Cross-sectional study on the awareness, susceptibility and use of heated tobacco products among adolescents in Guatemala City, Guatemala

Abstract

ObjectivesHeated tobacco products (HTPs) are increasingly marketed worldwide, yet limited research on HTPs has been conducted in low and middle-income countries (LMICs) or among adolescents. Guatemala is one of the few LMICs where HTPs are available. This study examined prevalence and correlates of HTP awareness, susceptibility and use among adolescents in Guatemala.Design, setting and participantsA cross-sectional survey on HTP awareness, susceptibility and use was conducted among 2870 students between the ages of 13 and 17 in private schools in Guatemala City, Guatemala.Primary and secondary outcome measuresThe primary outcome was susceptibility to future use of HTP among school-aged current and never smokers in Guatemala. We also explored awareness and use of HTPs. Multivariate binomial regression models were used to explore associations between these outcomes and both sociodemographic factors and established smoking correlates.ResultsOf all students (n=2870), about half were aware of HTPs (52.4%) and susceptible to future or continued use (52.4%). Whereas 8.4% of students had tried HTPs in the lifetime (but not in the last month), only 2.9% used HTPs in the past month. Independent correlates of HTP susceptibility and ever-use included: use of other tobacco products (current smoking: adjusted OR (AOR)=10.53 and 6.63, respectively; current e-cigarette use: AOR=21.87 and 10.40, respectively), moderate alcohol consumption (AOR=1.49 and 1.19, respectively), marijuana use in the past 30 days (AOR=3.49 and 2.29, respectively) and having friends who use HTPs (AOR=1.83 and 7.28, respectively).ConclusionsAmong this sample of adolescents in Guatemala City, where tobacco control is weak, the prevalence of HTP use was low but susceptibility to future use was high. Tobacco prevention and intervention strategies for cigarettes and e-cigarettes should now also include HTPs, which tend to be used by similar adolescent populations (ie, those who use other substances or are exposed to tobacco through family and friends).

Heated tobacco product use and hypertensive disorders of pregnancy and low birth weight: analysis of a cross-sectional, web-based survey in Japan

“…In a setting of weak tobacco restrictions such as Guatemala, even though the prevalence of HTP use is low (2.9%) among adolescents, a high prevalence is anticipated. 4 However, our findings imply that HTP use is not a healthy alternative. Evidence for unfavourable HTP-related health outcomes is still insufficient, particularly among reproductive age women.…”

“…Second, recall and reporting bias of HTP use could not be discarded, as suggested in a study on combustible cigarette and electronic cigarette Open access smoking. 4 Because self-report-based smoking status among pregnant women tends to misclassify ever smokers as never smokers, 24 our estimates might be biased toward the null. Third, the perinatal clinical information was self-reported and not based on medical charts, thereby limiting the precision of the results.…”

“… 3 The use of HTPs is increasing worldwide, particularly in the younger population; the prevalence of HTP use among Guatemala adolescents was 2.9% in 2020. 4 …”

“…3 The use of HTPs is increasing worldwide, particularly in the younger population; the prevalence of HTP use among Guatemala adolescents was 2.9% in 2020. 4 Although the advertisement of HTPs (eg, reduced harmfulness and a smoke-free image) promotes the impression that HTPs are healthy alternatives to combustible cigarettes, 5 HTP-related unfavourable health outcomes, including acute respiratory and cardiovascular risks, are likely to occur. 6 7 However, existing knowledge on HTP use and its association with maternal and neonatal risks in pregnant women is limited.…”

E-cigarette vending machines: a new access channel for youth in Guatemala City

“…Electronic cigarette (e-cigarette) availability and use has increased worldwide since they were first introduced around 2007 and became increasingly popular among youth starting around 2014 1 2. In the USA, Mexico and Guatemala, the prevalence of last 30-day use of e-cigarettes among adolescents is higher than for conventional cigarettes 3–5. In Guatemala, in a sample of 2870 adolescents, 28% were current users of e-cigarettes 3.…”