Electronic cigarette related topics with conflicting arguments in Chinese newspapers

Construction of a 'civilised smoking environment': a novel strategy undermining tobacco control efforts in China

OBJECTIVE

In 2018, the Chinese tobacco industry initiated the nationwide 'civilised smoking environment' campaign via a 5-year action plan. The goal of this study was to analyse content of reports regarding this topic as evidence to policy-makers to prevent interference from the tobacco industry.

METHODS

A search of WiseNews, a Chinese media information service provider, for reports regarding the 'civilised smoking environment' between January 2018 and December 2022. Reports were coded separately by two trained researchers using a codebook developed by the team, including four sections with 19 items.

RESULTS

A total of 1062 reports were included, of which 66.5% were from general media. Key themes include mention of approaches to promote the civilised smoking environment (59.8%), primarily by establishing civilised smoking areas (86.1%). A majority of reports (72.9%) disclosed key promoters of these initiatives, including the Tobacco Monopoly Administration (69.5%), Tobacco Corporation (52.3%) and other government agencies (20.4%). Funders were mentioned in 252 reports (23.7%), primarily the Tobacco Monopoly Administration (60.3%) and Tobacco Corporation (50.8%). Most reports (92.8%) supported these initiatives, while only 45 (4.2%) opposed it.

CONCLUSIONS

'Civilised smoking environment' in China was promoted and financed primarily by tobacco industry and widely supported by media. This undermines smoke-free environments and violates the WHO Framework Convention on Tobacco Control. China's government should cease its involvement in these initiatives, and government agencies should refrain from agreeing, supporting, cooperating or participating in these activities.

Understanding stakeholder responses to the electronic cigarette flavor ban in China: A news media analysis

OBJECTIVES

Electronic cigarettes (e-cigarettes) have been attracting users around the world due in part to appealing flavors. Many countries and regions have now taken action to limit the sales of flavored e-cigarettes. In 2022, China implemented a flavor ban on e-cigarettes, prohibiting all but tobacco-flavor. It is important for international tobacco control efforts to understand responses to the ban by analyzing news media content.

STUDY DESIGN

Articles identified through keyword searches in the HuiKe newspaper database were qualitatively examined by thematic analysis, focusing on stakeholder reactions and regulatory impacts.

METHODS

Using HuiKe news database and searching between May 1, 2022, and March 1, 2023, 125 news articles were identified and coded using thematic analysis to explore the main stakeholders mentioned in relation to the e-cigarette flavor ban, actions undertaken, and perceptions expressed.

RESULTS

Four stakeholders were identified: administrative departments, businesses, users and the public. Eight themes were developed through analysis: the purpose of the prohibition, supervision and penalties for illegal products, approaches adopted for legal sales, approaches adopted for illegal sales, shifting use habits, speculation about the impact of the prohibition, health concerns, and suggestions for reducing illegal sales.

CONCLUSION

The study revealed that enforcement of the policy is portrayed as a significant concern and that controlling the spread of illegal online sales remains a significant challenge. A comprehensive regulatory strategy to address youth e-cigarette use more effectively is urgently needed. Adaptive e-cigarettes control policy should co-evolve with ever-changing industries and markets.

Media Search Frequency, Source Credibility About e-Cigarette Health Information, and Motivation to Quit EC Among University Students in Chengdu, China

Purpose

E-cigarettes (ECs) are gaining popularity among young people. This study aimed to assess university student vapers' search frequency and source credibility of commonly used media in China, and their association with daily EC users' motivation to quit EC use.

Participants and Methods

This was a cross-sectional study involving an online quantitative survey in six universities in Chengdu, China. Participants answered questions on their EC use patterns, motivation to quit EC, use frequency and source credibility of media use. Hierarchical linear regression analyses were performed to determine the association between media search frequency and source credibility concerning EC health information with the motivation to quit EC.

Results

There were a total of 325 participants (Mean age = 20.43, SD = 1.333). Video platforms and social media were ranked frequently used by the participants and were deemed to be more trustworthy. Perceived trustworthiness of online media was the most influential predictor of motivation to quit EC. Those who reported a higher frequency of accessing video platforms and medical health applications recorded higher motivation to quit EC use. Source credibility of news portals were associated higher motivation to quit EC. The association between higher nicotine dependence and lower motivation to quit EC was attenuated when media source credibility and trustworthiness of online media were added into the fully adjusted regression models.

Conclusion

There is an association between media use frequency and source credibility to search for EC health information and motivation to quit vaping. More studies could be conducted to examine the effects of media use content on perceptions towards vaping and their motivation to quit vaping.

E-cigarette awareness and use, among adult residents in Shanghai, China

INTRODUCTION

The widespread popularity of e-cigarettes is considered an important public health concern. However, only some studies have investigated the prevalence of e-cigarette use in Shanghai, China. Research on the perceived harmfulness of e-cigarettes and public support for e-cigarette regulations in China is limited. This study aimed to estimate e-cigarette awareness, prevalence, and associated factors among adults in Shanghai, China.

METHODS

This study used data from a representative survey conducted in Shanghai, China, in 2019. The survey was conducted at 64 surveillance points in Shanghai, China, using a multistage, stratified, cluster-randomized sampling design, recruiting community-based Chinese adults aged ≥15 years. Based on the principles outlined in the Global Adult Tobacco Survey (GATS) China Project, data were collected by conducting face-to-face interviews in households. Of the 3200 selected households, 3060 people completed the individual survey. The overall response rate was 97.4%.

RESULTS

In all, 72.3% of the respondents had heard of e-cigarettes. The respondents who had used e-cigarettes at some point in their life, used them in the last 12 months, and used them currently were 5.8%, 2.6%, and 1.3%, respectively. Among adult residents who had heard of e-cigarettes, 38.2% thought they were less harmful than traditional cigarettes. The respondents who perceived e-cigarettes as more harmful than traditional cigarettes were less likely to have ever used e-cigarettes (AOR=0.2; 95% CI: 0.1-0.5, p=0.0015) and more likely to support incorporating e-cigarettes into the regulation of smoking control (AOR=3.9; 95% CI: 1.8-8.6, p=0.0008).

CONCLUSIONS

Our findings reveal that the awareness about e-cigarettes was high, and the prevalence of e-cigarette use was similar to the findings from previous studies in China. The harmful perception of e-cigarettes warrants further attention from public health practitioners.

Cigarette, e-cigarette and waterpipe cognitions and use among university students in Guangzhou, China

INTRODUCTION

There is currently little research on polytobacco use in China. The present study examined cognitions that predicted the use of cigarettes, e-cigarettes and waterpipes in a Chinese sample of students.

METHODS

A convenience sample of 281 university students, obtained using snowball sampling, completed an online survey during the 2019-2020 academic year in Guangzhou, China.

RESULTS

Men more strongly agreed, than women, with the possible advantages of using alternative nicotine and tobacco products, including: young people who smoke have more friends, smoking makes young people look cool, smoking makes young people feel more comfortable, smoking helps relieve stress, and it would be easy to quit. Factors significantly associated with regular cigarette use were the cognitions: 'I would smoke if my best friend offered', 'Young people who use these products have more friends', and 'It would be easy to quit these products' (global good classifications= 80.1%). In the case of waterpipes, agreement with the cognition: 'The product helps people relieve stress' was significantly associated with its use (global good classifications=80.1%). In the case of e-cigarettes, agreement with the cognitions: 'I would smoke if my best friend offered' and 'It would be easy to quit using these products' were significantly associated with the use of e-cigarettes (global good classifications=74.7%).

CONCLUSIONS

The results highlight the need to develop prevention programs that prepare young Chinese people to resist social pressure from friends to use tobacco products. There is also evidence of the need to facilitate and disseminate rigorous scientific information among young people about the possible negative health effects of alternative tobacco products. There were also gender differences in the use of these products and in the cognitions towards their use, so it is important to take the gender perspective into account in the analysis of the results and when writing future questionnaire items.

The portrayal of electronic cigarettes in Indonesia: a content analysis of news media

BACKGROUND

The news media play an essential role in shaping public opinion. Analyzing a specific issue reported in the news media provides insight and considerations for a government to form a policy. This study aimed to assess the portrayal of electronic cigarettes (e-cigarettes) in Indonesian news media, including the variety of arguments being presented and the actors behind them.

METHODS

We used a paid service database from eBdesk to collect Indonesian news articles from 2020 to 2021 using the keywords 'rokok elektronik' (electronic cigarette), 'rokok elektrik' (electric cigarette), 'e-rokok' (e-cigarette), 'vape', and 'vaping'. Content analysis of 551 full-text news articles was conducted to identify the concepts, topics, and frames of quoted arguments and to examine whether any frames were presented by different types of organizations and the origin of actors.

RESULTS

News articles related to e-cigarettes were mostly published in the national newspaper and in the non-health section of the newspaper desk. A total of 891 arguments from 393 persons representing 212 institutions were identified. Twenty-eight concepts were further categorized into 12 topics. Health impact was the most frequently reported topic, followed by regulation, tax/price, and e-cigarettes as smoking cessation tools. Overall, the articles and arguments with positive tones toward e-cigarettes outnumbered negative articles and arguments. The industry, university, and research-based institutions were the most involved types of organizations in the news articles. There were more neutral frames toward e-cigarettes among government, even though the frame within the non-health government sector was reported to be more positive toward e-cigarettes.

CONCLUSIONS

Although health impact is the most reported topic, the actors involved in delivering arguments were mainly from the non-health sector, including when the news articles were published by the newspaper desk. The e-cigarette issue in Indonesia was mainly played by the non-health sector, which is more inclined toward economic interest than health.