Perception of E-cigarette Use among Adult Users in China: A Mixed-method Study
2.1. Participant Eligibility and Recruitment
2.2. Interview Guides
2.3. Data Analysis
3.1. Participant Demographics
3.2. EC Use Patterns
“I use ECs in all kinds of places, except when I am with a client and we have to smoke traditional cigarettes together.”(Male, 36 years old, IQOS user).
“I would not recommend ECs to the elderly any more. They refused my recommendation because they did want to change their behaviors.”(Male, 35 years old, e-liquid EC user).
3.3. Perceptions of Using ECs
3.3.1. Motivational Factors for Using ECs
“It’s convenient to smoke ECs. My wife does not allow me to smoke traditional cigarettes.”(Male, 32 years old, e-liquid EC user).
“I don’t cough or feel uncomfortable or have phlegm (when using it). E-cigarettes are convenient, I can use them indoors and do not bother others.”(Male, 40 years old, e-liquid EC user).
3.3.2. Addictiveness of ECs
“Vaping ECs is like drinking soda. I am not addicted to ECs. When I am craving for nicotine, I will smoke traditional cigarettes.”(Male, 34 years old, e-liquid EC user).
3.3.3. Perceived Health Impact of ECs
“I am sure they are harmful because e-cigarettes have nicotine. But they are less harmful (than traditional cigarettes).”(Male, 53 years old, e-liquid EC user).
“It is less harmful to other people. The vapor is not as strong as smoke from traditional cigarettes.”(Male, 22 years old, IQOS user).
“ECs are new products. I am not sure whether it is less harmful than traditional cigarettes. But at least I have less phlegm.”(Male, 33 years old, e-liquid EC user).
“I saw the news that said ECs were more harmful than traditional cigarettes.”(Male, 33 years old, IQOS user).
3.3.4. Satisfaction with ECs
“Traditional cigarettes are stronger. But e-cigarettes are safer. At one time I almost scalded my daughter’s head (with a burning traditional cigarette).”(Male, 3 years old, e-liquid EC user).
“I like watermelon and mango flavors because there is no unpleasant odor in my mouth. Other people are not against me using EC because it smells good.”(Female, 28 years old, e-liquid EC user).
3.3.5. Regulatory Concerns about ECs
“I am afraid that the government would limit the use of e-cigarettes which would make their prices rise. Some countries have already banned e-cigarettes.”(Male, 34 years old, e-liquid EC user).
3.3.6. Promotion of ECs to Others
“Yes, I will (recommend to others), it is less harmful to me and other people. There will not be phlegm.”(Male, 33 years old, IQOS user).
3.3.7. Prediction of the Trend of EC Use in China
3.3.8. Impact of EC Use on Participants’ Smoking Behavior
“I am smoking less now. I only smoke traditional cigarettes while I am with my colleagues.”(Male, 38 years old, e-liquid EC user).
3.3.9. The Societal Perception of EC Use
“My wife supports me to use ECs because my health condition has got better. My friends are against me to use ECs because we cannot share and smoke traditional cigarettes like before.”(Male, 46 years old, IQOS user).
Conflicts of Interest
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|Demographic Data||Counts (%)|
|Current use of traditional cigarettes||24 (80.0%)|
|High school||3 (10.0%)|
|Undergraduate or graduate||27 (90.0%)|
|Cigarette Use Characteristics||Mean (SD)|
|Number of traditional cigarettes smoked per day||7.6 (8.3)|
|Years of smoking traditional cigarettes||13.0 (7.0)|
|Years since the first EC use||2.4 (2.0)|
|EC Use Patterns||Counts (%)|
|First use EC through|
|Introduced by others||20 (66.7%)|
|EC purchase channel|
|Physical stores||13 (43.3%)|
|Online stores||13 (43.3%)|
|Bought by others||13 (43.3%)|
|Types of ECs used||24 (80.0%)|
|Heated liquid products||14 (46.7%)|
|Heated tobacco products||16 (53.3%)|
|Chargeable and replenishable||29 (96.7%)|
|Reasons for using ECs|
|Curious about ECs||22 (73.3%)|
|To reduce cigarette smoking||25 (83.3%)|
|Addicted to EC||4 (13.3%)|
|Like the smell of the EC’s vapor||19 (63.3%)|
|Like the taste of the EC’s vapor||24 (80.0%)|
|Like the action and sensations of using ECs||11 (33.3%)|
|Can help me concentrate||5 (16.7%)|
|Can help me relax||17 (56.7%)|
|Refreshing and keeps me awake||16 (53.3%)|
|Cheaper than traditional cigarettes||8 (26.7%)|
|Know about nicotine concentration in ECs||17 (56.7%)|
|Use ECs every day||26 (86.7%)|
|Use ECs in non-smoking places||22 (73.3%)|
|Intend to quit ECs soon||0 (0%)|
|EC Use Patterns||Mean (SD)|
|EC cost per month (USD)||51.1 (32.6)|
|heated liquid product cost per month||40.3 (32.9)|
|heated tobacco product cost per month||61.2 (30.3)|
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Zhao, D.; Zuo, Y.; Urmi, D.S.; Liu, Y.; Zheng, P.; Fan, W.; Abdullah, A.S. Perception of E-cigarette Use among Adult Users in China: A Mixed-method Study. Int. J. Environ. Res. Public Health 2020, 17, 2754. https://doi.org/10.3390/ijerph17082754
Zhao D, Zuo Y, Urmi DS, Liu Y, Zheng P, Fan W, Abdullah AS. Perception of E-cigarette Use among Adult Users in China: A Mixed-method Study. International Journal of Environmental Research and Public Health. 2020; 17(8):2754. https://doi.org/10.3390/ijerph17082754Chicago/Turabian Style
Zhao, Duan, Yantao Zuo, Dilshat S. Urmi, Yangyujin Liu, Pinpin Zheng, Wang Fan, and Abu S. Abdullah. 2020. "Perception of E-cigarette Use among Adult Users in China: A Mixed-method Study" International Journal of Environmental Research and Public Health 17, no. 8: 2754. https://doi.org/10.3390/ijerph17082754