The Inclusion of E-cigarettes and Heated Tobacco Products in Smoke-free Home and Car Rules: A Cross-sectional Survey of Adults in Armenia and Georgia

Overview

Journal Tob Induc Dis

Date 2024 Jun 5

PMID 38835513

Authors

Varduhi Hayrumyan

Zhanna Sargsyan

Arevik Torosyan

Ana Dekanosidze

Lilit Grigoryan

Nour Alayan

Michelle C Kegler

Lela Sturua

Varduhi Petrosyan

Alexander Bazarchyan

Regine Haardorfer

Yuxian Cui

Carla J Berg

Affiliations

Soon will be listed here.

Abstract

Introduction: Understanding who includes e-cigarettes and heated tobacco products (HTPs) in smoke-free home or car rules could inform public health interventions, particularly in countries with high smoking prevalence and recently implemented national smoke-free laws, like Armenia and Georgia.

Methods: In 2022, we conducted a cross-sectional survey among 1468 adults in 28 Armenian and Georgian communities (mean age=42.92 years; 51.4% female, 31.6% past-month smoking). Multilevel regression (accounting for clustering within communities; adjusted for sociodemographics and cigarette use) examined e-cigarette/HTP perceptions (risk, social acceptability) and use intentions in relation to: 1) including e-cigarettes/HTPs in home and car rules among participants with home and car rules, respectively (logistic regressions); and 2) intention to include e-cigarettes/HTPs in home rules (linear regression, 1 = 'not at all' to 7 = 'extremely') among those without home rules.

Results: Overall, 72.9% (n=1070) had home rules, 86.5% of whom included e-cigarettes/HTPs; 33.9% (n=498) had car rules, 81.3% of whom included e-cigarettes/HTPs. Greater perceived e-cigarette/HTP risk was associated with including e-cigarettes/HTPs in home rules (AOR=1.28; 95% CI: 1.08-1.50) and car rules (AOR=1.46; 95% CI: 1.14-1.87) and next-year intentions to include e-cigarettes/HTPs in home rules (β=0.38; 95% CI: 0.25-0.50). Lower e-cigarette/HTP use intentions were associated with including e-cigarettes/HTPs in home rules (AOR=0.75; 95% CI: 0.63-0.88). While perceived social acceptability was unassociated with the outcomes, other social influences were: having children and no other household smokers was associated with including e-cigarettes/HTPs in car rules, and having children was associated with intent to include e-cigarettes/HTPs in home rules.

Conclusions: Interventions to address gaps in home and car rules might target e-cigarette/HTP risk perceptions.

References

Drehmer J, Nabi-Burza E, Hipple Walters B, Ossip D, Levy D, Rigotti N . Parental Smoking and E-cigarette Use in Homes and Cars. Pediatrics. 2019; 143(4). PMC: 6564069. DOI: 10.1542/peds.2018-3249. View

Topuridze M, Berg C, Dekanosidze A, Torosyan A, Grigoryan L, Bazarchyan A . Smokers' and Nonsmokers' Receptivity to Smoke-Free Policies and Pro- and Anti-Policy Messaging in Armenia and Georgia. Int J Environ Res Public Health. 2020; 17(15). PMC: 7432748. DOI: 10.3390/ijerph17155527. View

Hayrumyan V, Harutyunyan A, Torosyan A, Grigoryan L, Sargsyan Z, Bazarchyan A . Tobacco-related risk perceptions, social influences and public smoke-free policies in relation to smoke-free home restrictions: findings from a baseline cross-sectional survey of Armenian and Georgian adults in a community randomised trial. BMJ Open. 2022; 12(2):e055396. PMC: 8823221. DOI: 10.1136/bmjopen-2021-055396. View

Bandura A . Health promotion by social cognitive means. Health Educ Behav. 2004; 31(2):143-64. DOI: 10.1177/1090198104263660. View

Jankowski M, Pinkas J, Zgliczynski W, Kaleta D, Wierzba W, Gujski M . Voluntary Smoke-Free Home Rules and Exposure to Secondhand Smoke in Poland: A National Cross-Sectional Survey. Int J Environ Res Public Health. 2020; 17(20). PMC: 7602554. DOI: 10.3390/ijerph17207502. View

Amalia B, Fu M, Feliu A, Tigova O, Fayokun R, Mauer-Stender K . Regulation of Electronic Cigarette Use in Public and Private Areas in 48 Countries Within the WHO European Region: A Survey to In-country Informants. J Epidemiol. 2020; 32(3):131-138. PMC: 8824658. DOI: 10.2188/jea.JE20200332. View

Monson E, Arsenault N . Effects of Enactment of Legislative (Public) Smoking Bans on Voluntary Home Smoking Restrictions: A Review. Nicotine Tob Res. 2016; 19(2):141-148. PMC: 5234369. DOI: 10.1093/ntr/ntw171. View

Brose L, McNeill A, Arnott D, Cheeseman H . Restrictions on the use of e-cigarettes in public and private places-current practice and support among adults in Great Britain. Eur J Public Health. 2017; 27(4):729-736. PMC: 5881716. DOI: 10.1093/eurpub/ckw268. View

Xi B, Liang Y, Liu Y, Yan Y, Zhao M, Ma C . Tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years: data from 68 low-income and middle-income countries. Lancet Glob Health. 2016; 4(11):e795-e805. DOI: 10.1016/S2214-109X(16)30187-5. View

10.

. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021; 397(10292):2337-2360. PMC: 8223261. DOI: 10.1016/S0140-6736(21)01169-7. View

11.

Cheng K, Glantz S, Lightwood J . Association between smokefree laws and voluntary smokefree-home rules. Am J Prev Med. 2011; 41(6):566-72. PMC: 3222862. DOI: 10.1016/j.amepre.2011.08.014. View

12.

Sun T, Anandan A, Lim C, East K, Xu S, Quah A . Global prevalence of heated tobacco product use, 2015-22: A systematic review and meta-analysis. Addiction. 2023; 118(8):1430-1444. DOI: 10.1111/add.16199. View

13.

Gentzke A, Homa D, Kenemer J, Gomez Y, King B . Rules to prohibit the use of electronic vapor products inside homes and personal vehicles among adults in the U.S., 2017. Prev Med. 2018; 114:47-53. PMC: 6082704. DOI: 10.1016/j.ypmed.2018.05.025. View

14.

Simonavicius E, McNeill A, Arnott D, Brose L . What factors are associated with current smokers using or stopping e-cigarette use?. Drug Alcohol Depend. 2017; 173:139-143. PMC: 5380653. DOI: 10.1016/j.drugalcdep.2017.01.002. View

15.

Semple S, Dobson R, ODonnell R, Abidin E, Tigova O, Okello G . Smoke-free spaces: a decade of progress, a need for more?. Tob Control. 2022; 31(2):250-256. DOI: 10.1136/tobaccocontrol-2021-056556. View

16.

Kim C, Lee K, Lee C, Kim S, Cho H . Perceived relative harm of heated tobacco products and electronic cigarettes and its association with use in smoke-free places: A cross-sectional analysis of Korean adults. Tob Induc Dis. 2022; 20:20. PMC: 8859996. DOI: 10.18332/tid/145699. View

17.

Harutyunyan A, Hayrumyan V, Sargsyan Z, Torosyan A, Dekanosidze A, Kegler M . Smokers' and non-smokers' secondhand smoke experiences and interactions to reduce exposure in Armenia and Georgia. Tob Prev Cessat. 2021; 7:6. PMC: 7845734. DOI: 10.18332/tpc/131059. View

18.

Duan Z, Wysota C, Romm K, Levine H, Bar-Zeev Y, Choi K . Correlates of Perceptions, Use, and Intention to Use Heated Tobacco Products Among US Young Adults in 2020. Nicotine Tob Res. 2022; 24(12):1968-1977. PMC: 9653079. DOI: 10.1093/ntr/ntac185. View

19.

Tigova O, Amalia B, Castellano Y, Fu M, Nogueira S, N Kyriakos C . Secondhand exposure to e-cigarette aerosols among smokers: A cross-sectional study in six European countries of the EUREST-PLUS ITC Europe Surveys. Tob Induc Dis. 2019; 16:A11. PMC: 6661852. DOI: 10.18332/tid/99117. View

20.

Tehrani H, Rajabi A, Ghelichi-Ghojogh M, Nejatian M, Jafari A . The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health. 2022; 80(1):240. PMC: 9682677. DOI: 10.1186/s13690-022-00998-w. View