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Alshaibani M, Alajmi M, Alabduljalil N, Alajmi H, Alsalem Y, Aloqab D, Alawadhi H, Ali SS, Sharhan Y, Alzeeny A, Ziyab AH. Prevalence of use, perceptions of harm and addictiveness, and dependence of electronic cigarettes among adults in Kuwait: A cross-sectional study. Tob Induc Dis 2023; 21:90. [PMID: 37456607 PMCID: PMC10347961 DOI: 10.18332/tid/163300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/28/2023] [Accepted: 04/15/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) have become one of the most common forms of nicotine delivery used by youth and young adults worldwide. Given the lack of epidemiologic data in Kuwait, this study sought to estimate the prevalence of e-cigarette use, assess perceptions of harm and addictiveness of e-cigarettes, measure the level of dependence on e-cigarettes and assess factors associated with dependence level among adults. METHODS A cross-sectional study enrolled adults (n=3032, aged ≥18 years) living in Kuwait using a web-based questionnaire. Participants self-reported ever and current (past 30-day) e-cigarette use and self-completed the 10-item Penn State E-cigarette Dependence Index. Associations were evaluated using multinomial logistic regression. RESULTS The prevalence of ever and current e-cigarette use was estimated to be 40.2% (1220/3032) and 29.4% (892/3032), respectively. The prevalence of current e-cigarette use was higher in males compared to females (47.6% vs 14.4%, p<0.001). Relative to cigarette smoking, 40.6% of participants reported that e-cigarettes are less harmful, and 41.8% indicated that e-cigarettes are equally addictive. Among current e-cigarette users (n=892), 84.8% were ascertained to have developed either low, medium, or high dependence. The use of pod-based devices compared to disposable devices was associated with a high dependence level (adjusted odds ratio, AOR=8.56; 95% CI: 4.52-16.22). CONCLUSIONS These findings suggest that a large proportion of adults in Kuwait use e-cigarettes, and a considerable proportion of current users have developed dependence. Therefore, such results should alert public health authorities and warrant the development of evidence-based awareness campaigns, policies, and prevention measures to protect and improve the health of people.
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Affiliation(s)
- Munairah Alshaibani
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Mays Alajmi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Noura Alabduljalil
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Hajar Alajmi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Yousef Alsalem
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Danah Aloqab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Hamad Alawadhi
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Sara Sayed Ali
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Yaqoub Sharhan
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Ahmed Alzeeny
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Ali H. Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
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Mat Salleh R, Baharom N, Siau CS, Chan CMH, Amit N, Sia PY, Wee LH. E-Cigarette Users' Profiles and Their Association with Identified Impacts of COVID-19 on Vaping among Young Adults in Malaysia. Healthcare (Basel) 2023; 11:healthcare11030434. [PMID: 36767009 PMCID: PMC9914650 DOI: 10.3390/healthcare11030434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Electronic cigarettes (ECs) users' profiles and behaviors during the COVID-19 pandemic remain unclear. This cross-sectional study aimed to explore Malaysian EC users' profiles and their associations with related behaviors during the pandemic. The EC users (N = 351) were recruited from an official national vape entity. Respondents were predominantly of Malay ethnicity (90.6%), aged 31 to 35 years (27.6%), males (97.7%), married (68.7%), from Malaysia's west region states (63.5%) and tertiary educated (69.2%). The majority (80.3%) were non-dual users, and most purchased their vaping products online (77.2%), liked that they can vape while working at home (83.8%) and vaped more because of boredom (55.3%), had low and moderate nicotine addiction levels (94.9%), had low motivation level to quit EC use (92.6%) and were more likely to perceive that vaping did not increase the chances of complications from COVID-19. Respondents with moderate to high addiction levels had twice the odds of checking on their current EC supplies, whilst respondents with low motivation to quit had higher odds of using their tank/pod until the last drop and distancing from others when vaping. EC users should be encouraged to quit EC use, especially during the COVID-19 pandemic.
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Affiliation(s)
- Rawaida Mat Salleh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Nizam Baharom
- Primer Care Health Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Bandar Baru Nilai, Nilai 71800, Negeri Sembilan, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Pei Yin Sia
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Lei Hum Wee
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
- Faculty of Health and Medical Sciences, Taylors University Lakeside Campus, No. 1 Jalan Taylor’s, Subang Jaya 47500, Selangor, Malaysia
- Correspondence: or
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Tehrani H, Rajabi A, Ghelichi- Ghojogh M, Nejatian M, Jafari A. The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health 2022; 80:240. [DOI: 10.1186/s13690-022-00998-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
Abstract
Background
The purpose of this systematic review study was to determine the national, regional, and global prevalence of electronic cigarettes (e-cigarettes) vaping.
Method
The articles were searched in July 2020 without a time limit in Web of Science (ISI), Scopus, PubMed, and Ovid-MEDLINE. At first, the titles and abstracts of the articles were reviewed, and if they were appropriate, they entered the second stage of screening. In the second stage, the whole articles were reviewed and articles that met the inclusion criteria were selected. In this study, search, selection of studies, qualitative evaluation, and data extraction were performed by two authors independently, and any disagreement between the two authors was reviewed and corrected by a third author.
Results
In this study, the lifetime and current prevalence of e-cigarettes vaping globally were 23% and 11%, respectively. Lifetime and current prevalence of e-cigarettes vaping in women were 16% and 8%, respectively. Also, lifetime and current prevalence of e-cigarettes vaping in men were 22% and 12%, respectively. In this study, the current prevalence of e-cigarettes vaping in who had lifetime smoked conventional cigarette was 39%, and in current smokers was 43%. The lifetime prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 24%, 26%, 16%, and 25%, respectively. The current prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 10%, 14%, 11%, and 6%, respectively.
Conclusions
Based on the results of this study, it can be concluded that the popularity of e-cigarettes is increasing globally. Therefore, it is necessary for countries to have more control over the consumption and distribution of e-cigarettes, as well as to formulate the laws prohibiting about the e-cigarettes vaping in public places. There is also a need to design and conduct information campaigns to increase community awareness about e-cigarettes vaping.
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Martins BNFL, Normando AGC, Rodrigues-Fernandes CI, Wagner VP, Kowalski LP, Marques SS, Marta GN, Júnior GDC, Ruiz BII, Vargas PA, Lopes MA, Santos-Silva AR. Global frequency and epidemiological profile of electronic cigarette users: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:548-561. [PMID: 36182650 DOI: 10.1016/j.oooo.2022.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/19/2022] [Accepted: 07/26/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Electronic cigarette (e-cigarette) use is growing significantly worldwide, especially among young people. This product has been associated with renormalizing smoking and hindering quit attempts in smokers. Moreover, among nonsmokers, it can lead to subsequent cigarette smoking and nicotine dependence. The present study aimed to assess the epidemiological profile of e-cigarette users worldwide. STUDY DESIGN A systematic review was performed using 3 main electronic databases (Medline/PubMed, SCOPUS, and EMBASE). Studies were independently assessed by 2 reviewers based on established eligibility criteria. The risk of bias was assessed using the MAStARI critical appraisal instrument. RESULTS From 4,496 records, 43 were included. Among the 1,238,392 participants, 132,786 (10.72%) were e-cigarette users. The age range with the highest percentage of e-cigarette users was 18-24 years old, with 40,989 (30.86%) males, 34,875 (26.26%) females, and 33.6% being current cigarette smokers. The highest prevalence of users was 52.88% in Croatia and 49.62% in New Zealand. Other possible correlations were observed with e-cigarette use, such as a high level of education. CONCLUSION Overall, e-cigarette users tended to be male young adults with a higher level of education. The highest prevalence of use was found in Croatia. This systematic review provides valuable information to improve the development of appropriate intervention strategies targeting e-cigarette users for more accurate anti-smoking actions.
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Affiliation(s)
| | | | | | - Vivian Petersen Wagner
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of Sao Paulo Medical School and Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Sandra Silva Marques
- São Paulo State Reference Centre on Alcohol, Tobacco and Other Drugs, Secretary of Health, São Paulo, Brazil; State Coordination of the Tobacco Program, São Paulo, Brazil
| | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês São Paulo, São Paulo, Brazil
| | - Gilberto de Castro Júnior
- Clinical Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), São Paulo, São Paulo, Brazil
| | | | - Pablo Agustin Vargas
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil
| | - Marcio Ajudarte Lopes
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil.
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Kim SY, Jeong SH, Joo HJ, Park M, Park EC, Kim JH, Lee J, Shin J. High prevalence of hypertension among smokers of conventional and e-cigarette: Using the nationally representative community dwelling survey. Front Public Health 2022; 10:919585. [PMID: 36324451 PMCID: PMC9618945 DOI: 10.3389/fpubh.2022.919585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/12/2022] [Indexed: 01/22/2023] Open
Abstract
This study aimed to clarify the association between hypertension and conventional cigarette and electronic cigarette (e-cigarette) use, together or individually. A total of 275,762 participants were included, of which 120,766 were men and 154,996 were women. The data were drawn from the Korea Community Health Survey conducted in 2019. A multiple logistic regression model was used to examine the association between hypertension and types of smoking. Hypertension was defined as systolic blood pressure higher than 140 mmHg or diastolic blood pressure higher than 90 mmHg. Based on the types of smoking, participants were grouped as dual smokers of conventional and e-cigarettes, e-cigarette only smokers, conventional cigarette only smokers, past-smokers, and non-smokers. Compared to non-smokers, dual smokers presented the highest odds ratio for hypertension in the male [odds ratio (OR): 1.24, confidence interval (CI): 1.10 to 1.39] and female groups (OR: 1.44 CI: 0.96 to 2.15). According to the Cochran-Mantel-Haenszel test, the two-sided p-value of < 0.001 indicated an overall statistically significant association between types of smoking and hypertension. Use of both cigarette types was statistically significant in the male group, but only the use of conventional cigarettes and past smoking were statistically significant in the female group. Among smokers of the two cigarette types, those who were dual smokers of e-cigarettes and conventional cigarettes were the most likely to have the highest prevalence of hypertension.
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Affiliation(s)
- Soo Young Kim
- Department of Public Health, Yonsei University, Seoul, South Korea,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Sung Hoon Jeong
- Department of Public Health, Yonsei University, Seoul, South Korea,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Hye Jin Joo
- Department of Public Health, Yonsei University, Seoul, South Korea,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Minah Park
- Department of Public Health, Yonsei University, Seoul, South Korea,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, South Korea,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Hyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Junbok Lee
- Health IT Center, Yonsei University Health System, Seoul, South Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, Seoul, South Korea,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea,*Correspondence: Jaeyong Shin
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Hod R, Mohd Nor NH, Maniam S. Systematic review on e-cigarette and its effects on weight gain and adipocytes. PLoS One 2022; 17:e0270818. [PMID: 35788209 PMCID: PMC9255744 DOI: 10.1371/journal.pone.0270818] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/20/2022] [Indexed: 12/23/2022] Open
Abstract
Smoking and obesity are leading causes of morbidity and mortality worldwide. E-cigarette which was first introduced in 2000s is perceived as an effective alternative to conventional tobacco smoking. Limited knowledge is available regarding the risks and benefits of e-cigarettes. This study systematically reviews the current literature on the effects of e-cigarettes on body weight changes and adipocytes. The search was performed using OVID Medline and Scopus databases and studies meeting the inclusion criteria were independently assessed. This review included all English language, empirical quantitative and qualitative papers that investigated the effects of e-cigarettes on bodyweight or lipid accumulation or adipocytes. Literature searches identified 4965 references. After removing duplicates and screening for eligibility, thirteen references which involve human, in vivo and in vitro studies were reviewed and appraised. High prevalence of e-cigarette was reported in majority of the cross sectional studies conducted among respondent who are obese or overweight. More conclusive findings were identified in in vivo studies with e-cigarette causing weight decrease. However, these observations were not supported by in vitro data. Hence, the effect of e-cigarette on body weight changes warrants further investigations. Well-designed population and molecular studies are needed to further elucidate the role of e-cigarettes in obesity.
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Affiliation(s)
- Rafidah Hod
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nurul Huda Mohd Nor
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Sandra Maniam
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail:
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Hairi FM, Goh KT, Driezen P, Nordin ASA, Yee A, Tajuddin NAA, Hasan SI, Danaee M, Kamaludin IS, Kaai SC, Yan M, Grey M, Quah ACK, Thompson ME, Fong GT. Reasons for using e-cigarettes and support for e-cigarette
regulations: Findings from the 2020 ITC Malaysia Survey. Tob Induc Dis 2022; 20:33. [PMID: 35431720 PMCID: PMC8969647 DOI: 10.18332/tid/146364] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Farizah Mohd Hairi
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kok Tiong Goh
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Amer Siddiq Amer Nordin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Anne Yee
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Amani Ahmad Tajuddin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Idayu Hasan
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ina Sharyn Kamaludin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Susan C. Kaai
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Mi Yan
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Matthew Grey
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Anne C. K. Quah
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
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Driezen P, Nordin ASA, Hairi FM, Yee A, Tajuddin NAA, Hasan SI, Danaee M, Kamaludin IS, Kaai SC, Yan M, Grey M, Quah ACK, Thompson ME, Fong GT. E-cigarette prevalence among Malaysian adults and types and
flavors of e-cigarette products used by cigarette smokers who
vape: Findings from the 2020 ITC Malaysia Survey. Tob Induc Dis 2022; 20:32. [PMID: 35431719 PMCID: PMC8969646 DOI: 10.18332/tid/146363] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION E-cigarettes (ECs) have become increasingly common in many countries, including Malaysia. The prevalence of EC use increased in Malaysia from 0.8% in 2011 to 4.9% in 2019. Three quarters of Malaysian EC users also smoke combustible cigarettes, and the prevalence of EC use among Malaysian smokers in 2014 was consistent with the prevalence of use among smokers from Canada and the US in 2016. The purpose of this study was to estimate the prevalence of EC use among Malaysian adults aged ≥18 years in 2020 and the types of EC products and flavors used by cigarette smokers who also used ECs at least monthly. METHODS Data came from 1253 adults aged ≥18 years who participated in the 2020 International Tobacco Control Malaysia Wave 1 Survey. Weighted descriptive statistics were used to estimate the prevalence of adults who reported ever using ECs and the prevalence who used ECs either monthly, weekly, or daily. The types of EC products and flavors used were compared by frequency of EC use among current smokers who used ECs at least monthly (n=459). RESULTS Overall, 5.4% (95% CI: 3.7–7.5) of Malaysian adults reported using ECs on a daily basis in 2020. Among current cigarette smokers who used ECs daily, 81.0% (95% CI: 72.5–87.7) used nicotine in their ECs, 46.2% (95% CI: 37.8–54.7) used pre-filled ECs, and 60.4% (95% CI: 51.9–68.6) reported being somewhat/very addicted to ECs. The most common EC flavors were fruit, coffee, and menthol/ mint. CONCLUSIONS Continued surveillance of EC use is necessary to monitor EC use in non-tobacco using populations while longitudinal research is needed to determine the extent to which ECs are, or are not, related to quitting smoking.
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Affiliation(s)
- Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Amer Siddiq Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Amani Ahmad Tajuddin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Siti Idayu Hasan
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ina Sharyn Kamaludin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Susan C. Kaai
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Mi Yan
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Matthew Grey
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Anne C. K. Quah
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Canada
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Ontario Institute for Cancer Research, Toronto, Canada
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Wee LH, Tee GH, Chan CMH, Draman S, Jamalludin AR, Ho BK, Yn Ling JM, Lim KH, Mohd Yusoff MF, Baharom N, Robson N, Kartiwi M, Ab Rahman NS, Siau CS, Nik Mohamed MH. The Role of Media and Retailer Message Recall on Malaysian Male Perceptions of E-Cigarette Use: The 2016 National Study of E-Cigarettes Prevalence. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221079683. [PMID: 35225040 PMCID: PMC8891842 DOI: 10.1177/00469580221079683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the perceptions of current smokers on electronic cigarette (EC) use, after exposure to information on EC use and its potential harms from various media and retail outlets. This cross-sectional study is a sub-analysis of the National Study of Electronic Cigarettes Prevalence (N = 4289) using the multi-stage stratified sampling method. Respondents were interviewed face-to-face by a trained data collector using a structured questionnaire printed in both Bahasa Malaysia and English. The analysis included 376 males who smoked conventional cigarettes and/or used ECs and reported ever seeing messages on ECs/vape in various platforms were analyzed using weighted simple and multiple logistic regression. Our findings showed different media types resulted in differing perceptions among smokers towards EC use especially between social media and conventional media. Those exposed to messages promoting EC in social media had higher odds of believing that ECs help people quit smoking (OR: 2.28), the urge to smoke is reduced by ECs (OR: 1.86), ECs are more effective than medication for quitting smoking (OR: 1.96), breathing is improved after using ECs (OR: 2.85), the smell of EC is better than a tobacco cigarette (OR: 2.73), and ECs should be regulated rather than banned completely (OR: 3.08). Vape shops, social, and conventional media provided very different perceptions among smokers towards EC use. Beyond using traditional communication channels, EC promoters have successfully utilized social media to promote ECs among smokers.
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Affiliation(s)
- Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Guat Hiong Tee
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Caryn Mei Hsien Chan
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Samsul Draman
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ab Rahman Jamalludin
- Kulliyyah of Medicine, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Bee Kiau Ho
- Bandar Botanik Health Centre, Ministry of Health Malaysia, Putrajaya, Wilayah Persekutuan, Malaysia
| | - Jane Miaw Yn Ling
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Nizam Baharom
- Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Noorzurani Robson
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mira Kartiwi
- Kulliyyah of ICT, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Norny Syafinaz Ab Rahman
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Ching Sin Siau
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Mohamad Haniki Nik Mohamed
- Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia
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10
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Kavousi M, Pisinger C, Barthelemy JC, De Smedt D, Koskinas K, Marques-Vidal P, Panagiotakos D, Prescott EB, Tiberi M, Vassiliou VS, Løchen ML. Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol 2021; 28:1552-1566. [PMID: 32726563 DOI: 10.1177/2047487320941993] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/23/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Tobacco use is the single largest preventable risk factor for premature death of non-communicable diseases and the second leading cause of cardiovascular disease. In response to the harmful effects of tobacco smoking, the use of electronic cigarettes (e-cigarettes) has emerged and gained significant popularity over the past 15 years. E-cigarettes are promoted as safe alternatives for traditional tobacco smoking and are often suggested as a way to reduce or quit smoking. However, evidence suggests they are not harmless. DISCUSSION The rapid evolution of the e-cigarette market has outpaced the legislator's regulatory capacity, leading to mixed regulations. The increasing use of e-cigarettes in adolescents and young individuals is of concern. While the long-term direct cardiovascular effects of e-cigarettes remain largely unknown, the existing evidence suggests that the e-cigarette should not be regarded as a cardiovascular safe product. The contribution of e-cigarette use to reducing conventional cigarette use and smoking cessation is complex, and the impact of e-cigarette use on long-term cessation lacks sufficient evidence. CONCLUSION This position paper describes the evidence regarding the prevalence of e-cigarette smoking, uptake of e-cigarettes in the young, related legislations, cardiovascular effects of e-cigarettes and the impact of e-cigarettes on smoking cessation. Knowledge gaps in the field are also highlighted. The recommendations from the population science and public health section of the European Association of Preventive Cardiology are presented.
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Affiliation(s)
- Maryam Kavousi
- Department of Epidemiology, University Medical Center Rotterdam, The Netherlands
| | - Charlotta Pisinger
- Centre for Clinical Research and Prevention, University of Copenhagen, Denmark
| | | | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Belgium
| | | | | | | | | | | | | | - Maja-Lisa Løchen
- Department of Community Medicine, The Arctic University of Norway, Norway
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11
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Amalia B, Kapoor S, Sharma R, Singh RJ. E-cigarette retailer storefront availability following a nationwide prohibition of e-cigarettes in India: A multicentric compliance assessment. Tob Prev Cessat 2020; 6:42. [PMID: 33083675 PMCID: PMC7549508 DOI: 10.18332/tpc/123822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/27/2020] [Accepted: 06/09/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to assess the availability of retailer storefronts that continued to sell electronic nicotine/non-nicotine delivery systems (ENDS/ENNDS) in India, and characterise such retailers following the promulgation of 2019 Indian Ordinance and Act (Ordinance/Act) that prohibit ENDS/ENNDS nationwide. METHODS Discreet observations were conducted of retailer storefronts across different socioeconomic zones in nine major cities of India (Bengaluru, Chandigarh, Dehradun, Delhi, Indore, Kolkata, Ludhiana, Raipur, and Ranchi) from 28 November 2019 to 22 January 2020 to identify the availability of ENDS/ENNDS (i.e. electronic cigarettes, e-cigarette liquid, e-cigarette accessories, heated tobacco products (HTPs), and HTPs accessories). We report the number and proportion (%) of retailers that sold ENDS/ENNDS. Other characteristics of the retailers are also described, including indirect evaluation of the retailer's awareness of the Ordinance/Act. RESULTS Of the 199 retailer storefronts visited, 37 (18.6%) sold ENDS/ENNDS and, therefore, did not comply with the Ordinance/Act. The highest availability of non-compliant retailers was in Kolkata (n=26; 83.9%). The majority of the non-compliant retailers were tobacco retailers (n=35; 94.6%), sold e-cigarettes (n=22; 59.5%), and e-cigarette accessories (n=24; 64.9%). Although many of the non-compliant retailers displayed their ENDS/ENNDS products (n=33; 89.2%) and did not feature health warnings related to ENDS/ENNDS (n=32; 86.5%) in the stores, nearly 90% (n=33) were aware of the Ordinance/Act. CONCLUSIONS Despite a nationwide ban, ENDS/ENNDS are still available in major cities in India, and concentrated in a particular city. Indian authorities should focus on law enforcement to ensure that the prohibition is effectively implemented.
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Affiliation(s)
- Beladenta Amalia
- Tobacco Control Unit, Catalan Institute of Oncology, WHO Collaborating Centre for Tobacco Control, L'Hospitalet de Llobregat, Barcelona, Spain.,Tobacco Control Research Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain.,School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Consortium for Biomedical Research in Respiratory Diseases, Madrid, Spain
| | - Shivam Kapoor
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - Renu Sharma
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| | - Rana J Singh
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
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12
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Ofuchi T, Zaw AMM, Thepthien BO. Adverse Childhood Experiences and Prevalence of Cigarette and E-Cigarette Use Among Adolescents in Bangkok, Thailand. Asia Pac J Public Health 2020; 32:398-405. [PMID: 33025794 DOI: 10.1177/1010539520962956] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Currently, e-cigarettes are the most popular tobacco product among adolescents. The purpose of this study was to explore the relationship between exposure to adverse childhood experiences (ACEs) and use of cigarettes, e-cigarettes, and dual use in a sample of adolescents in Bangkok, Thailand. The sample comprises 6167 students from 48 schools (grades 9, 11, and vocational year 2) who participated in the 2019 round of the Behavior Surveillance Survey. History of 11 ACEs was used to calculate a cumulative ACE score (range 0-11). Multinomial logistic regression was used to assess the relationship between history of ACEs and smoking. In the sample, 7.0% reported using e-cigarettes only and 9.5% used e-cigarettes and cigarettes (dual use). After controlling for sociodemographic characteristics, history of ACEs was associated with increased odds of dual use. The odds of cigarette, e-cigarette, and dual use was significantly greater if the adolescent had a history of ≥4 ACEs. Special attention is needed to prevent smoking of different types among those with a history of ACEs.
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Affiliation(s)
- Takuma Ofuchi
- Niigata University of Health and Welfare, Ojiya City, Niigata Prefecture, Japan
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13
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Wipfli H, Bhuiyan MR, Qin X, Gainullina Y, Palaganas E, Jimba M, Saito J, Ernstrom K, Raman R, Withers M. Tobacco use and E-cigarette regulation: Perspectives of University Students in the Asia-Pacific. Addict Behav 2020; 107:106420. [PMID: 32251875 DOI: 10.1016/j.addbeh.2020.106420] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/28/2020] [Accepted: 03/26/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The Asia-Pacific is home to 30% of the world's smokers. Additional efforts are needed to reduce negative health impacts of tobacco, including e-cigarettes. The study objectives were to 1. Investigate Asian-Pacific students' knowledge, attitudes, and use of tobacco products; 2. Determine the level of student support for tobacco control policies; and 3. Examine differences in students' attitudes by the strength of national tobacco control policies based on implementation of WHO's MPOWER package, and e-cigarette regulation in their countries. METHODS A total of 1953 students from members of the Association of Pacific Rim Universities in 13 countries completed the online survey. We compared the results by the Fisher-Freeman-Halton test. RESULTS While about 83% of students had heard of e-cigarettes; only 14.1% had tried them. Students in countries with e-cigarette bans were the least likely to report having experimented with e-cigarettes (8.1%). While the vast majority of students (87.9%) reported having seen health campaigns targeting combustible cigarettes, far fewer (42.5%) had seen any health campaigns targeting e-cigarettes. About 80% of students supported smoke-free campuses, with the most support coming from those in countries with the weakest adoption of MPOWER policies (88.7%) and no e-cigarette regulations (80.4%). Students in countries with the weakest MPOWER policies were also the most likely to support campus bans and government regulation of e-cigarettes. CONCLUSIONS The adoption of tobacco control polices by government may have an impact on e-cigarette smoking behavior among students, and student support for tobacco control, including noncombustible products, is high. Universities should take action by adopting comprehensive tobacco control measures that include e-cigarette regulations.
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Affiliation(s)
- Heather Wipfli
- University of Southern California, Keck School of Medicine, 2001 N Soto Street, Los Angeles, CA 90032, USA.
| | - Mahfuzur Rahman Bhuiyan
- Organization for Human Development Initiatives through Research (OHDIR) Foundation, 403 East Kafrul, Dhaka Cantonment, Dhaka 1206, Bangladesh
| | - Xuezheng Qin
- Peking University, School of Economics, No 5 Yiheyuan Rd, Beijing 100871, China.
| | - Yuliya Gainullina
- Far Eastern Federal University, School of Arts and Humanities, Sukhanova 8, Vladivostok, Russia.
| | - Erlinda Palaganas
- University of the Philippines Baguio, Governor Pack Road, Baguio City 2600, Philippines.
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Junko Saito
- Division of Prevention, Centre for Public Health Sciences, National Cancer Centre, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
| | - Karin Ernstrom
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine of USC University of Southern California, 9860 Mesa Rim Rd, San Diego, CA 92121, USA.
| | - Rema Raman
- University of Southern California, Keck School of Medicine. 2001 N Soto Street SSB 318G, Los Angeles, CA 90032, USA.
| | - Mellissa Withers
- University of Southern California, Keck School of Medicine, 2001 N Soto Street, Los Angeles, CA 90032, USA.
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14
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Lim KH, Heng PP, Nik Mohamed MH, Teh CH, Mohd Yusoff MF, Ling JMY, Baharom N, Wee LH, Chan CMH, Ho BK, Robson Z, Draman S, Ab Rahman NS, Kartiwi M, Ab Rahman J. Prevalence and Factors Associated With Attempts to Quit and Smoking Cessation in Malaysia. Asia Pac J Public Health 2020; 31:22S-31S. [PMID: 31802718 DOI: 10.1177/1010539519874944] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Smoking cessation significantly reduces risk of smoking-related diseases and mortality. This study aims to determine the prevalence and factors associated with attempts to quit and smoking cessation among adult current smokers in Malaysia. Data from the National E-Cigarette Survey 2016 were analyzed. Forty nine percent of current smokers had attempted to quit at least once in the past 12 months and 31.4% of the respondents were former smokers. Multivariable analysis revealed that current smokers with low nicotine addiction and aged below 45 years were more likely to attempt to quit smoking. Being married, older age group, and having tertiary education were significantly associated with smoking cessation. Only half of the current smokers ever attempted to quit smoking and only a third of smokers quit. Stronger tobacco control policies are needed in Malaysia to encourage more smokers to quit smoking. Improved access to cessation support for underprivileged smokers is also needed.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Jane Miaw Yn Ling
- Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Nizam Baharom
- Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Klang, Malaysia
| | | | - Samsul Draman
- International Islamic University Malaysia, Kuantan, Malaysia
| | | | - Mira Kartiwi
- International Islamic University Malaysia, Kuantan, Malaysia
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15
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Gartner C, Yusoff HM. The Emergence of New Nicotine Products in Malaysia. Asia Pac J Public Health 2019; 31:6S-8S. [PMID: 31802719 DOI: 10.1177/1010539519882794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Coral Gartner
- Faculty of Medicine, School of Public Health, University of Queensland, Brisbane, Queensland, Australia.,Faculty of Health and Behavioural Sciences, Queensland Alliance for Environmental Health Sciences, University of Queensland, Brisbane, Queensland, Australia
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