Awareness and Current Use of Electronic Cigarettes in Indonesia, Malaysia, Qatar, and Greece: Findings From 2011–2013 Global Adult Tobacco Surveys

Abstract

Introduction Increases in electronic cigarette (e-cigarette) awareness and current use have been documented in high income countries but less is known about middle and low income countries. Methods Nationally representative household survey data from the first four Global Adult Tobacco Surveys to assess e-cigarettes were analyzed, including Indonesia (2011), Malaysia (2011), Qatar (2013), and Greece (2013). Correlates of e-cigarette awareness and current use were calculated. Sample sizes for Greece and Qatar allowed for further analysis of e-cigarette users. Results Awareness of e-cigarettes was 10.9% in Indonesia, 21.0% in Malaysia, 49.0% in Qatar, and 88.5% in Greece. In all four countries, awareness was higher among male, younger, more educated, and wealthier respondents. Current e-cigarette use among those aware of e-cigarettes was 3.9% in Malaysia, 2.5% in Indonesia, 2.2% in Greece and 1.8% in Qatar. Across these four countries, an estimated 818 500 people are currently using e-cigarettes. Among current e-cigarette users, 64.4% in Greece and 84.1% in Qatar also smoked cigarettes, and, 10.6% in Greece and 6.0% in Qatar were never-smokers. Conclusions E-cigarette awareness and use was evident in all four countries. Ongoing surveillance and monitoring of awareness and use of e-cigarettes in these and other countries could help inform tobacco control policies and public health interventions. Future surveillance should monitor use of e-cigarettes among current smokers and uptake among never-smokers and relapsing former smokers.

Elucidating challenges that electronic cigarettes pose to tobacco control in Asia: a population-based national survey in Taiwan

“…E-cigarette use is more prevalent among people with high socioeconomic status in Asia, 12 but not in Europe. 7 Likewise, people in Taiwan with higher education levels or high household incomes, especially former and current cigarette smokers, are more likely to self-report ever using e-cigarettes.…”

“…7 Epidemiological studies in Asia have suggested a relatively low prevalence of e-cigarette use: prevalence in Hong Kong was 2.3% in 2014, 11 and <1% in Indonesia and Malaysia in 2011. 12 No laws in Taiwan are specifically designed to regulate e-cigarettes and the Taiwan government has not yet approved any nicotine-containing e-cigarettes. Only nicotine-free products can be sold legally, but these nicotine-free products cannot claim to be smoking cessation aids, and cannot be sold in a form resembling tobacco products.…”

“…1 2 E-cigarette use has increased substantially, 3 4 especially among young adults in most, [4][5][6][7][8][9][10][11] but not all, countries. 12 Marketed as alternatives to conventional cigarettes, e-cigarettes lower users' exposure to toxins by delivering nicotine without burning tobacco. 1 13 14 However, data on the long-term health effects of chemicals in e-cigarette aerosols are lacking.…”

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

“…Nevertheless, these levels were significantly higher than in the low-income country of Indonesia (10.9% in 2011). 23 While it is difficult to separate out the different temporal and contextual factors that account for differences across countries, the population-level of awareness may depend both on policy context and the level of economic development.…”

Electronic cigarette use among Korean adults

“…According to the 2011-2013 Global Adult Tobacco Survey, the prevalence of e-cigarette awareness was 10.9 % in Indonesia,21.0 % in Malaysia,49.0 % in Qatar,and 88.5 % in Greece. Across these four countries, almost 818,500 individuals are current e-cigarette users (Palipudi et al 2015). All of these studies report a higher prevalence of e-cigarette use in current smokers than in non-smokers.…”