Age, Gender and Socioeconomic Patterns of Awareness and Usage of E-cigarettes Across Selected WHO Region Countries: Evidence from the Global Adult Tobacco Survey

Overview

Journal BMJ Open

Specialty General Medicine

Date 2023 Jan 19

PMID 36657753

Authors

Sampurna Kundu

Subhojit Shaw

Junaid Khan

Aparajita Chattopadhyay

Emerson Augusto Baptista

Balram Paswan

Affiliations

Soon will be listed here.

Abstract

Objectives: The study explores the awareness and e-cigarette use by demographic and socio-economic characteristics of selected 14 Global Adult Tobacco Survey (GATS) countries.

Design: Cross-sectional.

Setting: 14 countries.

Participants: Surveyed population ≥15 years selected through multi-stage cluster sampling.

Primary And Secondary Outcome Measures: We selected 14 countries from 6 different WHO regions where GATS was conducted in different years during 2011-2017.

Results: Awareness and usage of e-cigarette were highest in Greece and lowest in India. Females were less aware of e-cigarette across ages. The gender gap in awareness is wide in Greece post 50 years of age, while the gap is distinct in early ages in Kazakhstan and Qatar. The gender difference in use of e-cigarette was negligible in most of the countries except among the younger cohorts of Russia, Philippines Malaysia and Indonesia. Relatively higher prevalence of e-cigarette smoking among females in the older adult age was observed in some of the Asian countries like India. Multivariate analysis indicates that those who were younger, male, residing in urban areas, current tobacco smokers were more likely to use e-cigarette than their counterparts. Though prevalence of e-cigarette use increased with wealth and education, such pattern is not strong and consistent. Promotional advertisement plays important role in higher use of e-cigaratte. The predicted national prevalence of e-ciragette use was highest in Malaysia .

Conclusions: E-cigarette use is more among urban adults, current smokers, males and in countries with promotional advertisement of e-cigarette. Area specific interventions are needed to understand the nature of e-cigarette use. Russia, Ukraine, Costa Rica and Mexico need better understanding to explore whether e-cigaratte use is an indulgence to new mode of addiction, as youth being highly likely to adopt this practice.

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References

Morton J, Song Y, Fouad H, El Awa F, Abou El Naga R, Zhao L . Cross-country comparison of waterpipe use: nationally representative data from 13 low and middle-income countries from the Global Adult Tobacco Survey (GATS). Tob Control. 2013; 23(5):419-27. PMC: 4145417. DOI: 10.1136/tobaccocontrol-2012-050841. View

Eichler M, Blettner M, Singer S . The Use of E-Cigarettes. Dtsch Arztebl Int. 2017; 113(50):847-854. PMC: 5273587. DOI: 10.3238/arztebl.2016.0847. View

Mirbolouk M, Charkhchi P, Kianoush S, Uddin S, Orimoloye O, Jaber R . Prevalence and Distribution of E-Cigarette Use Among U.S. Adults: Behavioral Risk Factor Surveillance System, 2016. Ann Intern Med. 2018; 169(7):429-438. PMC: 10534294. DOI: 10.7326/M17-3440. View

Kong G, Kuguru K, Krishnan-Sarin S . Gender Differences in U.S. Adolescent E-Cigarette Use. Curr Addict Rep. 2018; 4(4):422-430. PMC: 5847300. DOI: 10.1007/s40429-017-0176-5. View

Hartmann-Boyce J, Begh R, Aveyard P . Electronic cigarettes for smoking cessation. BMJ. 2018; 360:j5543. DOI: 10.1136/bmj.j5543. View

Berry K, Fetterman J, Benjamin E, Bhatnagar A, Barrington-Trimis J, Leventhal A . Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths. JAMA Netw Open. 2019; 2(2):e187794. PMC: 6484602. DOI: 10.1001/jamanetworkopen.2018.7794. View

Gentzke A, Creamer M, Cullen K, Ambrose B, Willis G, Jamal A . Vital Signs: Tobacco Product Use Among Middle and High School Students - United States, 2011-2018. MMWR Morb Mortal Wkly Rep. 2019; 68(6):157-164. PMC: 6375658. DOI: 10.15585/mmwr.mm6806e1. View

Morean M, Butler E, Bold K, Kong G, Camenga D, Cavallo D . Preferring more e-cigarette flavors is associated with e-cigarette use frequency among adolescents but not adults. PLoS One. 2018; 13(1):e0189015. PMC: 5754053. DOI: 10.1371/journal.pone.0189015. View

Dyer O . India bans e-cigarettes by executive order. BMJ. 2019; 366:l5649. DOI: 10.1136/bmj.l5649. View

10.

Wu L, Schlenger W, Galvin D . The relationship between employment and substance use among students aged 12 to 17. J Adolesc Health. 2003; 32(1):5-15. DOI: 10.1016/s1054-139x(02)00447-0. View

11.

Kostova D, Chaloupka F, Yurekli A, Ross H, Cherukupalli R, Andes L . A cross-country study of cigarette prices and affordability: evidence from the Global Adult Tobacco Survey. Tob Control. 2012; 23(1):e3. DOI: 10.1136/tobaccocontrol-2011-050413. View

12.

McMillen R, Gottlieb M, Winickoff J . e-Cigarettes--The Roles of Regulation and Clinicians. JAMA Intern Med. 2015; 175(10):1603-4. DOI: 10.1001/jamainternmed.2015.4436. View

13.

Bhatnagar A, Payne T, Robertson R . Is There A Role for Electronic Cigarettes in Tobacco Cessation?. J Am Heart Assoc. 2019; 8(12):e012742. PMC: 6645650. DOI: 10.1161/JAHA.119.012742. View

14.

Pineiro B, Correa J, Simmons V, Harrell P, Menzie N, Unrod M . Gender differences in use and expectancies of e-cigarettes: Online survey results. Addict Behav. 2015; 52:91-7. PMC: 4644488. DOI: 10.1016/j.addbeh.2015.09.006. View

15.

Pesko M, Robarts A . Adolescent Tobacco Use in Urban Versus Rural Areas of the United States: The Influence of Tobacco Control Policy Environments. J Adolesc Health. 2017; 61(1):70-76. DOI: 10.1016/j.jadohealth.2017.01.019. View

16.

Gravely S, Driezen P, Ouimet J, Quah A, Cummings K, Thompson M . Prevalence of awareness, ever-use and current use of nicotine vaping products (NVPs) among adult current smokers and ex-smokers in 14 countries with differing regulations on sales and marketing of NVPs: cross-sectional findings from the ITC Project. Addiction. 2019; 114(6):1060-1073. PMC: 6510648. DOI: 10.1111/add.14558. View

17.

Caraballo R, Jamal A, Nguyen K, Kuiper N, Arrazola R . Electronic Nicotine Delivery System Use Among U.S. Adults, 2014. Am J Prev Med. 2015; 50(2):226-9. DOI: 10.1016/j.amepre.2015.09.013. View

18.

. Notes from the field: electronic cigarette use among middle and high school students - United States, 2011-2012. MMWR Morb Mortal Wkly Rep. 2013; 62(35):729-30. PMC: 4585627. View

19.

Li J, Bullen C, Newcombe R, Walker N, Walton D . The use and acceptability of electronic cigarettes among New Zealand smokers. N Z Med J. 2013; 126(1375):48-57. View

20.

Farrelly M, Duke J, Crankshaw E, Eggers M, Lee Y, Nonnemaker J . A Randomized Trial of the Effect of E-cigarette TV Advertisements on Intentions to Use E-cigarettes. Am J Prev Med. 2015; 49(5):686-693. DOI: 10.1016/j.amepre.2015.05.010. View