Special Issue "E-Cigarettes: A Global Public Health Perspective"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 May 2020).

Special Issue Editors

Prof. Dr. Richard Edwards
Website
Guest Editor
Department of Public Health, University of Otago, Dunedin, New Zealand
Interests: tobacco control policy; tobacco endgames; smoking prevention; epidemiology; public health
Prof. Dr. Kamran Siddiqi
Website
Guest Editor
The Hull York Medical School, University of York, Heslington, York YO10 5DD, UK
Interests: second-hand smoke; non-cigarette forms of tobacco use and tobacco and infections

Special Issue Information

Dear Colleagues,

E-cigarettes and other alternative nicotine delivery devices (ANDs) are a growing global phenomenon with major potential implications for public health. There is ongoing debate about their possible contribution (positive or negative) to addressing the tobacco smoking-related epidemic. Much of the research to date has focused on: exploring the relative harm of using these products compared to tobacco smoking, describing patterns of use, and investigating possible impacts on smoking prevalence through effects on smoking uptake and smoking cessation. Most available evidence comes from high-income countries such as the US, UK and Canada where e-cigarettes are relatively widely available and cheaper than smoked tobacco products; and where tobacco control efforts are well-established and smoking prevalence has been in decline. However, patterns of e-cigarette use and their impacts on smoking prevalence may vary greatly in countries with different levels of development, patterns of smoking, and policy and regulatory environments.

For this special edition we invite the submission of papers on broader aspects of the e-cigarette phenomenon in diverse global contexts (particularly in low- and middle-income countries) including:

  • evolving features of e-cigarette (and other ANDs) use, regulatory approaches and market structures;
  • exploration of the impacts of different regulatory approaches on patterns of use of e-cigarettes (and other ANDs) and smoking.

Please note, we will not usually consider simple descriptions of prevalence of e-cigarette/ANDs use unless a manuscript provides genuinely novel information e.g. data from a setting where e-cigarette use has not been previously reported, or description of new patterns of use with potentially important implications for public health and tobacco control.

Conflicts of interest/funding

Authors should note that IJERPH will not consider for publication papers reporting work that is funded, in whole or in part, by a tobacco company or tobacco industry organization or affiliate; or papers written by authors who accept tobacco industry or affiliate funding. Other sources of funding, particularly from e-cigarette or pharmaceutical related interests should be fully disclosed. The full policy is available here: https://www.mdpi.com/1660-4601/15/12/2831/htm.

Prof. Dr. Richard Edwards
Prof. Dr. Kamran Siddiqi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Keywords

  • E-cigarettes
  • ENDs/ANDs
  • Public health impact
  • LMICs
  • Global public health
  • Regulatory policy

Published Papers (8 papers)

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Research

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Open AccessArticle
Patterns of Use of Vaping Products among Smokers: Findings from the 2016–2018 International Tobacco Control (ITC) New Zealand Surveys
Int. J. Environ. Res. Public Health 2020, 17(18), 6629; https://doi.org/10.3390/ijerph17186629 - 11 Sep 2020
Abstract
Alternative nicotine products like e-cigarettes could help achieve an end to the epidemic of ill health and death caused by smoking. However, in-depth information about their use is often limited. Our study investigated patterns of use of e-cigarettes and attitudes and beliefs among [...] Read more.
Alternative nicotine products like e-cigarettes could help achieve an end to the epidemic of ill health and death caused by smoking. However, in-depth information about their use is often limited. Our study investigated patterns of use of e-cigarettes and attitudes and beliefs among smokers and ex-smokers in New Zealand (NZ), a country with an ‘endgame’ goal for smoked tobacco. Data came from smokers and ex-smokers in Waves 1 and 2 of the International Tobacco Control (ITC) NZ Survey (Wave 1 August 2016–April 2017, 1155 participants; Wave 2, June–December 2018, 1020 participants). Trial, current and daily use of e-cigarettes was common: daily use was 7.9% among smokers and 22.6% among ex-smokers in Wave 2, and increased between surveys. Use was commonest among 18–24 years and ex-smokers, but was similar among Māori and non-Māori participants, and by socio-economic status. Most participants used e-cigarettes to help them quit or reduce their smoking. The most common motivating factor for use was cost and the most common barrier to use cited was that e-cigarettes were less satisfying than smoking. The findings could inform developing interventions in order to maximise the contribution of e-cigarettes to achieving an equitable smoke-free Aotearoa, and to minimise any potential adverse impacts. Full article
(This article belongs to the Special Issue E-Cigarettes: A Global Public Health Perspective)
Open AccessArticle
Adult Smokers’ Awareness and Interest in Trying Heated Tobacco Products: Perspectives from Mexico, where HTPs and E-Cigarettes are Banned
Int. J. Environ. Res. Public Health 2020, 17(7), 2173; https://doi.org/10.3390/ijerph17072173 - 25 Mar 2020
Cited by 1
Abstract
Background: We evaluated smokers’ perceptions of heated tobacco products (HTPs) in Mexico, where industry publically lobbied to introduce HTPs into this country that banned both HTPs and e-cigarettes. Methods: Online surveys (November 2018 to July 2019) were analyzed from adults who only smoked [...] Read more.
Background: We evaluated smokers’ perceptions of heated tobacco products (HTPs) in Mexico, where industry publically lobbied to introduce HTPs into this country that banned both HTPs and e-cigarettes. Methods: Online surveys (November 2018 to July 2019) were analyzed from adults who only smoked cigarettes (n = 2091) or who smoked and used e-cigarettes (“dual users” n = 1128). Logistic models regressed HTP awareness, interest to trying HTPs, and having seen HTPs for sale (only among aware participants) on sociodemographics and tobacco-related variables. Results: Of the 17.1% who were aware of HTPs, 52.7% reported having seen HTPs for sale. Of all respondents, 75% were somewhat or very interested in trying HTPs. Compared to their counterparts, more frequent smokers, dual users, those exposed to online e-cigarette ads, and those with friends who used e-cigarettes were both more aware of and interested in trying HTPs. Greater awareness was also associated with higher education, recent attempts to quit, receipt of email e-cigarette ads, and smoking among friends and family. Seeing HTPs for sale was higher for those who recently attempted to quit, were exposed to e-cigarette ads online or by email, or had friends who used e-cigarettes. Conclusion: Interest in HTPs is high among smokers in Mexico, which already has a large black market for illegal e-cigarettes. HTPs use should be monitored in this context, especially given the public health impacts of HTPs are unclear. Full article
(This article belongs to the Special Issue E-Cigarettes: A Global Public Health Perspective)
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Open AccessArticle
Policy Debates Regarding Nicotine Vaping Products in Australia: A Qualitative Analysis of Submissions to a Government Inquiry from Health and Medical Organisations
Int. J. Environ. Res. Public Health 2019, 16(22), 4555; https://doi.org/10.3390/ijerph16224555 - 18 Nov 2019
Cited by 3
Abstract
Australia has maintained a highly restrictive regulatory framework for nicotine vaping products (NVPs) and the regulatory approach differs from most other high income countries. This paper employed a thematic analysis to assess policy consultation submissions made to a government inquiry regarding use and [...] Read more.
Australia has maintained a highly restrictive regulatory framework for nicotine vaping products (NVPs) and the regulatory approach differs from most other high income countries. This paper employed a thematic analysis to assess policy consultation submissions made to a government inquiry regarding use and marketing of NVPs. We included in the analysis submissions (n = 40) made by Australian institutions that influence or contribute to health policy-making including government agencies, health bodies and charities (n = 23), and public health academics and healthcare professionals (n = 18). Submissions from commercial entities and consumers were excluded. The majority of submissions from representatives of government agencies, health bodies and charities recommended maintaining current restrictions on NVPs. Arguments against widening access to NVPs included the demand for long-term evidence on safety and efficacy of an unusually high standard. There was widespread support for restrictions on sales, advertising and promotion, with most submissions supporting similar controls as for tobacco products. In contrast, the majority of individual submissions from healthcare professionals and public health academics advocated for widening access to NVPs for smokers and emphasized the potential benefits of smokers switching to vaping and the policy incoherence of regulating less harmful nicotine products more strictly than tobacco cigarettes. Progress in resolving the policy debate concerning NVP regulation in Australia will require policy makers, clinicians and the public health community to engage in a meaningful dialogue which gives due consideration to both intended and unintended consequences of proposed policies. Full article
(This article belongs to the Special Issue E-Cigarettes: A Global Public Health Perspective)
Open AccessArticle
Socioeconomic Inequalities in e-Cigarette Use in Korea: Comparison with Inequalities in Conventional Cigarette Use Using Two National Surveys
Int. J. Environ. Res. Public Health 2019, 16(22), 4458; https://doi.org/10.3390/ijerph16224458 - 13 Nov 2019
Abstract
Socioeconomic inequalities in conventional cigarette smoking are well established in developed countries. The aim of this study was to investigate socioeconomic inequalities in e-cigarette use in Korea, in comparison with inequalities in conventional cigarette use. Data from the Korea National Health and Nutrition [...] Read more.
Socioeconomic inequalities in conventional cigarette smoking are well established in developed countries. The aim of this study was to investigate socioeconomic inequalities in e-cigarette use in Korea, in comparison with inequalities in conventional cigarette use. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Community Health Survey (KCHS) were analyzed. The years of data collected were 2013 to 2016 for the KNHANES and 2014 to 2016 for the KCHS, respectively. The age-adjusted prevalence of ever and current e-cigarette use and conventional cigarette use was calculated according to socioeconomic status indicators, including education, occupation, and income. The prevalence of ever e-cigarette use in men increased from 12.1% in 2013 to 19.2% in 2016 in the KNHANES, and from 13.4% in 2014 to 17.9% in 2016 in the KCHS. Ever and current e-cigarette use was concentrated among current smokers and was much more prevalent among men and also more common among younger age groups in men and women. There was higher prevalences of conventional cigarette use among men and women with less education, manual occupational class and lower income, with the differences more pronounced for women. There was higher ever and current use of e-cigarettes among women with less education, manual occupational class and lower income, but among men there was much less difference in e-cigarette use by these indicators of socio-economic status. Full article
(This article belongs to the Special Issue E-Cigarettes: A Global Public Health Perspective)
Open AccessArticle
Predictors of E-Cigarette Use Susceptibility—A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland
Int. J. Environ. Res. Public Health 2019, 16(20), 3935; https://doi.org/10.3390/ijerph16203935 - 16 Oct 2019
Cited by 2
Abstract
Identification of the youth at risk of e-cigarette use is crucial for development of effective prevention strategies. The current study aims at evaluation of predictors of susceptibility to e-cigarette initiation and experimentation among adolescents. This cross-sectional study included 1693 students (non-current users of [...] Read more.
Identification of the youth at risk of e-cigarette use is crucial for development of effective prevention strategies. The current study aims at evaluation of predictors of susceptibility to e-cigarette initiation and experimentation among adolescents. This cross-sectional study included 1693 students (non-current users of e-cigarettes) attending 21 schools in Piotrkowski district (a socially disadvantaged rural area in central Poland). The regression models were applied so as to study factors linked to susceptibility to e-cigarette use among never users (n = 1054) and ever users (n = 639) of e-cigarettes, with susceptibility defined as the absence of a firm decision not to use these products. A high proportion of the youth was susceptible to e-cigarette use (68% of never and 78% of ever e-cigarette users). The adjusted model confirmed the following risk factors: smoking parents and friends (never users: OR = 3.0; p < 0.001; OR = 2.0; p < 0.05; ever users: OR = 2.2; OR = 2.2; p < 0.01), alcohol consumption (never users: moderate drinking OR = 2.9; p < 0.001; binge drinking OR = 2.2; p < 0.01; ever users: moderate drinking OR = 4.2; p < 0.001), cigarette smoking (never users: OR = 14.1; ever users: OR = 11.3; p < 0.001), and perception that e-cigarettes are less harmful than traditional cigarettes (never users: OR = 1.8; p < 0.001). The youth whose mothers had a medium and high educational level (never users: OR = 2.7; p < 0.01; OR = 2.7; p < 0.05; ever users: OR = 5.4; OR = 4.4; p < 0.001), those who perceived girls who use e-cigarettes as more attractive (never users: OR = 4.1; p < 0.001; ever users: OR = 2.9; p < 0.01), and secondary school students (ever users: OR = 5.6; p < 0.001) had higher odds of susceptibility to e-cigarette use. The youth who had more money per month were less susceptible to e-cigarette experimentation (OR = 0.4; p < 0.001). A multi-level intervention approach, considering vulnerable populations, is required to prevent the youth from e-cigarette initiation and experimentation. Full article
(This article belongs to the Special Issue E-Cigarettes: A Global Public Health Perspective)
Open AccessArticle
E-Cigarettes are More Addictive than Traditional Cigarettes—A Study in Highly Educated Young People
Int. J. Environ. Res. Public Health 2019, 16(13), 2279; https://doi.org/10.3390/ijerph16132279 - 27 Jun 2019
Cited by 9
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue E-Cigarettes: A Global Public Health Perspective)
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Review

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Open AccessReview
Use of Electronic Cigarettes in European Populations: A Narrative Review
Int. J. Environ. Res. Public Health 2020, 17(6), 1971; https://doi.org/10.3390/ijerph17061971 - 17 Mar 2020
Cited by 3
Abstract
The increasing popularity of electronic cigarettes in past decades has aroused public health concern. This study aims to review the literature on the prevalence of e-cigarette use among the general adult and young populations in Europe. We searched Medline and Google Scholar from [...] Read more.
The increasing popularity of electronic cigarettes in past decades has aroused public health concern. This study aims to review the literature on the prevalence of e-cigarette use among the general adult and young populations in Europe. We searched Medline and Google Scholar from September 2019, and included “prevalence of e-cigarettes”, “electronic cigarettes” or “e-cigarettes”, and “electronic nicotine delivery system” or “vaping”. The prevalence of current e-cigarette use ranged from 0.2% to 27%, ever-use ranged from 5.5% to 56.6% and daily use ranged from 1% to 2.9%. Current smokers of conventional cigarettes showed the highest prevalence for the use of e-cigarettes, ranging from 20.4% to 83.1%, followed by ex-smokers, with ranges from 7% to 15%. The following socio-demographic factors were associated with a higher chance of using e-cigarettes: male sex and younger age groups; results for economic status were inconclusive. In European countries, there is a higher prevalence of e-cigarette use among males, adolescents and young adults, smokers of conventional cigarettes, and former smokers. Full article
(This article belongs to the Special Issue E-Cigarettes: A Global Public Health Perspective)

Other

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Open AccessBrief Report
Did E-Cigarette Users Notice the New European Union’s E-Cigarette Legislation? Findings from the 2015–2017 International Tobacco Control (ITC) Netherlands Survey
Int. J. Environ. Res. Public Health 2019, 16(16), 2917; https://doi.org/10.3390/ijerph16162917 - 14 Aug 2019
Abstract
This study examined to what extent e-cigarette users noticed the European Union’s new legislation regarding e-cigarettes, and whether this may have influenced perceptions regarding addictiveness and toxicity. Data were obtained from yearly surveys (2015–2017) of the International Tobacco Control (ITC) Netherlands Survey. Descriptive [...] Read more.
This study examined to what extent e-cigarette users noticed the European Union’s new legislation regarding e-cigarettes, and whether this may have influenced perceptions regarding addictiveness and toxicity. Data were obtained from yearly surveys (2015–2017) of the International Tobacco Control (ITC) Netherlands Survey. Descriptive statistics and Generalized Estimating Equations were applied. About a third of the e-cigarette users noticed the text warning (28%) and the leaflet (32%). When compared to tobacco-only smokers, e-cigarette users showed greater increases in perceptions regarding addictiveness (β = 0.457, p = 0.045 vs. β = 0.135, p < 0.001) and toxicity (β = 0.246, p = 0.055 vs. β = 0.071, p = 0.010). In conclusion, the new legislation’s noticeability should be increased. Full article
(This article belongs to the Special Issue E-Cigarettes: A Global Public Health Perspective)
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