents within the University of Illinois - Chicago system. E-cigarettes are one component of a larger category of devices known as electronic nicotine delivery systems (ENDS). Our current hypothesis is that given this is relatively new technology, the resident trainee population lacks sufficient knowledge of ENDS to effectively discuss their use with patients and families. Moreover, given their unfamiliarity with ENDS, such a discussion may be uncomfortable …

GPs' and nurses' perceptions of electronic cigarettes in England: a qualitative interview study.

BackgroundReports from royal colleges and organisations such as Public Health England suggest that GPs and nurses should advise patients to switch to electronic cigarettes (e-cigarettes) if they do not want to stop smoking using licensed medication. However, there are no data on what practitioners think, feel, or do about e-cigarettes.AimTo explore practitioners’ perceptions and attitudes towards e-cigarettes, and their experiences of discussing e-cigarettes with patients.Design and settingA qualitative interview study was carried out with semi-structured interviews conducted with nurses and GPs across England in 2017.MethodParticipants were interviewed once either via telephone or face to face. Data were analysed using thematic analysis.ResultsInterviews were conducted with 23 practitioners (eight nurses and 15 GPs). There were three key themes: ambivalence and uncertainty; pragmatism; and responsibility. Many practitioners had uncertainties about the safety and long-term risks of e-cigarettes. Some had ambivalence about their own knowledge and ability to advise on their use, as well as uncertainty about whether to and what to advise patients. Despite this, many sought to provide honesty in consultations by acknowledging these uncertainties about e-cigarettes with patients and taking a pragmatic approach, believing that e-cigarettes were a ‘step in the right direction’. Practitioners wanted advice from healthcare regulators such as the National Institute for Health and Care Excellence to reassure them about the safety of e-cigarettes, practical tools to support the consultation, and to control their use by providing behavioural support programmes for reduction or cessation.ConclusionCurrent dissemination strategies for guidelines are not effective in reaching practitioners, who are offering more cautious advice about e-cigarettes than guidelines suggest is reasonable.

Smokers' knowledge and perception of electronic cigarettes (e-cigarettes): a qualitative study of non-quitting smokers in a North London general practice.

The introduction of electronic cigarettes (e-cigarettes) has provided smokers with an alternative source of nicotine. Interest and use of the device has increased exponentially in the last decade with an estimated 2.9 m adult users in Great Britain. Research so far on the attitudes and perceptions of smokers to this new product has largely focussed on the views of current e-cigarette users, smokers attempting to quit and former cigarette smokers. This study aimed to explore the views of current tobacco smokers who were not using e-cigarettes and not looking for a cessation method, their understanding and knowledge of e-cigarettes, and their views of e-cigarettes as a smoking cessation aid provided by the National Health Service (NHS). Semi-structured in-depth interviews were conducted with 14 patients from a general practice in North London, who smoked conventional tobacco cigarettes on a daily or weekly basis, over 18 years old. An iterative approach allowed for constant data analysis using a thematic approach throughout the data collection stage, and generated four recurring themes. E-cigarettes were primarily seen as a smoking cessation device, with the supply of nicotine viewed as a benefit helping to reduce withdrawal symptoms, although for some participants this supply could also be a hindrance to dealing with their addiction. Despite uncertainty about the components, e-cigarettes were mostly viewed as healthier due to their lack of carcinogens, tar and smoke inhalation. The lack of reliable information and strong evidence for both the effectiveness and the safety of e-cigarettes led participants to be apprehensive about their provision by the NHS, and acted as a barrier to their use as an aid to quitting. The recurring appeal for more information regarding e-cigarettes make it clear that further high-quality research is urgently needed in this field to provide reliable and accurate information to smokers.

Perceived barriers to smoking cessation and perceptions of electronic cigarettes among persons living with HIV

ABSTRACTSmoking is more prevalent in persons living with HIV than the general population and is linked to increased morbidity and mortality. Some have suggested that based on current knowledge of harms and benefits, it may be feasible to advise smokers who are unable or unwilling to quit to switch to electronic cigarettes (ECs) as a less harmful alternative. We conducted 25 qualitative interviews with HIV-positive current or former smokers to explore perceived barriers to smoking cessation and perceptions of ECs. A high level of nicotine dependence, smoking as a form of stress management, motivational factors (including lack of readiness, low self-efficacy, ambivalence toward quitting), and having a social network of smokers were identified as cessation barriers. Low knowledge of ECs and uncertainty about EC safety and efficacy were barriers to EC uptake. However, current smokers indicated a willingness to try ECs. This study provides evidence that HIV-positive smokers face significant individual and environmental barriers to cessation. ECs may have potential as a harm reduction strategy in this population; however, there is a significant need for education regarding use and relative safety.

Use and Perceptions of Electronic Cigarettes Among Caregivers of Infants and Children with Bronchopulmonary Dysplasia.

Background: Bronchopulmonary dysplasia (BPD) is a chronic lung disease associated with prematurity and very low birth weight. These children have increased morbidity and mortality associated with environmental exposures, such as cigarette smoke. As of 2015, 3.5% of US adults report current use of electronic cigarettes (e-cigarettes) with use increasing over time. Perceptions of e-cigarette harm are poorly understood, and there are no data among caregivers of children with BPD. Methods: Subjects (n = 119) in this study were recruited from the outpatient Johns Hopkins BPD Clinic from January to October 2015. Parental use and perceptions of e-cigarettes were assessed using a questionnaire adapted from the 2012 National Youth Tobacco Survey. Chi-square, t-test, and logistic regression analyses were used to assess characteristics associated with e-cigarette use and caregiver perceptions. Results: A total of 119 caregivers completed the questionnaire with 8% reporting current e-cigarette use and 14% reporting current conventional cigarette use. Households who used conventional cigarettes were eleven times more likely to also use e-cigarettes [odds ratio: 11.3 (95% confidence interval: 2.6-48.2); P = 0.001]. Households reporting conventional cigarette use were less likely to perceive e-cigarette emissions as harmful compared with nonsmoking households. Perceptions of e-cigarette emissions as less harmful to others were associated with conventional cigarette use, current e-cigarette use, and having public insurance. Conclusions: Among our population, both conventional cigarette and e-cigarette smoking households had decreased perceptions of harm regarding e-cigarette emissions to self and others. Our study suggests that e-cigarette use among caregivers is an underrecognized environmental exposure in households of children with BPD.

Adolescents and young adults' perceptions of electronic cigarettes as a gateway to smoking: a qualitative study in Switzerland.

Electronic cigarettes (ECs) acting as a gateway to smoking traditional cigarettes (TCs) is a growing public health concern of EC use among youths. To gather the opinions and perceptions of adolescents and young adults (AYAs) on whether and how EC can act as a gateway to smoking TC among youths. A qualitative method included 42 AYAs. Participants identified a significant risk of EC acting as a gateway to TC use, several factors contributing to this phenomenon such as a facilitated transition to smoking or its perception as a harmless toy. Participants considered an even greater gateway threat regarding very young adolescents. A minority did not identify the gateway risk and some believed that it was nicotine-dependent. This potential gateway effect brought forth several recommendations: health professionals should screen adolescents (even very young ones) for EC use and inform consumers of the potential gateway effect; this possible effect should be acknowledged to end the harmless perception many might have; there is an urge for better preventive and regulatory policies directed at protecting adolescents and children who never smoked and support those who have quit.

Family Physicians' Perceptions of Electronic Cigarettes in Tobacco Use Counseling.

Recent support has been shown for physicians to recommend e-cigarettes to patients who are trying to quit smoking. Supporters of this recommendation argue that e-cigarettes are not combustible products and are less harmful and more effective cessation products than regular cigarettes, with less inherent risk. Those who oppose this idea argue that little reliable evidence suggests that e-cigarettes are better cigarette cessation devices than currently available nicotine replacement therapies, and that they pose as much risk as cigarettes. This study was conducted to explore family physicians' perceptions of recommending e-cigarettes as smoking cessation aids to patients who smoke cigarettes. The study used a mixed-methods approach whereby a 12-item survey was sent to 154 family physicians throughout the state of Kansas. Data were collected from 117, a 76% response rate. A multidisciplinary team used an immersion-crystallization approach to analyze the content of respondents' qualitative data; contingency table analysis was used to evaluate the quantitative data. The results showed that family physicians have negative perceptions of e-cigarettes and do not recommend them for smoking cessation. Family physicians are concerned about the effectiveness of e-cigarettes and the uncertainty regarding safety. The results suggest that most family physicians do not recommend e-cigarettes for smoking cessation, citing lack of evidence on effectiveness and uncertainty regarding short- and long-term safety.

Survey of community pharmacists' perception of electronic cigarettes in London

ObjectivesTo seek community pharmacists' perception on use, safety and possible effectiveness of e-cigarettes as quit smoking tools, and their future regulation.SettingA survey of a sample of 154 community pharmacies across...