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1
Rostron, Brian L., Joanne T. Chang, Cindy M. Chang, Rebecca A. Jackson, and Bridget K. Ambrose. "ENDS Flavor Preference by Menthol Cigarette Smoking Status among US Adults, 2018–2019." International Journal of Environmental Research and Public Health 18, no. 1 (December 31, 2020): 240. http://dx.doi.org/10.3390/ijerph18010240.
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E-cigarette flavor preference may differ among smokers using e-cigarettes, but little information is available on preferences by menthol cigarette status. Using nationally representative data for US adults from the 2018–2019 Tobacco Use Supplement to the Current Population Survey, we analyzed e-cigarette flavor preference by menthol cigarette status and e-cigarette device type for dual-cigarette and e-cigarette users and e-cigarette users who had recently quit smoking by trying to switch to e-cigarettes (“switchers”). Approximately half (52.2%) of dual users of menthol cigarettes and e-cigarettes reported using menthol/mint-flavored e-cigarettes as did 41.4% of “switchers” who had smoked menthol cigarettes; exclusive menthol/mint flavor use was 13.1% for dual users and 21.3% for “switchers.” A similar proportion (45.1%) of dual users who smoked nonmenthol cigarettes used tobacco-flavored e-cigarettes, but only 26.7% of “switchers” who had smoked nonmenthol cigarettes used tobacco-flavored e-cigarettes. Approximately 60% of dual users and “switchers” used fruit/other flavors, regardless of menthol cigarette use. By device type, 63.9% of dual users of cartridge-based e-cigarettes and menthol cigarettes used menthol/mint-flavored e-cigarettes. Approximately 75% of dual users and 85% of “switchers” who used tank or mod systems used fruit/other flavors. Menthol cigarette smokers may be particularly likely to use menthol/mint e-cigarettes, and a majority of dual users and “switchers” used fruit/other flavors. These results can inform policy measures concerning flavored electronic nicotine delivery system products.
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Olonoff, Matthew, Raymond Niaura, and Brian Hitsman. "“Electronic Cigarettes” Are Not Cigarettes, and Why That Matters." Nicotine & Tobacco Research 21, no. 10 (September 28, 2018): 1441–44. http://dx.doi.org/10.1093/ntr/nty205.
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Abstract As the prevalence rates of cigarette use have declined over the past decade, use of electronic cigarettes (e-cigarettes) continues to increase, and companies are heavily invested in manufacturing new e-cigarette products. Scientists are therefore studying e-cigarette use at a rapid rate, generally by conceptualizing e-cigarettes as similar to traditional cigarettes in their use and effects. Thinking of e-cigarettes as largely comparable with cigarettes, however, fails to capture the unique e-cigarette capabilities, user experiences, and effects on nicotine dependence and even health. Assuming that e-cigarette users puff on their devices as they do cigarettes to attain doses of nicotine comparable in magnitude and asking questions about e-cigarette use modeled after how smoking behavior has been usually assessed (eg, puff number, duration, number of cigarettes per day) may miss important differences. A greater appreciation of the distinct uniqueness of e-cigarettes, as compared with cigarettes, will help to accelerate innovative research on e-cigarettes and other electronic devices, leading to new theoretical models and behavioral measures. Implications With research about electronic cigarettes (e-cigarettes) rapidly increasing, this commentary addresses the conceptualization of e-cigarettes as similar to traditional cigarettes. The more we attempt to understand and measure e-cigarettes as equivalent to cigarettes, the more likely research may err in conclusions about these unique devices. Our commentary notes how using unique conceptualizations and measures for e-cigarettes will help accelerate new research.
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Espinoza-Derout, Jorge, Kamrul M. Hasan, Xuesi M. Shao, Maria C. Jordan, Carl Sims, Desean L. Lee, Satyesh Sinha, et al. "Chronic intermittent electronic cigarette exposure induces cardiac dysfunction and atherosclerosis in apolipoprotein-E knockout mice." American Journal of Physiology-Heart and Circulatory Physiology 317, no. 2 (August 1, 2019): H445—H459. http://dx.doi.org/10.1152/ajpheart.00738.2018.
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Electronic cigarettes (e-cigarettes), also known as electronic nicotine delivery systems, are a popular alternative to conventional nicotine cigarettes, both among smokers and those who have never smoked. In spite of the widespread use of e-cigarettes and the proposed detrimental cardiac and atherosclerotic effects of nicotine, the effects of e-cigarettes on these systems are not known. In this study, we investigated the cardiovascular and cardiac effects of e-cigarettes with and without nicotine in apolipoprotein-E knockout (ApoE−/−) mice. We developed an e-cigarette exposure model that delivers nicotine in a manner similar to that of human e-cigarettes users. Using commercially available e-cigarettes, bluCig PLUS, ApoE−/− mice were exposed to saline, e-cigarette without nicotine [e-cigarette (0%)], and e-cigarette with 2.4% nicotine [e-cigarette (2.4%)] aerosol for 12 wk. Echocardiographic data show that mice treated with e-cigarette (2.4%) had decreased left ventricular fractional shortening and ejection fraction compared with e-cigarette (0%) and saline. Ventricular transcriptomic analysis revealed changes in genes associated with metabolism, circadian rhythm, and inflammation in e-cigarette (2.4%)-treated ApoE−/− mice. Transmission electron microscopy revealed that cardiomyocytes of mice treated with e-cigarette (2.4%) exhibited ultrastructural abnormalities indicative of cardiomyopathy. Additionally, we observed increased oxidative stress and mitochondrial DNA mutations in mice treated with e-cigarette (2.4%). ApoE−/− mice on e-cigarette (2.4%) had also increased atherosclerotic lesions compared with saline aerosol-treated mice. These results demonstrate adverse effects of e-cigarettes on cardiac function in mice. NEW & NOTEWORTHY The present study is the first to show that mice exposed to nicotine electronic cigarettes (e-cigarettes) have decreased cardiac fractional shortening and ejection fraction in comparison with controls. RNA-seq analysis reveals a proinflammatory phenotype induced by e-cigarettes with nicotine. We also found increased atherosclerosis in the aortic root of mice treated with e-cigarettes with nicotine. Our results show that e-cigarettes with nicotine lead to detrimental effects on the heart that should serve as a warning to e-cigarette users and agencies that regulate them.
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Jacob, Peyton, Gideon St. Helen, Lisa Yu, Natalie Nardone, Christopher Havel, Polly Cheung, and Neal L. Benowitz. "Biomarkers of Exposure for Dual Use of Electronic Cigarettes and Combustible Cigarettes: Nicotelline, NNAL, and Total Nicotine Equivalents." Nicotine & Tobacco Research 22, no. 7 (December 13, 2019): 1107–13. http://dx.doi.org/10.1093/ntr/ntz235.
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Abstract Introduction Dual use of electronic cigarettes (e-cigarettes) and combustible cigarettes is a major public health issue. It is generally accepted that exclusive e-cigarette use is less harmful than exclusive combustible cigarette use, but most e-cigarette users continue to smoke combustible cigarettes as well. To what extent the use of e-cigarettes reduces harm in people who continue to smoke combustible cigarettes has been debated. The aim of this study was to explore the utility of biomarkers as measures of dual use. Methods In two human studies of participants who used e-cigarettes only or both combustible cigarettes and e-cigarettes, we measured urine concentrations of the metabolites of nicotine (total nicotine equivalents) as well as two biomarkers of tobacco exposure: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a tobacco-specific carcinogen metabolite, and nicotelline, a tobacco alkaloid not found in significant concentrations in e-cigarette products. Results The presence of nicotine metabolites indicates either e-cigarette or combustible cigarette use. Nicotelline (half-life of 2–3 hours) indicates recent combustible cigarette use and NNAL (half-life of 10 days or more), indicates combustible cigarette use occurring within several weeks prior to sample collection. Conclusions Nicotelline and NNAL are useful biomarkers for combustible tobacco use in users e-cigarettes. The application of these biomarkers provides a tool to help assess whether, or to what extent, dual use of e-cigarettes and combustible cigarettes reduces harm compared to sole use of combustible cigarettes. These biomarkers can also verify exclusive use of e-cigarettes over short (24 hour) or long (several week) time periods. Implications: To what extent dual use of e-cigarettes and combustible cigarettes reduce harm compared to smoking combustible cigarettes only is of considerable public health interest. We show that the levels of the minor tobacco alkaloid nicotelline and the nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) are extremely low in electronic cigarette fluids. The urine biomarkers nicotelline and the NNK metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) are indicative of cigarette smoking and can be used to assess recent and past smoking in dual users.
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Brożek, Grzegorz Marek, Mateusz Jankowski, Joshua Allan Lawson, Andrei Shpakou, Michał Poznański, Tadeusz Maria Zielonka, Ludmila Klimatckaia, et al. "The Prevalence of Cigarette and E-cigarette Smoking Among Students in Central and Eastern Europe—Results of the YUPESS Study." International Journal of Environmental Research and Public Health 16, no. 13 (June 28, 2019): 2297. http://dx.doi.org/10.3390/ijerph16132297.
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Electronic cigarettes (e-cigarettes) are an alternative to traditional tobacco cigarette smoking. The aim of this study was to assess the prevalence of cigarette smoking and e-cigarette use among university students from Central and Eastern Europe and to investigate personal characteristics associated with cigarette and e-cigarette smoking. A questionnaire-based cross-sectional survey was performed between 2017–2018 among university students in five European countries: Belarus, Lithuania, Poland, Russia, and Slovakia. The questionnaire included 46 questions related to the frequency and habits of traditional cigarettes and e-cigarettes use. Completed questionnaires were obtained from 14,352 students (8800 medical; aged 20.9 ± 2.4 years) with an overall response rate of 72.2%. Two-thirds of the respondents had smoked a traditional tobacco cigarette and 43.7% had used an e-cigarette. Overall current smoking status included 12.3% traditional cigarette smokers, 1.1% e-cigarette users, and 1.8% were dual users with the remainder being non-smokers. Smoking status differed between the research centres (p < 0.001). Females were less likely to try either cigarettes (OR = 0.83) or e-cigarettes (OR = 0.62) and were less likely to be current cigarette (OR = 0.64), e-cigarette (OR = 0.34), or dual users (OR = 0.33) than males. Perception of e-cigarettes significantly differed between smokers and non-smokers (p < 0.001). Among university students, cigarettes are more popular than e-cigarettes.
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Ebrahimi Kalan, Mohammad, Karma McKelvey, Boubakari Ibrahimou, Elisa M. Trucco, and Ziyad Ben Taleb. "The Road to Vaping: E-cigarette Susceptibility and Curiosity Among U.S. Adolescents Susceptible and Nonsusceptible to Cigarette Smoking." Health Education & Behavior 47, no. 5 (July 22, 2020): 696–705. http://dx.doi.org/10.1177/1090198120943166.
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Background. Electronic cigarettes (e-cigarettes) are the most commonly used tobacco product among adolescents. We aimed to identify factors associated with e-cigarette susceptibility and curiosity among adolescents who are and are not susceptible to cigarette smoking. Method. Data were drawn from the 2018 U.S. National Youth Tobacco Survey. The study sample comprised 13,428 never cigarette or e-cigarette users. Four distinct weighted multivariable regression models were performed to assess associations between covariates and e-cigarette curiosity and susceptibility. Results. Among adolescents susceptible to smoking cigarettes, non-Hispanic (NH) Black participants were less likely to be susceptible to (adjusted odds ratio [aOR] = 0.42, 95% confidence interval [CI] [0.26, 0.67]) and curious about (aOR = 0.61, 95% CI [0.39, 0.95]) e-cigarettes than NH Whites. Among adolescents nonsusceptible to smoking cigarettes, Hispanics were more susceptible to (aOR = 1.33, 95% CI [1.04, 1.71]) and curious about (aOR = 1.29, 95% CI [1.02, 1.62]) e-cigarettes than NH Whites. Among adolescents (both susceptible and nonsusceptible to smoking cigarettes), being female, exposure to e-cigarette aerosol in public places, exposure to e-cigarette ads at point-of-sale, and having low perceived harm and addictiveness of e-cigarettes versus cigarettes were associated with having greater odds of susceptibility toward and curiosity about e-cigarette use. Conclusions. Future regulatory policies and tobacco control prevention campaigns should focus on increasing health awareness (e.g., potential harm and addictiveness) of e-cigarettes among adolescents and restrict marketing and the use of e-cigarettes in public places.
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Yadayna, Khofifatul. "Cigarette Rod Sorting System on Conveyors." Jurnal Jartel: Jurnal Jaringan Telekomunikasi 10, no. 1 (March 12, 2020): 8–12. http://dx.doi.org/10.33795/jartel.v10i1.160.
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Kretek cigarettes are a type of cigarette that is still in demand today. The manufacturing of kretek cigarettes in factories still has limitations, especially in the process weighing cigarettes per stick. From this problem, a tool is needed to separate cigarettes based on the weight of the cigarette that has been determined per stick. And the results of the cigarette weight sorter can be monitored via the website to reduce errors in the size of the clove cigarette. The method used in this study is to make a cigarette sorting tool using a conveyor with a DC servo motor component as a driving force for the conveyor to be 3 parts by weight, namely parts weigh <1.5 grams, parts weight> 1.5 grams and parts = 1.5. gram. Based on the results of the study, 1 pack of cigarettes where each pack contains 12 cigarettes shows that there are 2 cigarettes <1.5 grams, 7 cigarettes> 1.5 grams and 3 cigarettes corresponding to 1.5 grams. The results of the study indicate that the manufacture of a cigarette sorting system on the conveyor can help the cigarette weighing process to be more precise.
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Dowd, Ashley N., and Stephen T. Tiffany. "Comparison of Tobacco and Electronic Cigarette Reward Value Measured During a Cue-Reactivity Task: An Extension of the Choice Behavior Under Cued Conditions Procedure." Nicotine & Tobacco Research 21, no. 10 (July 13, 2018): 1394–400. http://dx.doi.org/10.1093/ntr/nty143.
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Abstract Introduction Up to 24% of electronic cigarette (e-cigarette) users are concurrent users of both tobacco and e-cigarettes (dual users). Dual users provide an opportunity to assess key motivational processes supporting e-cigarette use, such as the reward value of e-cigarettes. This study used the Choice Behavior Under Cued Conditions procedure to examine cue-specific reactions to tobacco and e-cigarettes with a primary focus on evaluating the relative reward value of both forms of cigarettes. Methods Fifty-four dual users were exposed to a lit tobacco cigarette, their own e-cigarette, or a cup of water across multiple trials. On each trial, participants rated their craving for both tobacco and e-cigarettes and indicated the amount of money they would spend to access the cue. Key measures included craving, amount of money spent to access the cue, latency to access the cue, spending choice time, and consumption. Results Participants reported significantly higher craving and spent significantly more money on tobacco and e-cigarette trials than on water trials. The magnitude of cue-specific craving was comparable across tobacco and e-cigarettes, but participants spent significantly more to access tobacco cigarettes than e-cigarettes. Conclusions This is the first study to demonstrate cue-specific reactivity to e-cigarettes utilizing a neutral comparison condition and to examine the reward value of e-cigarettes relative to tobacco cigarettes. Overall, the data suggest that e-cigarette puffs are less valued and generate less craving than tobacco cigarette puffs for dual users. The data provide clear support for the utility of Choice Behavior Under Cued Conditions for examining a range of motivational processes supporting e-cigarette use. Implications The test procedure used in this research generates multiple indices of nicotine and tobacco motivation and allows for an explicit comparison of those variables in people who use both e-cigarettes and tobacco cigarettes.
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Romijnders, Kim, Liesbeth van Osch, Hein de Vries, and Reinskje Talhout. "A Deliberate Choice? Exploring the Decision to Switch from Cigarettes to E-Cigarettes." International Journal of Environmental Research and Public Health 16, no. 4 (February 20, 2019): 624. http://dx.doi.org/10.3390/ijerph16040624.
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E-cigarettes are increasingly popular among both cigarette smokers and non-users. Although smoking cessation yields the most individual and population health benefits, switching to exclusive e-cigarette use offers some individual health benefits for cigarette smokers. However, e-cigarette use is not harmless, and its use among non-cigarette smokers should be prevented. Our study aims to explore the decision-making process about e-cigarettes among an e-cigarette users, cigarette smokers, and non-users. We conducted 12 semi-structured focus group interviews with e-cigarette users, cigarette smokers, and non-users. We performed a thematic analysis of the interview transcripts. First, knowledge reported by e-cigarette users was mainly based on other users’ experiences. Second, cigarette smokers and non-users were more negative towards e-cigarettes than e-cigarette users. Third, e-cigarette users considered switching from cigarette smoking to e-cigarette use by deliberating relevant information, and weighing up the benefits and disadvantages of e-cigarette use versus smoking. Additionally, important factors in the decision-making process were a perception of risks and benefits of e-cigarettes compared to cigarettes, a supportive social environment about e-cigarette use, and trust in information offered about the risks and benefits of e-cigarettes. Our findings provide insight into what we can learn from the conscious decision-making process of e-cigarette users who switched from cigarettes to e-cigarettes. This information can be considered to develop targeted communications strategies to stimulate a conscious decision-making process, these may highlight benefits of switching to e-cigarettes for cigarette smokers, discussing the risks of smoking, and correcting misperceptions about the perceived risks and benefits of e-cigarette use.
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Alcalá, Héctor E., and Sandhya V. Shimoga. "It Is About Trust: Trust in Sources of Tobacco Health Information, Perceptions of Harm, and Use of E-Cigarettes." Nicotine & Tobacco Research 22, no. 5 (January 26, 2019): 822–26. http://dx.doi.org/10.1093/ntr/ntz004.
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Abstract Introduction Recent research has highlighted disparities in people who perceive as trustworthy sources of e-cigarette health information. Research has yet to examine if trusting a particular source of information is associated with use of e-cigarettes or perceptions of e-cigarette harm. We use a nationally representative survey of American adults to address these gaps in knowledge. Methods This study used data from the Health Information National Trends Survey (N = 3738). Logistic regression models were used to calculate odds of ever using e-cigarettes and perceived health harm of e-cigarettes. Trust in seven different sources of e-cigarette health information served as the independent variables. Models accounted for confounders. Results Trusting religious organizations “a lot” as sources of e-cigarette health information was associated with lower odds of ever using e-cigarettes and with lower odds of perceiving e-cigarettes as less harmful than conventional cigarettes. Trusting e-cigarette companies “a lot” as sources of e-cigarette health information was associated with lower odds of viewing e-cigarettes as harmful to health. Conclusion Trusting health information about e-cigarettes from sources in the medical or public health field was not associated with lower use of e-cigarettes or viewing e-cigarettes as more harmful. Trusting health information from e-cigarette companies yielded perceptions of e-cigarette harm that are consistent with messaging provided by these companies. Implications As use of e-cigarettes continues to climb, leveraging different modes of health communication will be critical to both discourage e-cigarette use among never-smokers and, potentially, to encourage use of e-cigarettes as an option to achieve smoking cessation or reduce the harm of tobacco products. Our findings suggest that religious organizations may be helpful in communicating anti-e-cigarette messages.
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Jankowski, Krzystanek, Zejda, Majek, Lubanski, Lawson, and Brozek. "E-Cigarettes are More Addictive than Traditional Cigarettes—A Study in Highly Educated Young People." International Journal of Environmental Research and Public Health 16, no. 13 (June 27, 2019): 2279. http://dx.doi.org/10.3390/ijerph16132279.
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E-cigarettes are often considered less addictive than traditional cigarettes. This study aimed to assess patterns of e-cigarette use and to compare nicotine dependence among cigarette and e-cigarette users in a group of highly educated young adults. From 3002 healthy adults, a representative group of 30 cigarette smokers, 30 exclusive e-cigarette users, and 30 dual users were recruited. A 25-item questionnaire was used to collect information related to the patterns and attitudes towards the use of cigarettes and e-cigarettes. The Fagerström test for nicotine dependence (FTND) and its adapted version for e-cigarettes were used to analyze nicotine dependence in each of the groups. The nicotine dependence levels measured with FTND were over two times higher among e-cigarette users (mean 3.5) compared to traditional tobacco smokers (mean 1.6; p<0.001). Similarly, among dual users, nicotine dependence levels were higher when using an e-cigarette (mean 4.7) compared to using traditional cigarettes (mean 3.2; p=0.03). Habits and behaviors associated with the use of e-cigarettes did not differ significantly (p>0.05) between exclusive e-cigarette users and dual users. The findings suggest that e-cigarettes may have a higher addictive potential than smoked cigarettes among young adults.
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Vandrevala, Tushna, Adrian Coyle, Victoria Walker, Joshelyn Cabrera Torres, Izobel Ordoña, and Panna Rahman. "‘A good method of quitting smoking’ or ‘just an alternative to smoking’? Comparative evaluations of e-cigarette and traditional cigarette usage by dual users." Health Psychology Open 4, no. 1 (January 2017): 205510291668464. http://dx.doi.org/10.1177/2055102916684648.
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The development of e-cigarettes was initially hailed as a resource in facilitating a reduction in or cessation of cigarette smoking. Many users of e-cigarettes are ‘dual users’, smoking traditional cigarettes and e-cigarettes. The present qualitative study examines the factors that a group of 20 dual users considered to have been influential in their decisions to use e-cigarettes and their comparative evaluations of e-cigarettes and traditional cigarettes. Health concerns were not found to be sole motivators. Participants pointed to financial and contextual considerations, particularly peer influence on uptake and continued usage of e-cigarettes. E-cigarettes were evaluated as comparable to cigarettes in some ways but not in other important respects such as sensation and satisfaction. Different social evaluations of cigarette and e-cigarette usage were discerned which influenced how participants identified as smokers, ‘vapers’ or neither. Findings are discussed in relation to social representations, identity and implications for continued e-cigarette usage among dual users.
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Yang, Bo, Jiaying Liu, and Lucy Popova. "Feeling Hopeful Motivates Change: Emotional Responses to Messages Communicating Comparative Risk of Electronic Cigarettes and Combusted Cigarettes." Health Education & Behavior 46, no. 3 (February 10, 2019): 471–83. http://dx.doi.org/10.1177/1090198118825236.
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Background. Emotions are important in smoking-related communications, but the role of discrete positive and negative emotions in comparative risk messages about combusted and electronic cigarettes (e-cigarettes) is unclear. Method. In an online experiment, 1,202 U.S. adult current smokers or recent quitters were randomized to view one of six messages about comparative risk of e-cigarettes and cigarettes. Participants reported their feelings of hope, happiness, fear, guilt, disgust, and anger and risk perceptions and behavioral intentions about e-cigarettes and cigarettes. Results. Hope was associated with higher perceived absolute cigarette risk, lower perceived absolute and comparative e-cigarette risk, and stronger intentions to quit smoking, seek quit help, use nicotine replacement therapy (NRT), switch to e-cigarettes, and use e-cigarettes exclusively versus dual use. Happiness was related to stronger intentions to seek quit help, use NRT, and switch to e-cigarettes but higher perceived comparative risk of e-cigarettes. Fear was associated with stronger intentions to quit smoking, seek quit help, use NRT, and switch to e-cigarettes. Guilt was related to higher perceived absolute cigarette risk, lower perceived comparative e-cigarette risk, and stronger intentions to use NRT. Disgust was associated with higher absolute and comparative e-cigarette risk and stronger intentions to quit smoking, seek quit help, and use e-cigarettes exclusively versus dual use. Anger was related to lower perceived absolute cigarette risk, higher perceived comparative e-cigarette risk, and weaker intentions to quit smoking. Conclusion. Comparative risk messages about e-cigarettes that arouse hope, fear, and guilt and avoid anger might be particularly likely to have positive impact on smokers.
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Kamens, Helen M., Constanza P. Silva, Russell T. Nye, Carley N. Miller, Nayantara Singh, Joseph Sipko, Neil Trushin, et al. "Pharmacokinetic Profile of Spectrum Reduced Nicotine Cigarettes." Nicotine & Tobacco Research 22, no. 2 (March 20, 2019): 273–79. http://dx.doi.org/10.1093/ntr/ntz045.
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Abstract Introduction Spectrum research cigarettes have been developed with varying nicotine content for use in studies evaluating the effects of a regulatory policy reducing the permissible nicotine content in cigarettes. This study aimed to characterize the nicotine pharmacokinetic profile of Spectrum cigarettes. Methods Twelve daily smokers attended four sessions and had blood nicotine, exhaled carbon monoxide, and subjective effects measured before and after smoking either a single cigarette of their preferred brand or high (10.9 mg/cigarette), medium (3.2 mg/cigarette), or low (0.2 mg/cigarette) nicotine content Spectrum research cigarettes, in a double-blind design with order counterbalanced. Results The boost in blood nicotine concentration was dose-dependent, with a boost of 0.3, 3.9, and 17.3 ng/mL for low-, medium-, and high-nicotine content Spectrum cigarettes. The high dose Spectrum had a similar nicotine boost to the “preferred brand” cigarettes (19 ng/mL). Subjects took longer puffs on the low nicotine cigarettes, but smoked these cigarettes faster than other cigarette types. High nicotine Spectrum cigarettes reduced the urge to smoke more than other cigarette types. Conclusions This study shows that Spectrum research cigarettes produce blood nicotine absorption in a dose-dependent manner, and therefore, are appropriate for use in studies of nicotine reduction in cigarettes. Implications This is the first study to determine the pharmacokinetic profile of Spectrum reduced nicotine content research cigarettes following an overnight abstinence. These data could provide evidence to regulatory agencies about the effects of reduced nicotine cigarettes when considering regulations on tobacco reduction.
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Martuzevicius, Dainius, Tadas Prasauskas, Ari Setyan, Grant O’Connell, Xavier Cahours, Rémi Julien, and Stéphane Colard. "Characterization of the Spatial and Temporal Dispersion Differences Between Exhaled E-Cigarette Mist and Cigarette Smoke." Nicotine & Tobacco Research 21, no. 10 (June 19, 2018): 1371–77. http://dx.doi.org/10.1093/ntr/nty121.
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Abstract Introduction There are fundamental differences between electronic cigarettes (e-cigarettes) and conventional cigarette product categories with regards to potential environmental exposures, notably that e-cigarettes do not contain tobacco or generate side-stream emissions. Here we assess the spatial and temporal patterns of exhaled e-cigarette aerosol at a bystander’s position, and compare it with conventional cigarette smoke emissions. Methods Smokers were asked to use e-cigarettes or smoke conventional cigarettes in a room-simulating chamber. Volunteers used the products at different distances from a heated mannequin, representing a bystander, and under different room ventilation rates. Aerosol particle concentrations and size distributions at the bystander’s position were measured. Results For both product categories, the particle concentrations registered following each puff were in the same order of magnitude. However, for e-cigarettes the particle concentration returned rapidly to background values within seconds; for conventional cigarettes it increased with successive puffs, returning to background levels after 30–45 minutes. Unlike for the e-cigarette devices tested, such temporal variation was dependent on the room ventilation rate. Particle size measurements showed that exhaled e-cigarette particles were smaller than those emitted during smoking conventional cigarettes and evaporated almost immediately after exhalation, thus affecting the removal of particles through evaporation rather than displacement by ventilation. Conclusions Significant differences between emissions from the tested e- and conventional cigarettes are reported. Exhaled e-cigarette particles are liquid droplets evaporating rapidly; conventional cigarette smoke particles are far more stable and linger. Implications • Several factors potentially influencing particle behavior after exhalation of e-cigarette aerosols or emitted during smoking conventional cigarettes were studied. • Differences in particle size between those exhaled following use of e-cigarettes and those emitted during smoking of conventional cigarettes were observed. • E-cigarette particle concentrations decreased rapidly following exhalation due to evaporation. • The removal of particles following smoking conventional cigarettes was much slower and was dependent on the room ventilation rate.
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Heydari, Gholamreza, and Luk Joossens. "Trend of Smuggled Cigarette Consumption in Tehran in the Last Two Decades." Archives of Iranian Medicine 25, no. 7 (July 1, 2022): 428–31. http://dx.doi.org/10.34172/aim.2022.71.
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Background: Illicit tobacco trade is focused on Iran as a main target in the WHO’s eastern Mediterranean region. Serial studies of Cigarette Packs Survey with same method were conducted in Tehran between 2003 and 2015 to evaluate consumed smuggled cigarettes. This study as the fourth Cigarette Packs Survey is designed to indicate the trends of illicit cigarette trade in Tehran in the last two decades. Methods: A cross-sectional household study was carried out in early 2021 in Tehran on 3042 persons who smoked at least one daily cigarette for a year. The sampling method was like the sampling method used in three previous studies. Participants aged≥15 years were asked to reveal their current cigarette pack, which was either legal cigarettes (having governmental label); or illegal cigarettes (without governmental label). Results: The subjects included 2536 males (83.4%) and the mean age was 39.9±12.1 years; 1854 subjects (60.9%) showed foreign cigarettes and 1188 (39.1%) showed domestic cigarettes; 2705 (88.9%) consumed legal cigarettes and 337 (11.1%) consumed illegal cigarettes. Consumption of illegal cigarettes by gender showed greater use of smuggled cigarettes in males (11.7%vs 8.1%). No significant differences were seen based on the marital and educational status in terms of illegal cigarettes prevalence. Conclusion: Compare with previous studies, the trend of consumption of illicit cigarettes was decreasing in past two decades. This could be due to new regulation on monitoring cigarette distribution and changing illegal brands to legal as joint production.
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Koyama, Shihoko, Takahiro Tabuchi, and Isao Miyashiro. "E-Cigarettes Use Behaviors in Japan: An Online Survey." International Journal of Environmental Research and Public Health 19, no. 2 (January 14, 2022): 892. http://dx.doi.org/10.3390/ijerph19020892.
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Electronic cigarette (e-cigarette) use has become increasingly widespread throughout the world, including in Japan. However, little is known about how e-cigarettes are used in Japan, a country with heavy restrictions on nicotine-containing e-liquids and/or vaping products. This study examined e-cigarette use (e-cigarette use duration, frequency of use, device type, electrical resistance, nicotine use, favorite e-liquid flavors) among users in Japan, through an online survey using a web-based self-reported questionnaire which included questions about sex, age, combustible cigarette and heated tobacco product (HTP) use behaviors. Of 4689 e-cigarettes users analyzed, 93.5% were men and 52.9% had been using e-cigarettes for 1–3 years. Over 80% used e-cigarettes every day; 62.3% used nicotine liquid, and half of the nicotine liquid users used nicotine salt. The most popular liquid flavor was fruit (prevalence: 68.1%), followed by tobacco (prevalence: 48.4%). While 50.9% were e-cigarette single users, 35.2% were dual users (e-cigarettes and cigarettes or HTPs) and 13.8% were triple user (e-cigarettes, cigarettes and HTPs). This is the first comprehensive survey of Japanese e-cigarette users and our finding suggest more than half use nicotine liquid, although e-cigarettes containing nicotine liquid have been prohibited by the Pharmaceutical Affairs Act since 2010 in Japan. The study also showed 49.1% of participants used cigarettes and/or HTPs concurrently (dual or triple users).
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Cole, Adam, Sharon Cummins, and Shu-Hong Zhu. "Offers of Cigarettes and E-Cigarettes Among High School Students: A Population Study from California." International Journal of Environmental Research and Public Health 16, no. 7 (March 30, 2019): 1143. http://dx.doi.org/10.3390/ijerph16071143.
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Receiving offers of cigarettes or e-cigarettes can contribute to the progression from intention to actual use. However, there is a lack of data about the prevalence or characteristics of youth being offered cigarettes or e-cigarettes. A random sample of 91 high schools in the state of California (with 40,137 students) participated in the 2015–16 California Student Tobacco Survey. Offers of cigarettes and e-cigarettes in the last 30 days were assessed. Separate multilevel logistical regression models identified student characteristics associated with being offered cigarettes and e-cigarettes. On average, 11.1% and 16.1% of all students reported being offered cigarettes and e-cigarettes in the last 30 days, respectively. Among those who received offers of cigarettes, 45.5% were never smokers. Among those who received offers of e-cigarettes, 29.6% were never vapers. Male students were more likely to report being offered an e-cigarette than female students (Adjusted Odds Ratio (AOR) 1.13), as were students with friends that used e-cigarettes (AOR 5.14–23.31) and those with high sensation seeking tendencies (AOR 1.33). Similar characteristics were associated with offers of cigarettes. Including measures of offers of cigarettes and e-cigarettes in surveillance systems could help identify those at risk of future cigarette and e-cigarette use.
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Hansen, Julia, Reiner Hanewinkel, and Matthis Morgenstern. "Electronic cigarette marketing and smoking behaviour in adolescence: a cross-sectional study." ERJ Open Research 4, no. 4 (October 2018): 00155–2018. http://dx.doi.org/10.1183/23120541.00155-2018.
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The aim of this study was to investigate the association between exposure to electronic cigarette (e-cigarette) advertisements and use of e-cigarettes, combustible cigarettes and hookahs.A cross-sectional survey of 6902 German students (mean age 13.1 years, 51.3% male) recruited in six German states was performed. Exposure to e-cigarette advertisements was measured with self-rated contact frequency to three advertising images. Multilevel mixed-effect logistic regression models were used to assess associations between exposure to e-cigarette advertisement and use of e-cigarettes, combustible cigarettes and hookahs (ever and past 30 days).Overall, 38.8% of the students were exposed to e-cigarette advertisements; ever-use of e-cigarettes was 21.7%, of combustible cigarettes was 21.8% and of hookahs was 23.2%, and poly-use of all three products was 12.4%. Exposure to e-cigarette advertisements was positively related to ever and past 30-day use of e-cigarettes, combustible cigarettes, hookahs and combined use.We concluded that a considerable number of German teenagers are exposed to e-cigarette advertisement. There was a clear exposure–behaviour link, indicating that advertising contact was associated with different kinds of “vaping” and also smoking behaviour. Although causal interpretation is not possible due to the cross-sectional design, findings raise concerns about the current tobacco control policies.
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Harlow, Alyssa F., Andrew Stokes, and Daniel R. Brooks. "Socioeconomic and Racial/Ethnic Differences in E-Cigarette Uptake Among Cigarette Smokers: Longitudinal Analysis of the Population Assessment of Tobacco and Health (PATH) Study." Nicotine & Tobacco Research 21, no. 10 (July 7, 2018): 1385–93. http://dx.doi.org/10.1093/ntr/nty141.
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Abstract Introduction Sociodemographic differences in electronic cigarette use among cigarette smokers have not been previously characterized in the US adult population. Methods We analyzed longitudinal data from Waves 1 and 2 of the nationally representative Population Assessment of Tobacco and Health (PATH) study. Differences by income (based on federal poverty level (FPL)) and race/ethnicity in e-cigarette uptake at Wave 2 among cigarette smokers who were e-cigarette nonusers at Wave 1 were assessed using binomial and multinomial logistic regression. We differentiated e-cigarette users who quit cigarettes (exclusive users) from those who did not quit cigarettes (dual users). E-cigarette-related attitudes/beliefs were evaluated to understand potential contributions to sociodemographic differences in e-cigarette uptake and use patterns. Results Among 6592 smokers who were e-cigarette nonusers at Wave 1, 13.5% began using e-cigarettes at Wave 2, of whom 91.3% were dual users. Compared with non-Hispanic Whites, non-Hispanic Black, and Hispanics were less likely to become exclusive e-cigarette users (OR [Blacks] = 0.27, 95% CI = 0.09 to 0.77; OR [Hispanics] = 0.26, 95% CI = 0.09 to 0.70). Low-income smokers were less likely than higher-income smokers to become exclusive e-cigarette users (OR [<100% FPL vs. ≥200% FPL] = 0.48, 95% CI = 0.27 to 0.89). Black, Hispanic, and low-income smokers were more likely to believe e-cigarettes are more harmful than cigarettes and to have positive tobacco-related social norms. Conclusions Black, Hispanic, and low-income smokers were less likely than White and higher-income smokers to begin using e-cigarettes in the context of quitting cigarettes. Differences in e-cigarette uptake may be partly explained by perceived harm or social norms of e-cigarettes. Implications Results of this study show that the exclusive use of e-cigarettes is more prevalent in higher-income and White smokers. Our data suggest that higher-income and White smokers may be more likely to use e-cigarettes as a means to quit combustible cigarettes compared with low-income and racial/ethnic minority smokers. These findings suggest that sociodemographic differences in e-cigarette uptake and use patterns may contribute to widening disparities in cigarette smoking.
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Lee, Yue-Chune, Li-Chuan Chang, Chieh Hsu, and Pei-Ching Chen. "Comparing the Characteristics of Cigarette Smoking and e-Cigarette and IQOS Use among Adolescents in Taiwan." Journal of Environmental and Public Health 2020 (June 20, 2020): 1–8. http://dx.doi.org/10.1155/2020/7391587.
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Objectives. Our objective in this study was to identify the risk factors for cigarette, e-cigarette, and IQOS use among adolescents in Taiwan, with a particular focus on socioeconomic status, smoking status of parents and peers, cigarette promotions, and anti-tobacco campaigns. Methods. Data were obtained from the 2018 version of the annual cross-sectional Taiwan Global Youth Tobacco Survey, which is used to monitor tobacco use among Taiwanese adolescents in junior and senior high schools. The dependent variables in the study were “current cigarette smoking,” “current use of e-cigarettes,” and “current use of IQOS devices” (i.e., during the 30 days prior to survey completion). Independent variables included gender, school grade, monthly income/allowance, educational level of parents, smoking status of parents, smoking status of close friends, access to free cigarettes, exposure to cigarette advertisements, and attendance at anti-tobacco courses. Logistic regression was used in the identification of factors correlated with the current use of cigarettes, e-cigarettes, or IQOS. Results. We determined that 5.65% of the adolescents in the study were currently using cigarettes, 2.74% were currently using e-cigarettes, and 2.33% were currently using IQOS. Our analysis revealed a number of factors that have a bearing on smoking behavior, including gender, monthly allowance, educational level of parents, smoking status of parents and close friends, access to free cigarettes, and exposure to cigarette advertisements. Conclusions. The tobacco product that was most widely used by adolescents was cigarettes, followed by e-cigarettes and IQOS. The socioeconomic status, smoking status of parents/close friends, and access to cigarettes were all identified as important factors related to the current use of cigarettes, e-cigarettes, and IQOS by adolescents.
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McMillen, Robert, Jonathan D. Klein, Karen Wilson, Jonathan P. Winickoff, and Susanne Tanski. "E-Cigarette Use and Future Cigarette Initiation Among Never Smokers and Relapse Among Former Smokers in the PATH Study." Public Health Reports 134, no. 5 (August 16, 2019): 528–36. http://dx.doi.org/10.1177/0033354919864369.
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Objectives: Any potential harm-reduction benefit of electronic cigarettes (e-cigarettes) could be offset by nonsmokers who initiate e-cigarette use and then smoke combustible cigarettes. We examined correlates of e-cigarette use at baseline with combustible cigarette smoking at 1-year follow-up among adult distant former combustible cigarette smokers (ie, quit smoking ≥5 years ago) and never smokers. Methods: The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal study, surveyed 26 446 US adults during 2 waves: 2013-2014 (baseline) and 2014-2015 (1-year follow-up). Participants completed an audio computer-assisted interview in English or Spanish. We compared combustible cigarette smoking at 1-year follow-up by e-cigarette use at baseline among distant former combustible cigarette smokers and never smokers. Results: Distant former combustible cigarette smokers who reported e-cigarette past 30-day use (9.3%) and ever use (6.7%) were significantly more likely than those who had never used e-cigarettes (1.3%) to have relapsed to current combustible cigarette smoking at follow-up ( P < .001). Never smokers who reported e-cigarette past 30-day use (25.6%) and ever use (13.9%) were significantly more likely than those who had never used e-cigarettes (2.1%) to have initiated combustible cigarette smoking ( P < .001). Adults who reported past 30-day e-cigarette use (7.0%) and ever e-cigarette use (1.7%) were more likely than those who had never used e-cigarettes (0.3%) to have transitioned from never smokers to current combustible cigarette smokers ( P < .001). E-cigarette use predicted combustible cigarette smoking in multivariable analyses controlling for covariates. Conclusions: Policies and counseling should consider the increased risk for nonsmokers of future combustible cigarette smoking use as a result of using e-cigarettes and any potential harm-reduction benefits e-cigarettes might bring to current combustible cigarette smokers.
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Pu, Jia, and Xiao Zhang. "Exposure to advertising and perception, interest, and use of e-cigarettes among adolescents: findings from the US National Youth Tobacco Survey." Perspectives in Public Health 137, no. 6 (April 5, 2017): 322–25. http://dx.doi.org/10.1177/1757913917703151.
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Objective: US adolescents are exposed to high levels of advertisements for electronic cigarettes (e-cigarettes). This study aimed to examine the associations between exposure to e-cigarette advertisements and perception, interest, and use of e-cigarettes among US middle school and high school students. Methods: Data from the 2014 cross-sectional National Youth Tobacco Survey were used. Logistic regressions were conducted to model four outcomes, including perception of reduced harmfulness compared to regular cigarettes, perception of reduced addictiveness, intention to use, and current use of e-cigarettes. Main predictors were exposure to e-cigarette advertisements via four sources, including Internet, newspaper/magazines, retail stores, and TV. Results: When all the four sources of e-cigarette advertisements exposure were evaluated jointly, exposure via the Internet was associated with elevated likelihood of reporting all four outcomes related to e-cigarettes, while exposure via retail stores was associated with higher likelihood of current e-cigarette use and perception of reduced harmfulness of e-cigarettes compared to regular cigarettes ( p < .05). However, exposure via newspaper/magazines and TV was associated with lower likelihood of perceiving e-cigarettes to be less harmful or addictive ( p < .05). Conclusion: Exposure to e-cigarette advertisements via the Internet and retail stores may play a significant role in adolescents’ use and perception of e-cigarettes. The results call for more research on the influence of different sources of advertising exposure on e-cigarette use to help public health programmes curtail the fast growing use of e-cigarette products among youth.
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Harvanko, Arit M., Catherine A. Martin, Richard J. Kryscio, William W. Stoops, Joshua A. Lile, and Thomas H. Kelly. "A Prototypical First-Generation Electronic Cigarette Does Not Reduce Reports of Tobacco Urges or Withdrawal Symptoms among Cigarette Smokers." Journal of Addiction 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/6748948.
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It is unknown whether first-generation electronic cigarettes reduce smoking urges and withdrawal symptoms following a 24 h deprivation period. This study tested whether a first-generation electronic cigarette reduces smoking urges and withdrawal symptoms in cigarette smokers. Following 24 h of tobacco deprivation, using a within-subjects design, eight nontreatment seeking tobacco cigarette smokers (3 females) administered 10 puffs from a conventional cigarette or a first-generation electronic cigarette containing liquid with 0, 8 or 16 mg/ml nicotine. Conventional cigarettes ameliorated smoking urges and electronic cigarettes did not, regardless of nicotine concentration. First-generation electronic cigarettes may not effectively substitute for conventional cigarettes in reducing smoking urges, regardless of nicotine concentration.
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Al Rajeh, Ahmed M., Ilias Mahmud, Mahmudul Hassan Al Imam, Muhammad Aziz Rahman, Fariss Al Shehri, Salman Alomayrin, Nawaf Alfazae, Yousif Mohammed Elmosaad, and Ibrahim Alasqah. "E-Cigarette Use among Male Smokers in Al-Ahsa, Kingdom of Saudi Arabia: A Cross-Sectional Study." International Journal of Environmental Research and Public Health 20, no. 1 (December 22, 2022): 143. http://dx.doi.org/10.3390/ijerph20010143.
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E-cigarette use is increasing globally. Recent evidence suggests that e-cigarettes contain harmful substances that could cause adverse health outcomes. This study investigated the prevalence and associated factors of e-cigarette use among male current smokers in Saudi Arabia. We conducted a cross-sectional survey of adult male current smokers in the Al-Ahsa province of Saudi Arabia. Data were collected using a structured questionnaire. We performed logistic regression analyses to investigate the factors associated with e-cigarette use among adult male current smokers. 325 current smokers participated in the study. A third of them (33.5%) were e-cigarette users. Almost all the study participants (97.0%) had heard about e-cigarettes. Participants who were occasional smokers (Odds Ratio (OR): 2.28; 95% Confidence Interval (CI): 1.17–4.41) and had good knowledge perception of e-cigarettes (OR 3.49; 95% CI: 2.07–5.90) had higher odds of using e-cigarettes when compared to regular smokers of conventional cigarettes and current smokers with poor knowledge perception of e-cigarettes, respectively. In contrast, private employees (OR: 0.25, 95% CI: 0.07–0.85), and business owners (OR: 0.09, 95% CI: 0.01–0.63) had lower odds of using e-cigarettes compared to unemployed individuals. Compared with non-e-cigarette users, the rate of conventional cigarette smoking per day was significantly lower among e-cigarette users. Use of e-cigarette (OR: 3.57, 95% CI: 2.14–5.98), believing that e-cigarette quitting is hard (OR: 2.02, 95% CI: 1.17–3.49) and trying to quit e-cigarettes (OR: 2.17, 95% CI: 1.1–4.25) were found to be significant predictors of good knowledge perception of e-cigarettes among the current smokers. The use and knowledge perception of e-cigarettes were higher among occasional conventional male cigarette smokers than regular male smokers in Al-Ahsa province. The use of e-cigarettes as smoking cessation aids should be examined further in the Saudi Arabian setting.
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Franchyeda, Bianca, and Bintang Yinke Magdalena Sinaga. "Perception and Behavior about Electric Cigarette in Electric Cigarette Users in Medan City, Indonesia." Open Access Macedonian Journal of Medical Sciences 9, E (March 24, 2021): 235–40. http://dx.doi.org/10.3889/oamjms.2021.5701.
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BACKGROUND: As a new device and technology, the use of e-cigarettes has increased rapidly in Indonesia, e-cigarettes attract and make people curious. AIM: This study aims to determine the description of perceptions and behavior about e- cigarettes in e-cigarette users in Medan city, Indonesia. METHODS: This type of research is quantitative with descriptive design. The sample of this study was 100 electric cigarette users in Medan city, Indonesia, using consecutive sampling method. The data in this study were obtained through a questionnaire conducted in August–October 2019. RESULTS: The respondents of this study were 100 electric cigarette users, consisting of 92 men and 8 women, aged between 17 and 39 years and 42% worked as students. Some respondents had more than 1 electric cigarette device and used different atomizers on different devices. As many as, 42% of tobacco smoking respondents switched to e-cigarettes and stopped smoking. There is a decrease in the number of tobacco cigarette consumption among users who use tobacco cigarettes and electric cigarettes, respondents who had a positive perception of e-cigarettes were 51%, and most of respondents (88%) use e-cigarettes because they see the people around them. CONCLUSION: This study shows that the majority of e-cigarette users in Medan city, Indonesia, are former smokers and have a positive perception of e-cigarettes. Moreover, the most frequent reasons to start using electric cigarette are because they see others around them use it.
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Conner, Mark, Sarah Grogan, Ruth Simms-Ellis, Keira Flett, Bianca Sykes-Muskett, Lisa Cowap, Rebecca Lawton, et al. "Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study." Tobacco Control 27, no. 4 (August 17, 2017): 365–72. http://dx.doi.org/10.1136/tobaccocontrol-2016-053539.
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BackgroundIn cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use.MethodsData were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels.ResultsAt baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use.ConclusionsThis is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required.
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Aly, Ameera Syafiqah, Rokiah Mamikutty, and Jamaludin Marhazlinda. "Association between Harmful and Addictive Perceptions of E-Cigarettes and E-Cigarette Use among Adolescents and Youth—A Systematic Review and Meta-Analysis." Children 9, no. 11 (October 31, 2022): 1678. http://dx.doi.org/10.3390/children9111678.
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Background: Recognising the association between the perceived risks of e-cigarettes and e-cigarette usage among youth is critical for planning effective prevention and intervention initiatives; thus, a systematic review and meta-analysis were performed. Methods: Fourteen databases were searched for eligible studies from the Inception of database until March 2022 to examine the effect estimates of the association between perceptions of harmfulness and addictiveness and overall e-cigarette usage among adolescents and youth. Results: The meta-analysis showed that in comparison to non-users, young people who were ever e-cigarette users were two times more likely to disagree that e-cigarettes are harmful (OR: 2.20, 95% CI: 1.41–3.43) and perceived e-cigarettes as less harmful than tobacco cigarettes (OR: 2.01, 95% CI 1.47–2.75). Youths who were ever e-cigarette users were also 2.3 and 1.8 times more likely to perceive e-cigarettes as less addictive (OR: 2.28, 95% CI: 1.81–2.88) or perceive e-cigarettes as more addictive (OR: 1.82, 95% CI: 1.22–2.73) than tobacco cigarettes, as compared with non-users. The subgroup analysis reported that adolescents were more likely to believe that e-cigarettes are less harmful than tobacco cigarettes, while youth users perceived otherwise. Conclusion: the risk perceptions of e-cigarettes are associated with e-cigarette use among adolescents and youth and could be the focus of health promotion to prevent and curb the uptake of e-cigarettes among young people.
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Feng, Yitian, Fan Wang, Abu S. Abdullah, Xiaoyan Wang, Jing Wang, and Pinpin Zheng. "Beliefs, Attitudes, and Confidence to Deliver Electronic Cigarette Counseling among 1023 Chinese Physicians in 2018." International Journal of Environmental Research and Public Health 16, no. 17 (August 30, 2019): 3175. http://dx.doi.org/10.3390/ijerph16173175.
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Background: The use of electronic cigarettes (e-cigarettes) is gaining popularity, so it is important to evaluate physicians’ understanding of e-cigarettes. This study assessed the beliefs, attitudes, and confidence in e-cigarette counseling among Chinese physicians and explored the factors related to asking patients about e-cigarette use. Methods: Physicians from across China were invited to participate in a questionnaire survey using the platform provided by DXY (www.dxy.cn) in 2018. In total, 1023 physicians completed the online survey. Descriptive analyses were used to characterize the participants, and multivariate logistic regression analyses were applied to identify predictors of physicians’ asking about patients’ e-cigarette use. Results: Only 46.3% of respondents agreed that e-cigarettes had adverse health effects, and 66.8% indicated that e-cigarettes can be regarded as a type of smoking cessation treatment. We found that 61.3% thought it was important to discuss e-cigarettes with patients, and 71.7% reported feeling confident about their ability in counseling about e-cigarettes. Respondents who had used e-cigarettes (OR = 2.05; 95% CI: 1.16–2.63), had received training about e-cigarettes (OR = 3.13; 95% CI: 2.17–4.52), or were confident about their ability to answer patients’ question about e-cigarettes (OR = 2.45; 95% CI: 1.65–3.65) were more likely to ask patients about e-cigarette use. Physicians who showed a supportive attitude toward using e-cigarettes to quit smoking (OR = 0.79; 95% CI: 0.63–0.99) were less likely to ask about patients’ e-cigarettes use frequently. Conclusions: Chinese physicians appeared to ignore the adverse health effects of e-cigarettes, and considered e-cigarettes as a smoking cessation treatment. Comprehensive training and regulations are needed to help physicians incorporate the screening of e-cigarette use into routine practice and provide patients truthful information as new data emerge.
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Bono, Rose S., Andrew J. Barnes, Rebecca C. Lester, and Caroline O. Cobb. "Effects of Electronic Cigarette Liquid Flavors and Modified Risk Messages on Perceptions and Subjective Effects of E-Cigarettes." Health Education & Behavior 46, no. 2 (October 25, 2018): 197–203. http://dx.doi.org/10.1177/1090198118806965.
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Understanding how two characteristics—flavors and modified risk messages—affect perceptions and subjective effects of electronic cigarettes (e-cigarettes) can inform tobacco control efforts. In two within-subjects studies ( N = 17 and N = 19), the effects of e-cigarette flavors (tobacco vs. menthol and unflavored vs. cherry) and hypothetical modified risk messages (“reduced harm relative to cigarettes” vs. no message and “reduced carcinogen exposure relative to cigarettes” vs. no message) on cigarette smokers’ perceptions of e-cigarettes were measured after participants self-administered condition-specific products (own-brand cigarettes; e-cigarettes). Perceptions/subjective effects were tested using linear mixed-effects regressions. Cigarettes were perceived as most harmful but rated more positively than e-cigarettes ( ps < .05). Cherry and menthol e-cigarettes increased perceived pleasantness, taste, and physical sensations compared with unflavored and tobacco-flavored e-cigarettes, respectively ( ps < .05). Modified risk messages were associated with reduced ratings of aversive effects ( ps < .05) but not harm perceptions. Overall, few perceptions/subjective effects differed by e-cigarette flavor or message. Flavors and messages may have some influence on how smokers experience e-cigarettes.
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Bares, Cristina, and Catalina Lopez-Quintero. "Shared Environmental Influences on Electronic Cigarette Use Among Adolescent and Young Adult Females." Nicotine & Tobacco Research 23, no. 8 (February 4, 2021): 1425–30. http://dx.doi.org/10.1093/ntr/ntab022.
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Abstract Introduction Electronic cigarettes are now the most commonly used form of tobacco product among youth in the United States. Current evidence suggests that although e-cigarettes are perceived as less harmful and preferred over combustible cigarettes by adolescents, adolescents who try e-cigarettes are at greater risk of transitioning to combustible cigarettes. The genetic and environmental contributions to liability for e-cigarette use have not yet been examined using a behavioral genetic design. Methods Behavioral genetic models of lifetime and current e-cigarette use and friends who use e-cigarettes were examined among female monozygotic and dizygotic twins. Results A total of 41 female twin pairs (65.9% monozygotic twins; age = 19.7, SD = 1.6) with complete data on the study variables were included in the present analyses. The majority of the sample (68.1%) had at least some friends who use e-cigarettes. Additive genetic effects on e-cigarette use were not present, but the shared environment explained 98.7% of the variance in lifetime e-cigarette use, 96.6% in current e-cigarette use, and 94.9% in affiliation with friends who use e-cigarettes. Conclusion This first study on the behavioral genetics of e-cigarette use among adolescents and young adults suggest that environmental factors shared by twins within a family seem to play a predominant role in the initial stages of e-cigarette use, a finding that is consistent with what has been found for tobacco. The findings emphasize the importance of continuing population-based tobacco control interventions to reduce the burden of e-cigarette use among adolescents. Implications The shared environment significantly influences the initiation and regular use of electronic cigarettes and affiliation with friends who use electronic cigarettes among adolescent and young adult females. These findings underscore the importance of formulating preventive interventions that mitigate the social effects of familial influences on e-cigarette use through social skills training, education on harms of e-cigarettes for young people, or altering social norms regarding initiation of novel tobacco products.
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Kowitt, Sarah D., Dien Anshari, Elizabeth N. Orlan, KyungSu Kim, Leah M. Ranney, Adam O. Goldstein, and M. Justin Byron. "Impact of an e-cigarette tax on cigarette and e-cigarette use in a middle-income country: a study from Indonesia using a pre–post design." BMJ Open 12, no. 5 (May 2022): e055483. http://dx.doi.org/10.1136/bmjopen-2021-055483.
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ObjectivesIndonesia implemented its first e-cigarette regulation in 2018, a 57% tax on the retail price of e-cigarette liquid (e-liquid), exceeding the 40% average tax on cigarettes. Economic research suggests that this tax could unintentionally increase cigarette smoking among dual users, but this has not been examined in a low-income or middle-income country. We therefore investigated the effects of the e-liquid tax among adults in Indonesia.DesignPre–post study.SettingIndonesia.ParticipantsAdults who currently used e-cigarettes and either currently or occasionally smoked cigarettes or recently quit were recruited using Facebook and Instagram ads. Our follow-up response rate was 79%. A final sample of 1039 adults participated.Primary outcome measuresE-cigarette and cigarette use.ResultsFollowing the e-liquid tax, participants reported paying a 4.4% higher price for e-liquid (p=0.02). Participants also reported an average 0.5-day decrease in the number of days they used e-cigarettes in the past week (p<0.001), and the proportion of daily e-cigarette users decreased (75.9% to 63.6%; p<0.001). Overall, reported use of cigarettes also declined, on average, by nine cigarettes per week. Participants who reported decreasing their e-cigarette use had higher odds of reporting increasing their cigarette use rather than reporting no change (adjusted OR: 2.99; 95% CI: 1.95 to 4.59). Further, as participants reported using e-cigarettes less frequently, they reported using cigarettes more frequently (β=−2.41, p=0.007).ConclusionsFollowing an e-liquid tax in Indonesia, prices of e-liquid increased slightly, e-cigarette and cigarette use declined, and people who reported decreasing their e-cigarette use reported increasing their cigarette use. To avoid encouraging cigarette use, a prudent approach would be to raise cigarette taxes concurrently with e-cigarette taxes.
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Kalkhoran, Sara, Yuchiao Chang, and Nancy A. Rigotti. "Electronic Cigarette Use and Cigarette Abstinence Over 2 Years Among U.S. Smokers in the Population Assessment of Tobacco and Health Study." Nicotine & Tobacco Research 22, no. 5 (July 11, 2019): 728–33. http://dx.doi.org/10.1093/ntr/ntz114.
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Abstract Introduction Electronic cigarettes (e-cigarettes) could benefit public health if they help current smokers to stop smoking long term, but evidence that they do so is limited. We aimed to determine the association between e-cigarette use and subsequent smoking cessation in a nationally representative cohort of US smokers followed for 2 years. Methods We analyzed data from adult cigarette smokers in Waves 1 through 3 of the Population Assessment of Tobacco and Health study. The primary exposure was e-cigarette use at Wave 1. The primary outcome was prolonged cigarette abstinence, defined as past 30-day cigarette abstinence at Waves 2 and 3 (1- and 2-year follow-up). Results Among Wave 1 cigarette smokers, 3.6% were current daily e-cigarette users, 18% were current non-daily e-cigarette users, and 78% reported no current e-cigarette use. In multivariable-adjusted analyses, daily e-cigarette use at Wave 1 was associated with higher odds of prolonged cigarette smoking abstinence at Waves 2 and 3 compared to nonuse of e-cigarettes (11% vs. 6%, adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] = 1.08 to 2.89). Non-daily e-cigarette use was not associated with prolonged cigarette smoking abstinence. Among Wave 1 daily e-cigarette users who were abstinent from cigarette smoking at Wave 3, 63% were using e-cigarettes at Wave 3. Conclusions In this longitudinal cohort study of US adult cigarette smokers, daily but not non-daily e-cigarette use was associated with higher odds of prolonged cigarette smoking abstinence over 2 years, compared to no e-cigarette use. Daily use of e-cigarettes may help some smokers to stop smoking combustible cigarettes. Implications In this nationally representative longitudinal cohort study of US adult cigarette smokers, daily e-cigarette use, compared to no e-cigarette use, was associated with a 77% increased odds of prolonged cigarette smoking abstinence over the subsequent 2 years. Regular use of e-cigarettes may help some smokers to stop smoking combustible cigarettes.
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Herlina Silvani Purba Tambak, Estro Dariatno Sihaloho,. "Karakteristik Ekonomi Pada Pengguna Ganda Rokok Elektrik dan Rokok Konvensional Pada Mahasiswa di Kota Bandung." EQUILIBRIUM : Jurnal Ilmiah Ekonomi dan Pembelajarannya 8, no. 2 (July 27, 2020): 134. http://dx.doi.org/10.25273/equilibrium.v8i2.7111.
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<em>The number of electric cigarette users in Indonesia has increased significantly. They used electric cigarettes to stop used conventional cigarettes. In fact, users of electric cigarettes cannot reduce the use of conventional cigarettes. This study wants to see what factors cause university students in Bandung to use electronic cigarettes and conventional cigarettes together. This study uses primary data of 124 users of electric cigarettes and conventional cigarettes collected through surveys in the city of Bandung. This study uses the Logistic regression method with STATA 14. The results show that the allowance of students from parents, the status of other family members who smoke conventionally, how long they use conventional cigarettes, number of conventional cigarettes consumed per day before using electric cigarettes make university students be difficult to stop using conventional cigarettes after using electric cigarettes. The use of electric cigarettes and conventional cigarettes together will have a worse health impact. While the age and amount of e-cigarette expenditure reduces the possibility to consume e-cigarettes and conventional cigarettes together</em>
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Pike, James Russell, Nasya Tan, Stephen Miller, Christopher Cappelli, Bin Xie, and Alan W. Stacy. "The Effect of E-cigarette Commercials on Youth Smoking: A Prospective Study." American Journal of Health Behavior 43, no. 6 (November 1, 2019): 1103–18. http://dx.doi.org/10.5993/ajhb.43.6.8.
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Objectives: In this study, we assessed whether commercials for electronic cigarettes (e-cigarettes) influence the use of e-cigarettes, cigarettes, and cigars among high-risk youth in southern California. Methods: We recruited students (N = 1060) from 29 alternative high schools into a prospective cohort study. We used multilevel Poisson regression models to examine whether exposure to e-cigarette commercials and perceptions of their appeal predicted increased use of e-cigarettes, cigarettes, and cigars one year later. We also tested the potential moderating effect of gender and ethnicity. Results: Models with and without covariates suggest that exposure to e-cigarette commercials is a statistically significant predictor of increased use of e-cigarettes. When gender was added to the models as a moderator, the relationships between commercial exposure and future use of e-cigarettes and cigars were found to be stronger among females. Unadjusted and adjusted models also indicated that students with favorable perceptions of e-cigarette commercials reported greater use of e-cigarettes, cigarettes, and cigars one year later. Conclusions: E-cigarette commercials may play an important role in persuading high-risk youth to use nicotine and tobacco products. Extending the Broadcast Advertising Ban of 1971 to include a broader range of products may be critical to preventing future generations from becoming addicted to nicotine.
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Merianos, Ashley L., Alex M. Russell, E. Melinda Mahabee-Gittens, Adam E. Barry, Meng Yang, and Hsien-Chang Lin. "Assessment of Exclusive, Dual, and Polytobacco E-Cigarette Use and COVID-19 Outcomes Among College Students." American Journal of Health Promotion 36, no. 3 (December 6, 2021): 421–28. http://dx.doi.org/10.1177/08901171211055904.
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Purpose This study examined current (past 30-day) dual- and polytobacco use patterns and COVID-19 symptomatology, testing, and diagnosis status among college student electronic cigarette (e-cigarette) users. Design Cross-sectional online questionnaire administered during October–December 2020. Setting Four large, U.S. public universities in geographically diverse locations. Sample College students (N=756) ages 18–24 who reported current e-cigarette use. Measures Current use of e-cigarettes, combustible cigarettes, and cigars, and self-reported COVID-19 symptomatology, testing, and diagnosis status were measured. Analysis Multivariable logistic regression models accounting for students’ demographics, university site, fraternity/sorority membership, and current residence. Results Over half (53.6%) of students were exclusive e-cigarette users, 20.4% were dual e-cigarette and combustible cigarette users, 4.6% were dual e-cigarette and cigar users, and 21.4% were poly users of e-cigarettes, combustible cigarettes, and cigars. Compared to exclusive e-cigarette users, dual users of e-cigarettes and combustible cigarettes (AOR=2.12, 95%CI=1.05–4.27) and poly users of e-cigarettes, combustible cigarettes, and cigars (AOR=3.70, 95%CI=1.78–7.70) had increased odds of COVID-19 symptomatology, even when accounting for covariates. While current tobacco use groups did not differ based on COVID-19 testing, polytobacco users had significantly increased odds (AOR=2.16, 95%CI=1.11–4.20) of having received a positive COVID-19 diagnosis. Conclusion Given use of two or more tobacco products increased COVID-19-related risks, results underscore the need to prevent dual- and polytobacco use behaviors in college student e-cigarette users.
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Lozano, Paula, Edna Arillo-Santillán, Inti Barrientos-Gutíerrez, Luz Myriam Reynales Shigematsu, and James F. Thrasher. "E-Cigarette Social Norms and Risk Perceptions Among Susceptible Adolescents in a Country That Bans E-Cigarettes." Health Education & Behavior 46, no. 2 (January 4, 2019): 275–85. http://dx.doi.org/10.1177/1090198118818239.
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Background. This study examined how risk perceptions and social norms around e-cigarettes are associated with susceptibility (i.e., openness to using the product in the next 12 months) of e-cigarettes and smoking among adolescents. Methods. We analyzed data from a 2016 representative survey of 8,718 middle school students in Mexico. The study sample was restricted to students who had tried neither e-cigarettes nor cigarettes, ( N = 4471). Students reported on the risks of e-cigarettes compared with those of cigarettes, and product-specific norms were measured by assessing current use by family members, at least one close friend, and, for e-cigarettes, by perceived societal acceptability of use (i.e., acceptability among people in general). Adjusted prevalence ratios (APR) were estimated using generalized estimating equation models that regressed e-cigarette societal acceptability on study variables. Adjusted generalized estimating equation models also regressed susceptibility for each product on study variables. Results. Susceptibility to both e-cigarettes and smoking was higher among students who reported that their family and friends used only cigarettes or both products when compared with students whose family and friends did not use either of these products. Friend use of e-cigarettes was associated with e-cigarette susceptibility (APR = 1.33) but not smoking susceptibility. Students who perceived that e-cigarettes were less risky than smoking were more susceptible to e-cigarette use (APR = 1.45). The association between e-cigarette susceptibility and friend or family use was not mediated by societal acceptability. Conclusions. E-cigarette use among family and peers appears associated with susceptibility to use e-cigarettes in a way that is similar to the patterns found for cigarettes. However, the influences appear somewhat specific to the type of product that network members use.
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Volesky, K. D., A. Maki, C. Scherf, L. M. Watson, E. Cassol, and P. J. Villeneuve. "Characteristics of e-cigarette users and their perceptions of the benefits, harms and risks of e-cigarette use: survey results from a convenience sample in Ottawa, Canada." Health Promotion and Chronic Disease Prevention in Canada 36, no. 7 (July 2016): 130–38. http://dx.doi.org/10.24095/hpcdp.36.7.02.
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Introduction Although e-cigarette use (‘‘vaping’’) is increasing in Canada, few attempts have been made to describe e-cigarette users (‘‘vapers’’). In this context, we conducted a study in Ottawa, Canada, to describe e-cigarette users’ perceptions of the benefits, harms and risks of e-cigarettes. We also collected information on why, how and where they use e-cigarettes as well as information on side effects. Methods A 24-item online survey was administered to individuals who purchased e-cigarettes or e-cigarette-related supplies at one of Ottawa’s 17 e-cigarette shops. Descriptive analyses characterized respondents, and logistic regression models were fitted to evaluate the relationship between respondents’ characteristics and their perception of e-cigarette harms. Results The mean age of the 242 respondents was 38.1 years (range: 16–70 years); 66% were male. Nearly all had smoked 100 or more cigarettes in their lifetime (97.9%). More than 80% indicated that quitting smoking was a very important reason for starting to use e-cigarettes and 60% indicated that they intend to stop using e-cigarettes at some point. About 40% reported experiencing some side effects within 2 hours of using e-cigarettes. Those who did not report experiencing any of the listed side effects had approximately 3.2 times higher odds of perceiving e-cigarettes as harmless than those who reported having side effects (odds ratio ¼ 3.17; 95% confidence interval: 1.75–5.73). Conclusion Our findings suggest that most e-cigarette users are using them to reduce or stop smoking cigarettes and perceive them as harmless. Due to our use of convenience sampling, the reader should be cautious in generalizing our findings to all Canadian e-cigarette users.
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Wang, Lilan, Yao Wang, Jianwen Chen, Peiqing Liu, and Min Li. "A Review of Toxicity Mechanism Studies of Electronic Cigarettes on Respiratory System." International Journal of Molecular Sciences 23, no. 9 (May 1, 2022): 5030. http://dx.doi.org/10.3390/ijms23095030.
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Electronic cigarettes (e-cigarettes) have attracted much attention as a new substitute for conventional cigarettes. E-cigarettes are first exposed to the respiratory system after inhalation, and studies on the toxicity mechanisms of e-cigarettes have been reported. Current research shows that e-cigarette exposure may have potentially harmful effects on cells, animals, and humans, while the safety evaluation of the long-term effects of e-cigarette use is still unknown. Similar but not identical to conventional cigarettes, the toxicity mechanisms of e-cigarettes are mainly manifested in oxidative stress, inflammatory responses, and DNA damage. This review will summarize the toxicity mechanisms and signal pathways of conventional cigarettes and e-cigarettes concerning the respiratory system, which could give researchers a better understanding and direction on the effects of e-cigarettes on our health.
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Durazo, Arturo, Marlena Hartman-Filson, Holly Elser, Natalie M. Alizaga, and Maya Vijayaraghavan. "E-Cigarette Use among Current Smokers Experiencing Homelessness." International Journal of Environmental Research and Public Health 18, no. 7 (April 1, 2021): 3691. http://dx.doi.org/10.3390/ijerph18073691.
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Two-thirds of cigarette smokers experiencing homelessness report using alternative tobacco products, including blunts, cigarillos (little cigars) or roll-your-own tobacco or electronic nicotine delivery systems such as e-cigarettes. We examined attitudes toward e-cigarette use and explored whether e-cigarette use patterns were associated with past-year cigarette quit attempts among current smokers experiencing homelessness. Among the 470 current cigarette smokers recruited from homeless service sites in San Francisco, 22.1% (n = 65) reported the use of e-cigarettes in the past 30 days (‘dual users’). Compared to cigarette-only smokers, dual users considered e-cigarettes to be safer than cigarettes. Patterns of e-cigarette use, including the number of times used per day, duration of use during the day, manner of use and nicotine concentration were not associated with past-year cigarette quit attempts. Studies that examine the motivations for use of e-cigarettes, particularly for their use as smoking cessation aids, could inform interventions for tobacco use among people experiencing homelessness.
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Wen, Xiaozhong, Lufeiya Liu, Aye A. Moe, Isabelle K. Ormond, Chelsea C. Shuren, I’Yanna N. Scott, Jenny E. Ozga, et al. "Use of E-Cigarettes and Cigarettes During Late Pregnancy Among Adolescents." JAMA Network Open 6, no. 12 (December 13, 2023): e2347407. http://dx.doi.org/10.1001/jamanetworkopen.2023.47407.
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ImportancePregnant adolescents sometimes use cigarettes; however, little is known about e-cigarette use among pregnant adolescents, a population with increased health vulnerability.ObjectiveTo examine yearly trends, sociodemographic and pregnancy-related determinants, and the association with small-for-gestational-age (SGA) birth of e-cigarette and/or cigarette use during late pregnancy among adolescents.Design, Setting, and ParticipantsThis cohort study used existing data from the 2016-2021 Pregnancy Risk Assessment Monitoring System on 10 428 US adolescents aged 10 to 19 years who had a singleton birth with complete data on e-cigarette or cigarette use and SGA birth.ExposureAdolescents reported e-cigarette and cigarette use during the last 3 months of pregnancy.Main Outcomes and MeasuresSGA birth (birth weight below the 10th percentile for the same sex and gestational duration) was determined from birth certificates. Multivariable logistic regression was used to compare the odds of SGA birth across pregnant adolescents who exclusively used e-cigarettes, exclusively used cigarettes, used e-cigarettes and cigarettes, or did not use either.ResultsOf the 10 428 pregnant adolescents, 72.7% were aged 18 or 19 years; 58.9% self-identified as White and 23.3% as Black; and 69.8% were non-Hispanic. The weighted prevalence of exclusive e-cigarette use during late pregnancy increased from 0.8% in 2016 to 4.1% in 2021, while the prevalence of exclusive cigarette use decreased from 9.2% in 2017 to 3.2% in 2021. The prevalence of dual use fluctuated, ranging from 0.6% to 1.6%. White pregnant adolescents were more likely than those who self-identified as another race and ethnicity to use e-cigarettes (2.7% vs 1.0% for American Indian or Alaska Native adolescents, 0.8% for Asian or other race adolescents, 0.6% for Black adolescents, and 0.7% for multiracial adolescents). Compared with those who did not use either product, adolescents who exclusively used e-cigarettes (16.8% vs 12.9%; confounder-adjusted odds ratio [AOR], 1.68 [95% CI, 0.89-3.18]) or who used cigarettes and e-cigarettes (17.6% vs 12.9%; AOR, 1.68 [95% CI, 0.79-3.53]) had no statistically significant difference in risk of SGA birth. However, adolescents who exclusively used cigarettes had a more than 2-fold higher risk of SGA birth (24.6% vs 12.9%; AOR, 2.51 [95% CI, 1.79-3.52]).Conclusions and RelevanceThis cohort study suggests that pregnant adolescents increasingly used e-cigarettes, with the highest use among White adolescents. Results from this analysis found that, unlike cigarette use, e-cigarette use during late pregnancy was not statistically significantly associated with an increased risk of SGA birth among adolescents. Due to the uncertainty of this nonsignificant association, future research could benefit from a larger sample size.
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Chankaew, Tamonwan, Peeraporn Baiya, Dujrudee Chinwong, Voratima Yoodee, and Surarong Chinwong. "Electronic Cigarettes in Thailand: Behaviour, Rationale, Satisfaction, and Sex Differences." International Journal of Environmental Research and Public Health 19, no. 14 (July 6, 2022): 8229. http://dx.doi.org/10.3390/ijerph19148229.
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Electronic cigarettes (e-cigarettes) use is trending in Thailand. Electronic cigarettes are banned and illegally imported. This study aimed to investigate the behaviour, rationale, and satisfaction of e-cigarettes users and compared them between males and females. A cross-sectional study was conducted involving 1050 participants using e-cigarettes from December 2019 to February 2020. The participants were recruited by an online questionnaire posted on social media. The participants were current e-cigarettes users aged 18 years and older. Of 1050 participants, 936 were male (89.1%). The average age was 31.2 ± 8.4 years. The participants were from all regions of the country, but most (64.5%) were from central Thailand. Most e-cigarettes users comprised private employees (43.2%). The main source of e-cigarettes in Thailand is online sources such as social media. Tank-style e-cigarettes were popular among users. Amongst e-cigarettes users, the top three rationales for using e-cigarettes were fewer harmful effects from e-cigarettes than conventional cigarettes (81.0%), smoking cessation aids (80.6%), and their lack of attaching cigarette odour (58.2%). The top three reasons for satisfaction were using e-cigarettes as a conventional cigarette cessation aid (5.1 ± 1.3), lessening cravings for conventional cigarettes (5.1 ± 1.3), and reducing conventional cigarettes withdrawal symptoms (5.0 ± 1.3). Online purchase was the main source of e-cigarettes in Thailand. The general rationale for using electronic cigarettes was that they are less harmful and to quit conventional cigarettes. Thai users were satisfied to use e-cigarettes as a conventional cigarette cessation aid. Males and females differed in behaviour, rationale, and satisfaction of e-cigarettes. Public health organisations should provide accurate information about the harm of electronic cigarettes and their efficacy for tobacco cessation.
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Booth, Paula, Ian P. Albery, Sharon Cox, and Daniel Frings. "Survey of the effect of viewing an online e-cigarette advertisement on attitudes towards cigarette and e-cigarette use in adults located in the UK and USA: a cross-sectional study." BMJ Open 9, no. 6 (June 2019): e027525. http://dx.doi.org/10.1136/bmjopen-2018-027525.
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ObjectivesThis study explored the potential for e-cigarette advertisements to (1) enhance attitudes towards cigarettes and/or (2) reduce barriers to e-cigarettes uptake. The study tested whether exposure to an online electronic cigarette advertisement changed attitudes towards cigarettes and e-cigarettes in smokers, non-smokers, e-cigarette users and dual users (smokers who also use e-cigarettes).DesignCross-sectional studySettingOnline surveyParticipantsAdults (n=964) aged 18 to 65 years old (M=36 years, SD=11.6) from the UK and USA. Participants were grouped into current non-smokers, e-cigarette users, dual users and smokers.InterventionsParticipants viewed 1 of 15 randomly assigned online e-cigarette advertisements.Primary measuresThree single seven-point Likert scales measuring health, desirability, social acceptability were completed pre and post advertisement exposure.ResultsPost exposure all smoking groups showed a decrease or no change in how socially acceptable or desirable they rated cigarettes. Paradoxically, dual users rated cigarettes as being significantly healthier after viewing the advertisement (p=0.01) while all other smoking group ratings remained the same. There was an increase or no change in how all smoking groups perceived the healthiness and desirability of e-cigarettesConclusionsWe observed no evidence that exposure to an e-cigarette advertisement renormalises or encourages smoking in smokers, non-smokers or e-cigarette users. However, there is some indication that viewing an e-cigarette advertisement may increase duals users’ perceptions of the health of smoking.
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AlMuhaissen, Suha, Haneen Mohammad, Afnan Dabobash, Marya Q. Nada, and Zahra M. Suleiman. "Prevalence, Knowledge, and Attitudes among Health Professions toward the Use of Electronic Cigarettes." Healthcare 10, no. 12 (November 30, 2022): 2420. http://dx.doi.org/10.3390/healthcare10122420.
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Healthcare professionals are standing against the widespread use of e-cigarettes among the population, especially young adults. E-cigarettes are generally introduced, especially via social media platforms, as a safer alternative to conventional cigarette smoking. The aim of this study was to measure the prevalence of e-cigarette use among healthcare professions students at the University of Jordan, as well as to explore their knowledge and attitudes toward the use of e-cigarettes. An anonymous Google-Form®®-based cross-sectional questionnaire was presented to potential participants at the University of Jordan. Students’ responses were analyzed using SPSS®® 23.0 software. A total of 679 online surveys were completed. About 37.4% of students reported using e-cigarettes at least once in their lifetime and about 20% of students were current e-cigarette users. The multivariate analysis showed that the factors associated with E-cigarette smoking are being male, having mothers, siblings, or friends using e-cigarettes, having easy access to e-cigarettes, and having social media as the main source of knowledge regarding e-cigarettes. The relatively high acceptance level and use of e-cigarettes among health professions students should be an alarming sign to decision-makers to give more attention to legislation that controls tobacco products including e-cigarette selling and advertising.
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Y. S. Lee DMD MD PHD MPH MSEd, Cameron, Cameron Y. S. Lee DMD MD PHD MPH MSEd, Cameron Y. S. Lee DMD MD PHD MPH MSEd, and Jon B. Suzuki DDS PHD MBA. "The Risk of Oropharyngeal Cancer from E-Cigarette Use: An Urgent Public Health Concern." Journal of Public Health International 5, no. 4 (November 4, 2022): 1–4. http://dx.doi.org/10.14302/issn.2641-4538.jphi-22-4335.
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It is estimated that over 47 million people use tobacco products, mostly in the form of combustible (smokable) tobacco cigarettes. Thirteen to 50% of smokers also use electronic cigarettes (also known as e-cigarettes or vaping). Use of tobacco is the primary preventable cause of death and risk factor for lung, head, neck, and oropharyngeal cancer. Electronic cigarettes are a $10 billion dollar industry and has the potential to surpass the tobacco cigarette market. E-cigarette use is a public health concern because of the health issues of vaping and the limited amount of scientific research to support the safety of e-cigarette use. The authors of this paper want to create awareness that use of e-cigarettes is not a safer alternative to smoking tobacco cigarettes as e-cigarettes contain known carcinogens that may lead to development of oropharyngeal cancer.
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Morean, Meghan E., Suchitra Krishnan-Sarin, Steve Sussman, Jonathan Foulds, Howard Fishbein, Rachel Grana, and Stephanie S. O’Malley. "Psychometric Evaluation of the E-cigarette Dependence Scale." Nicotine & Tobacco Research 21, no. 11 (January 2, 2018): 1556–64. http://dx.doi.org/10.1093/ntr/ntx271.
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Abstract Introduction Psychometrically sound measures of e-cigarette dependence are lacking. Methods We modified the PROMIS Item Bank v1.0—Smoking: Nicotine Dependence for All Smokers for use with e-cigarettes and evaluated the psychometrics of the 22-, 8-, and 4-item adapted versions, referred to as The E-cigarette dependence scale (EDS). Adults (1009) who reported using e-cigarettes at least weekly completed an anonymous survey in summer 2016 (50.2% male, 77.1% White, mean age 35.81 [10.71], 66.4% daily e-cigarette users, 72.6% current cigarette smokers). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, examination of mean-level differences, convergent validity, and test-criterion relationships with e-cigarette use outcomes. Results All EDS versions had confirmable, internally consistent latent structures that were scalar invariant by sex, race, e-cigarette use (nondaily/daily), e-liquid nicotine content (no/yes), and current cigarette smoking status (no/yes). Daily e-cigarette users, nicotine e-liquid users, and cigarette smokers reported being more dependent on e-cigarettes than their counterparts. All EDS versions correlated strongly with one another, evidenced convergent validity with the Penn State E-cigarette Dependence Index and time to first e-cigarette use in the morning, and evidenced test-criterion relationships with vaping frequency, e-liquid nicotine concentration, and e-cigarette quit attempts. Similar results were observed when analyses were conducted within subsamples of exclusive e-cigarette users and duals-users of cigarettes and e-cigarettes. Conclusions Each EDS version evidenced strong psychometric properties for assessing e-cigarette dependence in adults who either use e-cigarette exclusively or who are dual-users of cigarettes and e-cigarettes. However, results indicated little benefit of the longer versions over the 4-item EDS, which provides an efficient assessment of e-cigarette dependence. Implications The availability of the novel, psychometrically sound EDS can further research on a wide range of questions related to e-cigarette use and dependence. In addition, the overlap between the EDS and the original PROMIS that was developed for assessing nicotine dependence to cigarettes provides consistency within the field.
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Dai, Luojia, Yaping He, Yinliang Tan, Zhiping Yu, and Jingfen Zhu. "Online E-Cigarette Information Exposure and Its Association with E-Cigarette Use among Adolescents in Shanghai, China." International Journal of Environmental Research and Public Health 19, no. 6 (March 11, 2022): 3329. http://dx.doi.org/10.3390/ijerph19063329.
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E-cigarettes are widely advertised, while the potential risks of e-cigarette use have been reported among adolescents. This study assessed online e-cigarette information exposure and its association with adolescents’ e-cigarette use in Shanghai, China. A total of 12,470 students aged 13–18 years participated. A questionnaire collected information on students’ sociodemographic factors, e-cigarette information exposure, cigarette use, e-cigarette use, and e-cigarette use intention. A multivariate logistic regression was performed to assess correlates of exposure to e-cigarette information and the association between e-cigarette information exposure and e-cigarette use. Overall, 73.9% of students knew about e-cigarettes and the primary sources of information were the internet (42.4%), movies/TV (36.4%), bulletin boards in retail stores or supermarkets (34.9%), advertising flyers (33.9%), and friends (13.8%). Students who had friends using e-cigarettes were curious about e-cigarettes and showed a greater monthly allowance; smokers and females were at a higher risk of social media and website exposure. Moreover, online information exposure (social media exposure, website exposure, and total internet exposure) was significantly associated with the intention to use e-cigarettes. The enforcement of regulations on online e-cigarette content should be implemented. Moreover, efforts to prevent young people from using e-cigarettes may benefit from targeting students at a higher risk of online e-cigarette information exposure.
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Solihat, Siti Sarah, and Gunadi Gunadi. "Urgensi Kebijakan Kenaikan Tarif Cukai Rokok Elektrik di Indonesia." Owner 7, no. 3 (July 1, 2023): 2389–400. http://dx.doi.org/10.33395/owner.v7i3.1480.
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The Indonesian Government added electric cigarettes (e-cigarettes) as excise objects to improve the cigarette excise policy. Since 2018, the level of e-cigarettes has increased continuously. The age distribution of smokers who consume e-cigarettes is also starting to be troubling. Tobacco Control Support and the Association of Indonesian Public Health discovered that many e-cigarettes smoker are young children and teenagers. To reduce the prevalence rate of smokers, especially among children and teenagers, the Indonesian government made a policy to increase the excise tariffs and its minimum retail selling price. Increasing cigarette excise is often a problem because it has many impacts on other related sectors. In contrast to regular cigarettes, e-cigarettes had not much relation to many other sectors so the researchers aim to see whether increases in e-cigarette excise and minimum retail prices can help the government achieve its goals. By the government making an excise tariff policy, several sectors must be considered such as state revenue, consumption levels, involved sectors, and controlling illegal cigarettes. The tariff system and excise structure are also important instruments for the government to control the level of cigarette consumption. Researchers used qualitative methods and descriptive techniques to analyze data. The increase in excise tariffs for e-cigarettes has not reached its maximum, however increasing retail prices of e-cigarettes could also reduce consumption levels, especially the prevalence of using e-cigarettes among young kids and teenagers.
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Zulkifli, Aziemah, Emilia Zainal Abidin, Najihah Zainol Abidin, Amer Siddiq Amer Nordin, Sarva Mangala Praveena, Sharifah Norkhadijah Syed Ismail, Irniza Rasdi, Karmegam Karuppiah, and Anita Abd Rahman. "Electronic cigarettes: a systematic review of available studies on health risk assessment." Reviews on Environmental Health 33, no. 1 (March 28, 2018): 43–52. http://dx.doi.org/10.1515/reveh-2015-0075.
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AbstractObjective:This paper primarily aimed to review articles which specifically quantified the risk of electronic cigarette’s (e-cigarette) usage via the health risk assessment (HRA) approach.Methods:Systematic literature searches were conducted using PubMed search engine databases. Search terms such as “electronic cigarette”, “e-cigarette”, “electronic nicotine delivery systems”, “electronic cigarette liquid”, “electronic cigarette vapors”, and “health risk assessment” were used to identify the relevant articles to be included in this review. To enable comparison, hazard quotient (HQ) and lifetime cancer risk (LCR) for the chemicals measured in the selected articles were calculated for three of the articles using the formula: [1] HQ=average daily dose (ADD)/reference dose (RfD) or exposure air concentration (EC)/reference concentration (RfC); [2] LCR=lifetime average daily dose (LADD) × cancer slope factor (CSF) or exposure air concentration (EC) × inhalation unit risk (IUR).Results:Four articles pertaining to HRA of e-cigarettes were critically reviewed, three of the papers focused on specific chemicals namely nicotine, propylene glycol (PG), glycerol and 1,2-propanediol, while one article evaluated the health risks posed by heavy metals contained in e-cigarettes. The calculated HQs for the chemicals in this review had large variations. HQs of the six chemicals, i.e. nicotine, PG, glycerol, cadmium, ethylene glycol, nickel, aluminum and titanium, were found to have the potential to contribute to non-carcinogenic health risks. None of the LCR calculated had risks exceeding the acceptable limit.Conclusion:There are limited HRA studies and the ones that were available provided inconsistent scientific evidences on the health risk characterization arising from the usage of e-cigarettes. As such, there is a need to perform more studies on HRA of e-cigarettes by using uniformed and comprehensive steps and similar reference threshold levels of exposures.
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Chulasai, Phantara, Purida Vientong, Surarong Chinwong, John J. Hall, and Dujrudee Chinwong. "Factors Associated with the Dual Use of Electronic Cigarettes and Cigarettes among Thai Undergraduate Students Who Smoked Cigarettes." Children 8, no. 12 (December 17, 2021): 1197. http://dx.doi.org/10.3390/children8121197.
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This study proposed to identify factors associated with the dual use of electronic cigarettes (e-cigarettes) and cigarettes among undergraduate students who smoked cigarettes. This cross-sectional study employed a self-administered, anonymous online questionnaires to collect information from undergraduate smokers in northern Thailand. Of the 494 participants, 82.8% were dual users of e-cigarettes and cigarettes. The two main reasons for using e-cigarettes were an absence of cigarette smoke odor (76.8%) and availability of flavors (70.7%). Undergraduate smokers who initiated smoking at ≥18 years old were more likely to be dual users than those who initiated smoking at younger age (adjusted odds ratio [aOR]: 2.79, 95% confidence intervals [CI]: 1.32–5.89, p = 0.007). Undergraduate smokers who smoked ≥11 cigarettes daily were more likely to be dual users than those who smoked less (aOR: 2.64, 95% CI: 1.52–4.61, p = 0.001). Conversely, undergraduate smokers who had attempted to quit during the past year were less likely to be dual users (aOR: 0.26, 95% CI: 0.12–0.56, p = 0.001). In conclusion, dual use of e-cigarettes and cigarettes among undergraduate smokers was associated with older age at cigarette smoking initiation, a higher number of cigarettes smoked daily, and having no past year’s cigarette quit attempts.