Age, gender and socioeconomic patterns of awareness and usage of e-cigarettes across selected WHO region countries: evidence from the Global Adult Tobacco Survey

Abstract

ObjectivesThe study explores the awareness and e-cigarette use by demographic and socio-economic characteristics of selected 14 Global Adult Tobacco Survey (GATS) countries.DesignCross-sectional.Setting14 countries.ParticipantsSurveyed population ≥15 years selected through multi-stage cluster sampling.Primary and secondary outcome measuresWe selected 14 countries from 6 different WHO regions where GATS was conducted in different years during 2011–2017.ResultsAwareness 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 .ConclusionsE-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.

Patterns and socioeconomic differences in secondhand exposure to cigarettes, e-cigarettes, and heated tobacco products at home in Hong Kong adolescents

“…The incomerelated difference in indoor EC/HTP exposure could be explained by the higher prevalence of ECs and HTP use among adults with higher incomes 25,26 , coupled with the perception that ECs and HTPs are less harmful and more acceptable for indoor use 27 . Although EC use is more prevalent in adults with higher education 28 , we found adolescents reporting 'Tertiary' parental education level were less exposed to SH-EC/HTP. One explanation, as has been reported previously, is that tobacco users in households with higher education level are more likely to adopt smoke-free bans at home 29 and avoid exposing their children to tobacco smoke.…”

E-cigarette use, perceived risks, attitudes, opinions of e-cigarette policies, and associated factors among Thai university students

“…Nevertheless, it is worth noting that 70% of the study participants were female, which could potentially explain the lower proportion of e-cigarette users in our study. Previous research has indicated that males were more inclined to use e-cigarettes 27,28 . This study identified perceived risk, attitudes, and policy opinions as significant predictors of e-cigarette use among university students.…”

Ocular Symptoms in Adolescents and Young Adults With Electronic Cigarette, Cigarette, and Dual Use

“…Causal or temporal association between ocular symptoms and e-cigarette and cigarette use could not be determined given the observational cross-sectional study design . The findings cannot be generalized to the adolescent and young adult population outside of the US, given that our sample was restricted to US residents . While we controlled for potential confounders (age, gender, race and ethnicity, and use of other combustible substances), there might be other confounders (eg, screen time, facemask use during the COVID-19 pandemic) that can lead to increased ocular symptoms.…”