1
|
Awua J, Tuliao AP, Gabben-Mensah D, Kanjor F, Botor NJB, Ohene L, Meisel MK. Interpersonal communication and perceived norms as social influence mechanisms of e-cigarette use among adults: a systematic review. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-14. [PMID: 38832973 DOI: 10.1080/00952990.2024.2346928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/21/2024] [Indexed: 06/06/2024]
Abstract
Background: Given the increasing popularity of e-cigarette use among adults and the ongoing debate about the benefits and the potential adverse health risks associated with e-cigarette use, it is critical to identify the correlates of e-cigarette use. Prior research has found associations between interpersonal communication, perceived norms, and adults' e-cigarette use, but the evidence has yet to be summarized and synthesized.Objectives: This paper reviewed empirical studies examining the relationship between interpersonal communication, perceived norms, and e-cigarette use among adults.Methods: Following PRISMA guidelines, articles were searched on DOAJ, EMBASE, Europe PubMed Central, Google Scholar, PsychINFO, PubMed, Web of Science, and the reference list of the retrieved studies for studies that examined social influence on e-cigarette use. Three reviewers independently screened 1,713 non-duplicate papers and further screened the full text of 195 articles for inclusion.Results: Thirty studies (30), consisting of quantitative (n = 25) and qualitative (n = 5) data, were included in this review. The twenty-five (25) quantitative studies consisted of both cross-sectional (n = 20) and longitudinal (n = 5) studies. Interpersonal communication portraying e-cigarettes as beneficial or harmful was found to increase e-cigarette use and quit attempts, respectively. Across study designs, greater perceptions of others' e-cigarette use or approval were related to more frequent e-cigarette use.Conclusions: The findings highlight that e-cigarette-related interpersonal communication and perceived norms are associated with e-cigarette use. These factors may be useful targets in brief interventions. However, most of the included studies were cross-sectional, limiting the ability to establish clear cause-and-effect relationships; therefore, more longitudinal studies are needed.
Collapse
Affiliation(s)
- Joshua Awua
- Center for Addiction Recovery Research, Texas Tech University, Lubbock, TX, USA
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | - Antover P Tuliao
- Center for Addiction Recovery Research, Texas Tech University, Lubbock, TX, USA
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | | | - Francis Kanjor
- Counseling Department, Bantuk Rehabilitation and Recovery Centre, Accra, Ghana
| | - Nephtaly Joel B Botor
- Center for Addiction Recovery Research, Texas Tech University, Lubbock, TX, USA
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | - Lilian Ohene
- Center for Addiction Recovery Research, Texas Tech University, Lubbock, TX, USA
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | - Matthew K Meisel
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
2
|
Tveleneva A, Kim SJ, Minich M, Liu J, Padon A, Silver L, Yang S. Yet Again Conversations Matter: The Importance of Interpersonal Discussions, Educational Campaigns, and Advertising on Cannabis-Related Risk Perceptions, Attitudes, and Intentions in At-Risk Young Adults. JOURNAL OF HEALTH COMMUNICATION 2022; 27:717-726. [PMID: 36475420 DOI: 10.1080/10810730.2022.2153291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The present study seeks to evaluate the relationships between cannabis-related communication and outcomes of interest such as cannabis-related risk perceptions, attitudes, and behaviors among young adults. Young adults who were at risk for cannabis use were surveyed online in 2020. Results showed that exposure to online educational messages was associated with higher intentions of engaging in peer intervention, while exposure to online advertising was related to higher intention to use cannabis. Anti-cannabis interpersonal discussion was associated with increased risk perceptions, less favorable cannabis attitudes, and a higher likelihood of peer intervention. More pro-cannabis interpersonal discussion was associated with decreased risk perceptions, more favorable cannabis attitudes, higher use intention, and decreased likelihood of peer intervention. In addition, pro-cannabis interpersonal discussion mediated the relationship between exposure to advertising and cannabis risk perceptions, intentions to use cannabis, attitudes about cannabis, and the likelihood of peer intervention. In contrast, anti-cannabis interpersonal discussion mediated the relationship between exposure to educational messages online and cannabis risk perceptions and the likelihood of peer intervention. These findings underscore the need to regulate online cannabis marketing and the importance of investing in online education campaigns to increase public understanding of the risks associated with cannabis consumption in young adulthood.
Collapse
Affiliation(s)
- Arina Tveleneva
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Sang Jung Kim
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Matt Minich
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jiaying Liu
- Department of Communication Studies, University of Georgia, Athens, Georgia, USA
| | - Alisa Padon
- Public Health Institute, Oakland, California, USA
| | - Lynn Silver
- Public Health Institute, Oakland, California, USA
| | - Sijia Yang
- School of Journalism and Mass Communication, University of Wisconsin-Madison, Madison, Wisconsin, USA
| |
Collapse
|
3
|
East K, Reid JL, Burkhalter R, Wackowski OA, Thrasher JF, Tattan-Birch H, Boudreau C, Bansal-Travers M, Liber AC, McNeill A, Hammond D. Exposure to negative news stories about vaping, and harm perceptions of vaping, among youth in England, Canada, and the US before and after the outbreak of E-cigarette or Vaping-Associated Lung Injury (EVALI). Nicotine Tob Res 2022; 24:1386-1395. [PMID: 35368062 PMCID: PMC9356695 DOI: 10.1093/ntr/ntac088] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 02/02/2023]
Abstract
Introduction Little is known about the international impact of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’) on youth perceptions of vaping harms. Methods Repeat cross-sectional online surveys of youth aged 16–19 years in England, Canada, and the United States before (2017, 2018), during (2019 August/September), and after (2020 February/March, 2020 August) the ‘EVALI’ outbreak (N = 63380). Logistic regressions assessed trends, country differences, and associations between exposure to negative news stories about vaping and vaping harm perceptions. Results Exposure to negative news stories increased between 2017 and February–March 2020 in England (12.6% to 34.2%), Canada (16.7% to 56.9%), and the United States (18.0% to 64.6%), accelerating during (2019) and immediately after (February–March 2020) the outbreak (p < .001) before returning to 2019 levels by August 2020. Similarly, the accurate perception that vaping is less harmful than smoking declined between 2017 and February–March 2020 in England (77.3% to 62.2%), Canada (66.3% to 43.3%), and the United States (61.3% to 34.0%), again accelerating during and immediately after the outbreak (p < .001). The perception that vaping takes less than a year to harm users’ health and worry that vaping will damage health also doubled over this period (p ≤ .001). Time trends were most pronounced in the United States. Exposure to negative news stories predicted the perception that vaping takes less than a year to harm health (Adjusted Odds Ratio = 1.55, 1.48-1.61) and worry that vaping will damage health (Adjusted Odds Ratio = 1.32, 1.18-1.48). Conclusions Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. Effects were seen in all countries but were most pronounced in the United States. Implications This is the first study examining changes in exposure to news stories about vaping, and perceptions of vaping harms, among youth in England, Canada, and the United States before, during, and after ‘EVALI’. Between 2017 and February–March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained. Exposure to negative news stories also predicted two of the three harm perception measures. Overall, findings suggest that ‘EVALI’ may have exacerbated youth’s perceptions of vaping harms internationally.
Collapse
Affiliation(s)
- Katherine East
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada.,National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jessica L Reid
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Robin Burkhalter
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Olivia A Wackowski
- School of Public Health, Rutgers, The State University of New Jersey, NJ, USA
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Ontario, Canada
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Alex C Liber
- Cancer Prevention and Control, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David Hammond
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| |
Collapse
|
4
|
Mun K, Yang J, Yoo W. The Exploration of How Social Media Cultivate College Student Smokers: Theorizing Valence of Communication, Impression Management, and Perceived Risks and Benefits of Smoking in the O 1-S-R 1-O 2-R 2 Model. HEALTH COMMUNICATION 2021; 36:1426-1440. [PMID: 32466677 DOI: 10.1080/10410236.2020.1767445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The purpose of this study is to build a theoretical framework to account for how social media lead college students to smoke. Arguing critical concepts, such as valence of communication, impression management, perceived risks and benefits, this study develops the O 1 -S-R 1 -O 2 -R 2 model. For this, we test a separated model for smokers and nonsmokers. For smokers, the effect of exposure to pro-smoking content on smoking behavior is mediated by an impression of smokers, a favorable expression about smoking, and perceived benefits. And, the effect of exposure to anti-smoking content on smoking behavior is mediated by an unfavorable expression about smoking and perceived risks. However, such mediation processes cannot be observed for nonsmokers; namely, the effect of exposure to pro-smoking content on smoking intention is only mediated by a favorable expression about smoking. Considering the separated path models for smokers and nonsmokers, theoretical and practical implications are suggested for future study. Methodological limitations are discussed as well.
Collapse
Affiliation(s)
- Kwansik Mun
- School of Journalism and Mass Communication, University of Wisconsin-Madison
| | - JungHwan Yang
- Department of Communication, University of Illinois at Urbana-Champaign
| | - Woohyun Yoo
- Department of Mass Communication & Institute of Social Sciences, Incheon National University
| |
Collapse
|
5
|
Morgan JC, Silver N, Cappella JN. How did beliefs and perceptions about e-cigarettes change after national news coverage of the EVALI outbreak? PLoS One 2021; 16:e0250908. [PMID: 33930093 PMCID: PMC8087005 DOI: 10.1371/journal.pone.0250908] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 04/07/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Exposure to media content can shape public opinions about tobacco. In early September 2019, the outbreak of e-cigarette, or vaping, product use–associated lung injury (EVALI) became headline news in the United States. Methods In August and September 2019, we conducted two cross-sectional online surveys with current and former smokers assessing attitudes and beliefs about e-cigarettes. Study one (n = 865) was collected before the EVALI outbreak was widely covered and study two (n = 344) was collected after the outbreak had become nation-wide news. We examined differences in perceptions and beliefs between time points. Results E-cigarette harm perceptions increased between study one (mean = 2.67) and study two (mean = 2.90, p < .05). Ever-users of e-cigarettes largely account for this change. Endorsement of the belief that e-cigarettes were risky and more likely to cause lung damage compared to cigarettes increased between studies (p < .05). Seventy eight percent of participants at study two were aware of the vaping illness story. Being aware of the story was associated with more endorsement of the belief that e-cigarettes were risky to use, but not that using e-cigarettes would make the participant more likely to get damaged lungs. Discussion When the stories about the health and safety of tobacco products dominate the public information environment, it presents an opportunity to change beliefs that are frequently targeted by paid health campaigns. Changes in participant’s perceptions of e-cigarettes were associated with coverage of this large news story, underscoring the importance of working to ensure that coverage is a scientifically accurate as possible.
Collapse
Affiliation(s)
- Jennifer C. Morgan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, United States of America
- * E-mail:
| | - Nathan Silver
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Joseph N. Cappella
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, United States of America
| |
Collapse
|
6
|
Harm Perceptions and Beliefs about Potential Modified Risk Tobacco Products. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020576. [PMID: 33445525 PMCID: PMC7827331 DOI: 10.3390/ijerph18020576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 01/17/2023]
Abstract
Under US law, tobacco products may be authorized to claim lower exposure to chemicals, or lower risk of health harms. We sought to examine the harm perceptions and beliefs about potential modified risk tobacco products (MRTPs). We recruited 864 adult current and former smokers in August 2019. Participants read a paragraph describing the potential for the FDA to authorize MRTPs and a brief description of MRTPs. The most endorsed beliefs for each product were that they contained nicotine and that they were risky. Believing that e-cigarettes can help smokers quit smoking, that they tasted good, and looked cool were associated with greater odds of intending to try e-cigarettes after controlling for demographic and use factors. For snus, the beliefs that the product was not addictive and tasted good were associated with increased odds of intending to try snus. The beliefs that heated tobacco would taste good and would be a good quit aid was associated with increased odds of intentions to try heated tobacco products. Understanding what the public believes about products currently or potentially authorized to be marketed as modified risk tobacco products can inform communication efforts.
Collapse
|
7
|
Morphett K, Puljević C, Borland R, Carter A, Hall W, Gartner C. Attitudes towards a hypothetical 'clean nicotine' product and harm reduction among smokers. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 88:103020. [PMID: 33161296 DOI: 10.1016/j.drugpo.2020.103020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/18/2020] [Accepted: 10/22/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Cleaner nicotine delivery devices, such as nicotine vaping products (NVPs), could expose smokers to less harm than combustible cigarettes. While use of NVPs is increasing, it is unknown how harm reduction attitudes are related to intention to use these or other "clean nicotine" products and how smokers would prefer to use them. METHODS A sample of 1,538 Australian smokers participated in an online survey. Questions covered use NVPs and nicotine replacement therapy (NRT), and attitudes towards a hypothetical "clean nicotine" product and tobacco harm reduction. RESULTS Lifetime use of NVPs was reported by 21% of participants, while 42% reported that they would probably or definitely use NVPs as a cessation aid in the future. Around three-quarters expressed interest in using a hypothetical clean nicotine product as a short-term cessation aid (75.7%), a long-term substitute for cigarettes (72.4%), or as a partial replacement for cigarettes (74.9%). However, despite this interest, 52% endorsed the statement that using nicotine products long-term was undesirable because it maintained nicotine addiction. A binary logistic regression showed that interest in using the hypothetical "clean nicotine" product was associated with higher education, moderate nicotine dependence, support of tobacco harm reduction, and previous use of NRT and NVPs. CONCLUSION Most smokers were interested in the use of a hypothetical clean nicotine product that is as addictive as combustible cigarettes but much less harmful. However, many of the participants who were interested in the use of a hypothetical clean nicotine product also endorsed statements that long-term addiction to nicotine is undesirable. These seemingly contradictory findings have implications for communication with smokers about tobacco harm reduction approaches with non-smoked nicotine products.
Collapse
Affiliation(s)
- Kylie Morphett
- School of Public Health, The University of Queensland, Herston, Queensland, Australia.
| | - Cheneal Puljević
- School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adrian Carter
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Melbourne, Australia
| | - Wayne Hall
- National Centre for Youth Substance Use Research, The University of Queensland, St Lucia, Queensland, Australia
| | - Coral Gartner
- School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Alliance for Environmental Health Sciences, The University of Queensland, Woolloongabba, Queensland, Australia
| |
Collapse
|
8
|
Owusu D, Massey Z, Popova L. An experimental study of messages communicating potential harms of electronic cigarettes. PLoS One 2020; 15:e0240611. [PMID: 33085686 PMCID: PMC7577451 DOI: 10.1371/journal.pone.0240611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
There has been an upsurge of e-cigarette use in the United States in recent years. While e-cigarettes may contain lower levels of toxic chemicals than combusted cigarettes, they still pose serious health hazards, including increased risk for heart and respiratory disease. Despite these risks, public awareness of the health harms of e-cigarettes remains low. Thus, it is important to educate the public about the potential harms of e-cigarettes. This study took themes commonly found in antismoking messages and used them to develop messages about harms of e-cigarettes. A national sample of 2801 current smokers and nonsmokers (aged 18+ years) were randomized to view one of four e-cigarette messages (harmful effect of chemicals, uncertainty about ingredients, distrust of big tobacco, or cost of vaping) or a control message (bottled water ad). Participants' reactions to the messages and behavioral intentions were assessed immediately following the exposure. MANOVA examined effects of the messages on blocks of the outcome variables and univariate analyses estimated adjusted means for each experimental condition for each outcome. The message about harmful chemicals was perceived as the most informative and effective and elicited the highest levels of negative emotions (Ps<0.05). However, on measures of actual effectiveness, the other messages performed equally well. Specifically, messages with different themes (harmful chemicals, uncertainty about ingredients, anti-industry, or financial cost) increased perceived risk of e-cigarettes, support for e-cigarette control, and lowered self-exempting beliefs and intentions to use e-cigarettes (Ps<0.05). Themes commonly used in anti-smoking messages may be effective in educating the public about the potential harm of e-cigarettes. The observed differential effects of the messages suggest the need to use multiple themes in a public education campaign about e-cigarettes.
Collapse
Affiliation(s)
- Daniel Owusu
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Zachary Massey
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| |
Collapse
|
9
|
Amalia B, Liu X, Lugo A, Fu M, Odone A, van den Brandt PA, Semple S, Clancy L, Soriano JB, Fernández E, Gallus S. Exposure to secondhand aerosol of electronic cigarettes in indoor settings in 12 European countries: data from the TackSHS survey. Tob Control 2020; 30:49-56. [PMID: 32123139 DOI: 10.1136/tobaccocontrol-2019-055376] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/12/2019] [Accepted: 12/31/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Exposure to secondhand aerosol from e-cigarette (SHA) may pose harmful effects to bystanders. This study aims to investigate the prevalence, duration and determinants of SHA exposure in various indoor settings in 12 European countries. METHODS In 2017-2018, we conducted a cross-sectional study, the TackSHS survey, on a representative sample of the population aged ≥15 years in 12 European countries (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania and Spain). We described the prevalence and duration of exposure to SHA in several indoor settings among 11 604 e-cigarette non-users. Individual-level and country-level characteristics associated with SHA exposure were also explored using multilevel logistic regression analyses. RESULTS Overall, 16.0% of e-cigarette non-users were exposed to SHA in any indoor setting at least weekly, ranging from 4.3% in Spain to 29.6% in England. The median duration of SHA exposure among those who were exposed was 43 min/day. 'Other indoor settings' (eg, bar and restaurant) was reported as the place where most of e-cigarette non-users were exposed (8.3%), followed by workplace/educational venues (6.4%), home (5.8%), public transportation (3.5%) and private transportation (2.7%). SHA exposure was more likely to occur in certain groups of non-users: men, younger age groups, those with higher level of education, e-cigarette past users, current smokers, those perceiving SHA harmless and living in countries with a higher e-cigarette use prevalence. CONCLUSIONS We found inequalities of SHA exposure across and within European countries. Governments should consider extending their tobacco smoke-free legislation to e-cigarettes to protect bystanders, particularly vulnerable populations such as young people. TRIAL REGISTRATION NUMBER NCT02928536.
Collapse
Affiliation(s)
- Beladenta Amalia
- Tobacco Control Unit and WHO Collaborating Center for Tobacco Control, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Catalonia, Spain.,Tobacco Control Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain.,Department of Clinical Sciences, University of Barcelona (UB), L'Hospitalet de Llobregat, Catalonia, Spain.,CIBER Respiratory Diseases (CIBERES), Madrid, Spain
| | - Xiaoqiu Liu
- Department of Environmental Health Sciences, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Marcela Fu
- Tobacco Control Unit and WHO Collaborating Center for Tobacco Control, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Catalonia, Spain.,Tobacco Control Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain.,Department of Clinical Sciences, University of Barcelona (UB), L'Hospitalet de Llobregat, Catalonia, Spain.,CIBER Respiratory Diseases (CIBERES), Madrid, Spain
| | - Anna Odone
- School of Public Health, Universita Vita-Salute San Raffaele, Milano, Lombardia, Italy
| | - Piet A van den Brandt
- CAPHRI-School for Public Health and Primary Care, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sean Semple
- Institute for Social Marketing, University of Stirling, Stirling, Scotland, UK
| | - Luke Clancy
- TobaccoFree Research Institute Ireland (TFRI), Dublin, Ireland
| | - Joan B Soriano
- CIBER Respiratory Diseases (CIBERES), Madrid, Spain.,Respiratory DepartmentH, Hospital Universitario de la Princesa, Madrid, Spain
| | - Esteve Fernández
- Tobacco Control Unit and WHO Collaborating Center for Tobacco Control, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Catalonia, Spain .,Tobacco Control Research Group, Bellvitge Institute for Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain.,Department of Clinical Sciences, University of Barcelona (UB), L'Hospitalet de Llobregat, Catalonia, Spain.,CIBER Respiratory Diseases (CIBERES), Madrid, Spain
| | - Silvano Gallus
- Department of Environmental Health Sciences, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | | |
Collapse
|
10
|
Zhu J, Shi F, Xu G, Li N, Li J, He Y, Yu J. Conventional Cigarette and E-Cigarette Smoking among School Personnel in Shanghai, China: Prevalence and Determinants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173197. [PMID: 31480564 PMCID: PMC6747063 DOI: 10.3390/ijerph16173197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 12/25/2022]
Abstract
Smoking cigarettes and e-cigarettes is widely popular among Chinese students. Considering that school personnel are considered role models in the student community, we investigated the prevalence and determinants of such behavior among high school personnel in China so as to provide references for future related intervention measures. We used a stratified cluster sampling design on a total number of 3311 school employees recruited from 33 representative schools. Complex sampling analysis and logistic regressions were used for univariate and multivariate analyses. Among 3194 participants that met the study criteria, 7.4% were cigarette users, and 3.6% e-cigarette consumers. For conventional cigarette smokers, certain characteristics, such as being older and male, attaining less education, and having been exposed to secondhand smoke, were associated with heavier smoking. Nevertheless, e-cigarette users were predominantly male and of younger age. Those who understood the hazards of conventional cigarette smoking had less inclination to smoke but were at a higher risk of e-cigarette use. Our analysis suggests that it is necessary to target different populations for monitoring and controlling conventional cigarette smoking and e-cigarette use respectively among school personnel. In addition, China is in need of more relevant and strict anti-smoking regulations.
Collapse
Affiliation(s)
- Jingfen Zhu
- School of Public Health, Fudan University, 130 Dongan Road, Shanghai 200032, China
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai 200025, China
| | - Fanghui Shi
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai 200025, China
| | - Gang Xu
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai 200025, China
| | - Na Li
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai 200025, China
| | - Jiahui Li
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai 200025, China
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Shanghai 200025, China.
| | - Jinming Yu
- School of Public Health, Fudan University, 130 Dongan Road, Shanghai 200032, China.
| |
Collapse
|
11
|
Where Do People Vape? Insights from Twitter Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173056. [PMID: 31443591 PMCID: PMC6747114 DOI: 10.3390/ijerph16173056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 08/17/2019] [Accepted: 08/21/2019] [Indexed: 11/19/2022]
Abstract
Background: Emerging evidence suggests that exposure to secondhand and thirdhand aerosol from electronic cigarettes may have serious health risks including respiratory and cardiovascular diseases. Social media data can help identify common locations referenced in vaping-related discussions and offer clues about where individuals vape. These insights can strengthen current tobacco regulations and prioritize new policies to improve public health. This study identified commonly referenced locations in vaping-related discussions on Twitter in 2018. Methods: Vaping-related posts to Twitter were obtained from 1 January 2018 to 31 December 2018. Rule-based classifiers categorized each Twitter post into 11 location-related categories (social venues, living spaces, stores, modes of transportation, schools, workplaces, healthcare offices, eateries, correctional facilities, religious institutions, and miscellaneous) using a data dictionary of location-related keywords (n = 290,816). Results: The most prevalent category was social venues (17.9%), followed by living spaces (16.7%), stores (15.9%), modes of transportation (15.5%), schools (14.9%), and workplaces (11.9%). Other categories pertained to: healthcare offices (2.0%), eateries (1.2%), correctional facilities (0.7%), and religious institutions (0.4%). Conclusion: This study suggests that locations related to socialization venues may be priority areas for future surveillance and enforcement of smoke-free air policies. Similarly, development and enforcement of similar policies at workplaces, schools and multi-unit housing may curb exposure to secondhand and thirdhand aerosol among the public.
Collapse
|
12
|
Jun J, Kim SH, Wu L. Tobacco Risk Information and Comparative Risk Assessment of E-Cigarettes Vs. Cigarettes: Application of the Reinforcing Spirals Model. JOURNAL OF HEALTH COMMUNICATION 2019; 24:422-431. [PMID: 31210588 DOI: 10.1080/10810730.2019.1630526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We examine how individuals seek information about e-cigarette risk and selectively expose themselves to media sources that may provide information consistent with their existing beliefs and behaviors related to e-cigarettes in application of the Reinforcing Spirals Model (Slater, 2007). Additionally, the associations among e-cigarette risk information-seeking, tobacco risk information exposure via media, and comparative risk assessment of e-cigarettes versus conventional cigarettes were identified. The results were compared among current users, former users, and those who had never used e-cigarettes ("never users"). A nationally representative data from the 2017 Health Information National Trends Surveys - FDA was employed. Our analyses suggest the presence of comparative risk perception among current users as assessing the health harm and addiction risk of e-cigarettes significantly lower than cigarettes. Current users did not avoid information about the health effects of e-cigarettes; they were more likely to look for such information than former and never users. Current users' e-cigarette risk information-seeking was negatively associated with the difference between perceived addiction risk of e-cigarettes and that of cigarettes. Current users' tobacco risk information exposure via social media was related with a lower level of the perceived risk of e-cigarettes, while such exposure via news media was related with a higher level of perceived risk of e-cigarettes. Our findings suggest the need for regulating and counteracting the prevalent e-cigarette information that discounts the relative risks of e-cigarettes as well as the potential of news media as influential sources helping current users scrutinize the risks.
Collapse
|
13
|
Bigman CA, Mello S, Sanders-Jackson A, Tan ASL. Speaking up about Lighting up in Public: Examining Psychosocial Correlates of Smoking and Vaping Assertive Communication Intentions among U.S. Adults. HEALTH COMMUNICATION 2019; 34:500-510. [PMID: 29364737 PMCID: PMC6501571 DOI: 10.1080/10410236.2018.1428849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Against a backdrop of increasing smoke-free policies, electronic cigarette use, and discussion about public health risks posed by smoking and vaping, this study examines psychosocial predictors of intentions to ask others not to use e-cigarettes (vape) and smoke - i.e., assertive communication intentions. A national sample of U.S. adults (n = 474) reported assertive communication intentions for public venues. Psychosocial correlates included perceived risks of exposure to secondhand smoke (SHSe) and secondhand vapor (SHVe), SHSe and SHVe attitudes, subjective norms, and perceived self-efficacy. Separate linear regression models were conducted for smoking and vaping assertive communication intention outcomes. Perceived risks and self-efficacy were associated with greater vaping and smoking assertive communication intentions; subjective norms were only significant for vaping assertive communication intentions. Although a majority of respondents indicated they were unlikely to intervene to voice objections about SHSe and SHVe in public venues, this study suggests that incidental or intentional messages and policies that influence perceptions of risk, norms, and efficacy could affect willingness to voice objections about others' vaping and smoking in public.
Collapse
Affiliation(s)
- Cabral A Bigman
- a Department of Communication , University of Illinois Urbana-Champaign
| | - Susan Mello
- b Department of Communication Studies , Northeastern University
| | | | - Andy S L Tan
- d Department of Social and Behavioral Sciences , Harvard University T.H. Chan School of Public Health and Division of Population Sciences, Center for Community-Based Research, Dana-Farber Cancer Institute
| |
Collapse
|
14
|
Tigova O, Amalia B, Castellano Y, Fu M, Nogueira SO, Kyriakos CN, Mons U, Trofor AC, Zatoński WA, Przewoźniak K, Demjén T, Tountas Y, Quah ACK, Fong GT, Fernández E, Vardavas CI. 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. [PMID: 31516465 PMCID: PMC6661852 DOI: 10.18332/tid/99117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/11/2018] [Accepted: 10/21/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Electronic cigarette (e-cigarette) use has grown significantly in some European Union (EU) Member States (MS). A better understanding of the exposure to secondhand e-cigarette aerosols (SHA) is necessary to develop and implement comprehensive regulations on e-cigarette use in public places. This study aims to assess the observation of e-cigarette use in public places, the self-reported exposure to SHA, and the level of users' comfort using e-cigarettes in the presence of others. METHODS This is a cross-sectional study of the Wave 1 International Tobacco Control 6 European Countries Survey recruiting adult smokers (n=6011) across six EU MS: Germany, Greece, Hungary, Poland, Romania, and Spain, within the EURESTPLUS Project. A descriptive analysis was conducted to estimate the prevalence (%) of observed e-cigarette use in different places, frequency of self-reported exposure to SHA, and level of comfort using e-cigarettes in the presence of others. RESULTS In all, 31.0% of smokers observed others using e-cigarette in public places, 19.7% in indoor places where smoking is banned, and 14.5% indoors at work. Almost 37% of smokers reported to be ever exposed to SHA, ranging from 17.7% in Spain to 63.3% in Greece. The higher prevalence of observed e-cigarette use and passive exposure to SHA was reported by smokers of younger age, of higher educational level and those being current or former e-cigarette users. Part (8.8%) of the smokers who were also e-cigarette users reported feeling uncomfortable using e-cigarettes in the presence of others. CONCLUSIONS A third of smokers from six EU MS reported being exposed to SHA. Prevalence differences were observed among the countries. In the context of scarce evidence on long-term health effects of exposure to SHA, precautionary regulations protecting bystanders from involuntary exposure should be developed.
Collapse
Affiliation(s)
- Olena Tigova
- Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
| | - Beladenta Amalia
- Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Yolanda Castellano
- Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
| | - Marcela Fu
- Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Sarah O. Nogueira
- Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Christina N. Kyriakos
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
- University of Crete (UoC), Heraklion, Greece
| | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Antigona C. Trofor
- University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, Iasi, Romania
- Aer Pur Romania, Bucharest, Romania
| | - Witold A. Zatoński
- Health Promotion Foundation (HPF), Warsaw, Poland
- European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland
| | - Krzysztof Przewoźniak
- Health Promotion Foundation (HPF), Warsaw, Poland
- Maria Skłodowska-Curie Institute-Oncology Center (MSCI), Warsaw, Poland
| | - Tibor Demjén
- Maria Skłodowska-Curie Institute-Oncology Center (MSCI), Warsaw, Poland
| | - Yannis Tountas
- National and Kapodistrian University of Athens (UoA), Athens, Greece
| | - Anne C. K. Quah
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Geoffrey T. Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Esteve Fernández
- Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Constantine I. Vardavas
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
- University of Crete (UoC), Heraklion, Greece
| | | |
Collapse
|
15
|
Robertson L, Hoek J, Blank ML, Richards R, Ling P, Popova L, McMillan L. A qualitative exploration of information-seeking by electronic nicotine delivery systems (ENDS) users in New Zealand. BMJ Open 2018; 8:e023375. [PMID: 30366916 PMCID: PMC6224741 DOI: 10.1136/bmjopen-2018-023375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Given recent increases in awareness and uptake of electronic nicotine delivery systems (ENDS), we aimed to explore ENDS users' information needs and search behaviours and whether information gaps exist. DESIGN Qualitative study using semistructured interviews that probed participants' smoking behaviours and ENDS use; data in this study examine ENDS information-seeking behaviours. We used qualitative description to analyse interview transcripts. PARTICIPANTS AND SETTING We recruited 39 current ENDS users (20 dual users and 19 exclusive ENDS users who reported having previously smoked cigarettes regularly) aged 18 and over, from three urban centres in New Zealand. RESULTS Several participants used Google to search for information on ENDS' health effects, but described the material they retrieved as vague or contradictory. Some interpreted the absence of information on long-term health effects as evidence ENDS did not pose potential health risks, and several perceived e-liquids as benign. Many relied on information sourced from other ENDS users, gleaned from online forums, YouTube or from discussions with friends and acquaintances; these sources typically presented ENDS positively. Several participants found specialist ENDS retailers provided valuable advice; non-specialist store staff generally lacked detailed product knowledge and sometimes offered inaccurate information. CONCLUSION People seeking information on ENDS' health effects are more likely to retrieve recommendations, product reviews and endorsements from online sources or through exchanges with other users, than they are to find scientific data. Health authorities could help meet potential users' information needs by, first, creating and frequently updating objective lay summaries of the latest scientific evidence; second, by mandating licensing for retailers with guidelines to disclose uncertainty over ENDS' efficacy for cessation and longer-term health effects, and the need for complete substitution of ENDS for combustible cigarettes among those who use these products.
Collapse
Affiliation(s)
- Lindsay Robertson
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Dunedin, New Zealand
- Department of Marketing, University of Otago, Wellington, New Zealand
| | - Mei-Ling Blank
- Department of Public Health, University of Otago, Dunedin, New Zealand
- Department of Marketing, University of Otago, Wellington, New Zealand
| | - Rosalina Richards
- Cancer Society Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Pamela Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, Dunedin, New Zealand
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Lydia McMillan
- Department of Public Health, University of Otago, Dunedin, New Zealand
- Department of Marketing, University of Otago, Wellington, New Zealand
| |
Collapse
|
16
|
Gentzke AS, Homa DM, Kenemer JB, Gomez Y, King BA. 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. [PMID: 29857024 PMCID: PMC6082704 DOI: 10.1016/j.ypmed.2018.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/24/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022]
Abstract
Most U.S. adults have voluntary rules prohibiting the use of smoked tobacco products in their homes and vehicles. However, the prevalence of similar rules for electronic vapor products (EVPs) is uncertain. This study assessed the prevalence and correlates of rules prohibiting EVP use inside homes and vehicles. Data from a 2017 Internet-based panel survey of U.S. adults aged ≥18 years (n = 4107) were analyzed. For homes and vehicles, prevalence of reporting that EVP use was not allowed, partially allowed, fully allowed, or unknown was assessed overall and by covariates. Correlates of prohibiting EVP use was assessed by multivariable logistic regression. In homes, 58.6% of adults did not allow EVP use, 7.7% partially allowed use, 10.1% fully allowed use, and 23.6% were unsure of the rules. In vehicles, 63.8% of respondents did not allow EVP use, 6.0% partially allowed use, 8.9% fully allowed use, and 21.4% were unsure of the rules. Following multivariable adjustment, prohibiting EVP use inside homes and vehicles was more likely among respondents with higher income and education, and with a child aged <18 years. Users of EVPs and other tobacco products, and respondents living with users of EVPs and other tobacco products, were less likely to prohibit EVP use in these locations. These findings show that about 6 in 10 U.S. adults have rules prohibiting EVP use inside homes and vehicles, but variations exist by population subgroups. Voluntary smoke-free rules in homes and vehicles that include EVPs can help protect children and non-users from secondhand EVP aerosol exposure.
Collapse
Affiliation(s)
- Andrea S Gentzke
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-79, Atlanta, GA 30341, USA.
| | - David M Homa
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-79, Atlanta, GA 30341, USA
| | - J Brandon Kenemer
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-79, Atlanta, GA 30341, USA
| | - Yessica Gomez
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-79, Atlanta, GA 30341, USA
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-79, Atlanta, GA 30341, USA
| |
Collapse
|
17
|
Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
Collapse
Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
18
|
Payne JD, Orellana-Barrios M, Medrano-Juarez R, Buscemi D, Nugent K. Electronic cigarettes in the media. Proc (Bayl Univ Med Cent) 2016; 29:280-3. [PMID: 27365871 DOI: 10.1080/08998280.2016.11929436] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Electronic cigarettes (e-cigarettes) are an increasingly popular source of nicotine and an increasingly popular topic in the media. Concerns about potential hazards associated with e-cigarette use and advertising, especially to adolescents, have led to studies on e-cigarettes in both traditional media (TV, mail, print, and outdoor advertising) and social media (websites, social networking sites, blogs, and e-mails). This review presents a narrative description of available studies related to e-cigarettes in the media. These articles have focused on promotion in both traditional and social media across a broad range of topics and have concentrated on target audiences, smoking cessation, harm reduction, and advertising. E-cigarette advertising is the most frequent topic in the published articles. Identifying the target audience also is a common objective in articles. The representation of e-cigarettes as a "healthier alternative" to traditional cigarettes and their use as a "smoking cessation aid" are main themes presented through all types of media.
Collapse
Affiliation(s)
- J Drew Payne
- Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, Texas
| | - Menfil Orellana-Barrios
- Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, Texas
| | - Rita Medrano-Juarez
- Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, Texas
| | - Dolores Buscemi
- Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, Texas
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, Texas
| |
Collapse
|
19
|
Gorzkowski JA, Whitmore RM, Kaseeska KR, Brishke JK, Klein JD. Pediatrician Knowledge, Attitudes, and Practice Related to Electronic Cigarettes. J Adolesc Health 2016; 59:81-6. [PMID: 27338665 DOI: 10.1016/j.jadohealth.2016.03.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 01/22/2023]
Abstract
PURPOSE Electronic cigarettes (e-cigarettes) have grown rapidly in popularity, creating concerns for pediatricians and families. Evaluating pediatricians' understanding of e-cigarettes is an important first step in effectively addressing these products in practice. This qualitative study assesses pediatricians' knowledge, attitudes, and current clinical practices related to e-cigarettes. METHODS We conducted six focus groups with 37 pediatric clinicians in 2014. Groups were led by a trained facilitator using a semistructured discussion guide. Responses were recorded, transcribed, and coded to identify relevant themes. RESULTS Pediatricians know that e-cigarettes generally contain nicotine and that adolescents and young adults are most likely to use them. However, most feel uninformed about the health effects of e-cigarettes and report wanting scientific evidence for safety or harm from credible sources. Pediatricians are skeptical of claims that e-cigarettes are safe, either for users or for those exposed to second-hand e-cigarette vapor or emissions. Participants noted that clinical conversations about e-cigarettes were rare, citing barriers including a lack of systematic screening, competing priorities during clinical visits, and, for some, limited confidence in their ability to address e-cigarettes during clinical encounters. No participants recommended e-cigarettes for cessation. CONCLUSIONS Pediatricians feel poorly informed about e-cigarettes and are concerned about their potential health effects. While clinical discussions about e-cigarettes are rare, recent increases in their use leaves many clinicians wanting guidance about what to say to patients and families.
Collapse
Affiliation(s)
- Julie A Gorzkowski
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois.
| | - Regina M Whitmore
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois
| | - Kristen R Kaseeska
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois
| | - Janet K Brishke
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois
| | - Jonathan D Klein
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois
| |
Collapse
|
20
|
Wackowski OA, Bover Manderski MT, Delnevo CD, Giovenco DP, Lewis MJ. Smokers' Early E-cigarette Experiences, Reasons for Use, and Use Intentions. TOB REGUL SCI 2016; 2:133-145. [PMID: 27042688 PMCID: PMC4810443 DOI: 10.18001/trs.2.2.4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study examined the context of smokers' first e-cigarette experiences, reasons for trying e-cigarettes, not continuing their use, and future use intentions. METHODS We surveyed a nationally representative sample of 519 current cigarette smokers in the United States (classified as never, current, or former e-cigarette users/triers) in April 2014 about their e-cigarette experiences and use intentions. RESULTS Among ever e-cigarette users/triers, 43% purchased an e-cigarette on their own as their first method of trial. These respondents were more likely to have used e-cigarettes more times than those who first tried e-cigarettes from a friend. Positive perceptions about first experiences were significantly higher among current (34.5%) compared to former e-cigarette users/triers (17.9%). Few (8.7%) current e-cigarette users/triers had a negative first experience. Susceptibility to future e-cigarette use was significantly associated with e-cigarette use status, intention to quit smoking and satisfaction with first e-cigarette experience. Among those interested in e-cigarettes, 26.3% were more interested in trying an e-cigarette made by a major tobacco company and 31.8% in trying an e-cigarette that looked "similar" versus different (13.8%) than a real cigarette. CONCLUSIONS The context and perceptions of e-cigarette trial experiences, product quality, style and manufacturer may influence e-cigarette trial and use.
Collapse
Affiliation(s)
- Olivia A Wackowski
- Rutgers School of Public Health, Center for Tobacco Studies, New Brunswick, NJ
| | | | - Cristine D Delnevo
- Rutgers School of Public Health, Center for Tobacco Studies, New Brunswick, NJ
| | - Daniel P Giovenco
- Rutgers School of Public Health, Center for Tobacco Studies, New Brunswick, NJ
| | - M Jane Lewis
- Rutgers School of Public Health, Center for Tobacco Studies, New Brunswick, NJ
| |
Collapse
|
21
|
Ford A, MacKintosh AM, Bauld L, Moodie C, Hastings G. Adolescents' responses to the promotion and flavouring of e-cigarettes. Int J Public Health 2016; 61:215-24. [PMID: 26650455 PMCID: PMC4819499 DOI: 10.1007/s00038-015-0769-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/11/2015] [Accepted: 11/17/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The purpose of the study is to examine adolescents' awareness of e-cigarette marketing and investigate the impact of e-cigarette flavour descriptors on perceptions of product harm and user image. METHODS Data come from the 2014 Youth Tobacco Policy Survey, a cross-sectional in-home survey conducted with 11-16 year olds across the UK (n = 1205). Adolescents' awareness of e-cigarette promotion, brands, and flavours was assessed. Perceptions of product harm, and likely user of four examples of e-cigarette flavours was also examined. RESULTS Some participants had tried e-cigarettes (12 %) but regular use was low (2 %) and confined to adolescents who had also smoked tobacco. Most were aware of at least one promotional channel (82 %) and that e-cigarettes came in different flavours (69 %). Brand awareness was low. E-cigarettes were perceived as harmful (M = 3.54, SD = 1.19) but this was moderated by product flavours. Fruit and sweet flavours were perceived as more likely to be tried by young never smokers than adult smokers trying to quit (p < 0.001). CONCLUSIONS There is a need to monitor the impact of future market and regulatory change on youth uptake and perceptions of e-cigarettes.
Collapse
Affiliation(s)
- Allison Ford
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK.
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK.
| | - Anne Marie MacKintosh
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Linda Bauld
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Crawford Moodie
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Gerard Hastings
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK
- UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| |
Collapse
|
22
|
Kruger J, Patel R, Kegler M, Babb SD, King BA. Perceptions of harm from secondhand smoke exposure among U.S. adults, 2009-2010. Tob Induc Dis 2016; 14:3. [PMID: 26839528 PMCID: PMC4736086 DOI: 10.1186/s12971-016-0069-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 01/26/2016] [Indexed: 12/03/2022] Open
Abstract
Background Exposure to secondhand smoke (SHS) causes significant disease and death. We assessed the prevalence and correlates of perceptions about the health harm of SHS among U.S. adults at the national and state level. Methods Data came from the 2009–2010 National Adult Tobacco Survey, a national landline and cellular telephone survey. Perceptions about the health harms of SHS were assessed as follows: ‘not at all harmful’, ‘somewhat harmful’, and ‘very harmful’. Descriptive statistics were used to assess the prevalence of SHS harm perceptions by tobacco use and sociodemographic factors, including sex, age, race/ethnicity, education, marital status, annual household income, region, sexual orientation, children in the household, and smoke-free law coverage. Logistic regression was used to assess odds of perceiving SHS to be “very harmful” (vs. “not at all harmful” or “somewhat harmful”), adjusting for the aforementioned factors. Results Nationally, 64.5 % of adults perceived SHS as ‘very harmful’ (state range: 73.5 % [Utah] to 53.7 % [Kentucky]). By tobacco use, the perception that SHS is ‘very harmful’ was: 76.5 % among nonusers of tobacco; 62.1 % among noncombustible only users; 47.9 % among combustible only users; and 40.8 % among dual combustible and noncombustible users. Following adjustment, the perception that SHS was ‘very harmful’ was higher among females, non-Hispanic minorities and Hispanics, respondents living with children, and states with 100 % smoke-free law coverage. Among current tobacco users the odds of perceiving SHS to be ‘very harmful’ was lower in the Midwest than the West. Conclusions Almost two-thirds of American adults perceive SHS as ‘very harmful’; however, currently only half of all Americans are protected by comprehensive state or local smoke-free laws. These findings underscore the importance of public education campaigns to increase awareness of SHS exposure harm and the benefits of smoke-free environments. Expanding comprehensive smoke-free laws could protect all Americans from SHS.
Collapse
Affiliation(s)
- Judy Kruger
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Roshni Patel
- Contractor Support for NCCDPHP/NGIS, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA USA
| | - Michelle Kegler
- Emory University, Rollins School of Public Health, Atlanta, GA USA
| | - Steven D Babb
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Brian A King
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| |
Collapse
|
23
|
Comparison of beliefs about e-cigarettes' harms and benefits among never users and ever users of e-cigarettes. Drug Alcohol Depend 2016; 158:67-75. [PMID: 26621550 DOI: 10.1016/j.drugalcdep.2015.11.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 10/15/2015] [Accepted: 11/03/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION E-cigarette use is rapidly increasing, especially among youth and young adults. We need to learn what factors are associated with uptake in e-cigarettes. One important set of predictors is beliefs about e-cigarettes' potential harms and benefits. METHODS Online survey data were collected in July, 2014 from 527 U.S. adults from a nationally representative online panel (KnowledgePanel) who reported being aware of e-cigarettes. Participants were asked to rate 7 statements related to e-cigarettes harms or benefits (e.g., breathing vapors from other people's e-cigarettes is harmful to my health; vaping or using e-cigarettes can help people quit smoking regular cigarettes completely). Responses were categorized into agree, disagree, or no opinion. We compared the proportions of agreement between respondents who ever used e-cigarettes and those who had never used. Multinomial logistic regression was used to predict agree or no opinion versus disagree (base outcome) for each belief. Relative risk ratios (RRRs) are reported. The analyses were completed in December, 2014 and were weighted to match the general U.S. adult population. RESULTS Agreement across the 7 beliefs ranged from 33% (vaping can help people quit smoking) to 56% (e-cigarettes make smoking look more acceptable to youth). Ever use of e-cigarettes was associated with lower relative risk of agreeing with statements about potential harms and higher relative risk of agreeing with statements about benefits (versus disagreeing) compared with never users. DISCUSSION These findings provide timely data on beliefs about e-cigarettes between e-cigarette users and non-users to inform potential message topics for health campaign interventions.
Collapse
|
24
|
E-cigarette advertisements, and associations with the use of e-cigarettes and disapproval or quitting of smoking: Findings from the International Tobacco Control (ITC) Netherlands Survey. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 29:73-9. [PMID: 26818084 DOI: 10.1016/j.drugpo.2015.12.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Much attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviours of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success. METHODS We used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n=1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months. RESULTS There was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR=0.99, p=0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta=0.05, p=0.019) and with a higher likelihood of attempting to quit smoking (OR=1.37, p=0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR=0.92, p=0.807). CONCLUSION Noticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation.
Collapse
|
25
|
Ford A, MacKintosh AM, Bauld L, Moodie C, Hastings G. Adolescents' responses to the promotion and flavouring of e-cigarettes. Int J Public Health 2015. [PMID: 26650455 DOI: 10.1007/s00038-015-0769–5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The purpose of the study is to examine adolescents' awareness of e-cigarette marketing and investigate the impact of e-cigarette flavour descriptors on perceptions of product harm and user image. METHODS Data come from the 2014 Youth Tobacco Policy Survey, a cross-sectional in-home survey conducted with 11-16 year olds across the UK (n = 1205). Adolescents' awareness of e-cigarette promotion, brands, and flavours was assessed. Perceptions of product harm, and likely user of four examples of e-cigarette flavours was also examined. RESULTS Some participants had tried e-cigarettes (12 %) but regular use was low (2 %) and confined to adolescents who had also smoked tobacco. Most were aware of at least one promotional channel (82 %) and that e-cigarettes came in different flavours (69 %). Brand awareness was low. E-cigarettes were perceived as harmful (M = 3.54, SD = 1.19) but this was moderated by product flavours. Fruit and sweet flavours were perceived as more likely to be tried by young never smokers than adult smokers trying to quit (p < 0.001). CONCLUSIONS There is a need to monitor the impact of future market and regulatory change on youth uptake and perceptions of e-cigarettes.
Collapse
Affiliation(s)
- Allison Ford
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK. .,UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK.
| | - Anne Marie MacKintosh
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK.,UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Linda Bauld
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK.,UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Crawford Moodie
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK.,UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| | - Gerard Hastings
- Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, Stirling, UK.,UK Centre for Tobacco and Alcohol Studies, University of Stirling, Stirling, UK
| |
Collapse
|
26
|
Public support for selected e-cigarette regulations and associations with overall information exposure and contradictory information exposure about e-cigarettes: Findings from a national survey of U.S. adults. Prev Med 2015; 81:268-74. [PMID: 26400638 DOI: 10.1016/j.ypmed.2015.09.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/06/2015] [Accepted: 09/12/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE We assessed public support for six e-cigarette regulations and examined whether self-reported exposure to e-cigarette information and contradictory e-cigarette information were associated with support. METHOD We conducted an online survey among a nationally representative sample of 527 U.S. adults in July 2014. Weighted, fully adjusted multinomial logistic regression models predicted support for banning e-cigarettes in smoke-free areas, prohibiting e-cigarette sales to youth, requiring addiction warnings, banning flavors, requiring labeling nicotine and harmful ingredients, and banning youth-targeted marketing. RESULTS Between 34% and 72% supported these six policies (disagreed 6-24%; no opinion 18-38%). We found higher support for policies to protect youth (prohibit sales to youth and youth-targeted marketing) and to require labeling e-cigarette constituents (nicotine and harmful ingredients). Banning the use of flavors in e-cigarettes was the least supported. Overall information exposure predicted lower relative risk of support for three policies (prohibit sales to youth, nicotine and harmful ingredient labeling, addiction warnings). In comparison, contradictory information exposure predicted lower relative risk of support for two policies (prohibit sales to youth, nicotine and harmful ingredient labeling). CONCLUSIONS Exposure to overall and conflicting information about e-cigarettes in the public sphere is associated with reduced support for certain proposed e-cigarette policies. These findings are important for policymakers and tobacco control advocates involved in promulgation of e-cigarette policies. The results provide insights on which policies may meet some public resistance and therefore require efforts to first gain public support.
Collapse
|
27
|
Mello S, Bigman CA, Sanders-Jackson A, Tan ASL. Perceived Harm of Secondhand Electronic Cigarette Vapors and Policy Support to Restrict Public Vaping: Results From a National Survey of US Adults. Nicotine Tob Res 2015; 18:686-93. [PMID: 26470722 DOI: 10.1093/ntr/ntv232] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/01/2015] [Indexed: 12/25/2022]
Abstract
INTRODUCTION There is ongoing debate over banning electronic cigarette (e-cigarette) use (vaping) in public places. Many people perceive secondhand e-cigarette vapors (SHV) to be relatively harmless, which may affect their support for policies to restrict vaping in public places. Given that awareness of secondhand cigarette smoke risks predicts public support for clean air policies, we hypothesized that greater perceived harm of SHV to personal health would be associated with stronger support for vaping restrictions. METHODS Data from 1449 US adults in a national online panel was collected from October to December 2013. Using multiple regressions, we predict a three-item scale of support for e-cigarette restricting policies in restaurants, bars/casinos/clubs, and parks using a two-item scale measuring concern and perceptions of harm to personal health from breathing SHV. Analyses adjusted for demographic covariates, smoking status and e-cigarette use, and were weighted to represent the US adult population. RESULTS Overall, respondents considered SHV exposure to be moderately harmful to their health and tended to favor restricting vaping in public places. Perceived harm of SHV to personal health was associated with support for vaping restrictions in public spaces (unstandardized regression coefficient, B = 0.18, 95% CI = 0.16, 0.20). Current smokers (vs. nonsmokers), those who ever tried e-cigarettes (vs. never), those who directly observed others vaping, and those with some college education (vs. high school or less) demonstrated less support for such policies. IMPLICATIONS This study shows that support for banning vaping in public spaces in the United States is positively associated with perceived health harms of SHV exposure. The findings suggest that continued monitoring of public perception of SHV harm and the accuracy of e-cigarette marketing claims about reduced harm would be needed to guide clean air policy decisions. With the emergence of new scientific evidence of the potential effects of SHV exposure, these results will serve as an important baseline of public perceptions and opinion during a time when such evidence was particularly limited.
Collapse
Affiliation(s)
- Susan Mello
- Department of Communication Studies, Northeastern University, Boston, MA;
| | - Cabral A Bigman
- Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Ashley Sanders-Jackson
- Department of Advertising and Public Relations, Michigan State University, East Lansing, MI
| | - Andy S L Tan
- Population Sciences Division, Center for Community Based Research, Dana-Farber Cancer Institute, Boston, MA; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
| |
Collapse
|