RESEARCH PAPER
Associations of e-cigarette experimentation with support for tobacco control policies in the European Union, 2012-2014
 
More details
Hide details
1
Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
2
Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
3
Tobacco Control Unit, WHO Collaborating Center for Tobacco Control, Institut Català d’Oncologia-ICO, L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain
4
Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
Publish date: 2018-03-16
 
Tob. Induc. Dis. 2018;16(March):9
KEYWORDS:
TOPICS:
Smoking
 
ABSTRACT:
Introduction:
There are limited data on the potential effects of e-cigarette experimentation on support for tobacco control policies. To bridge this gap, we assessed associations between e-cigarette experimentation and support for tobacco control policies in the European Union 2012-2014. We also investigated variations across tobacco-use status, e-cigarette experimentation and sociodemographic characteristics.

Methods:
Datasets were used from the Special Eurobarometer for Tobacco surveys performed in 2012 (n=26 751) and 2014 (n=27 801). Tobacco control policies assessed were: banning advertising, policies to keep tobacco out of sight, banning online sales, banning flavors, standardized packaging, tax increases, and policies to reduce illicit trade in tobacco. We use multilevel logistic regression models to assess variations in socio-demographics and tobacco/e-cigarette use with support for these policies in 2014, and examined changes in support for these policies, between 2012 and 2014, separately by tobacco-use status (never, current, and former smokers).

Results:
Population support for tobacco control policies was high in 2014: policies to reduce illicit trade had the highest level of support at 70.1%, while tax increases were the least likely measure to be supported with 52.3% support. Among never and former smokers, experimentation with e-cigarettes was associated with reduced support for all tobacco control policies assessed. For example, never smokers who had experimented with e-cigarettes were less likely to support either tobacco advertising bans (adjusted odds ratio aOR=0.57, 95% confidence interval 0.46-0.71) or standardized packaging for tobacco (aOR=0.58, 95% CI: 0.47-0.71). Former smokers who had experimented with e-cigarettes were less likely to either support standardized packaging for tobacco (aOR=0.70, 95% CI: 0.60-0.82) or keeping tobacco out of sight (aOR=0.77, 95% CI: 0.65-0.90). Among current smokers, e-cigarette experimentation was not associated with support for the tobacco control policies assessed.

Conclusions:
E-cigarette experimentation was consistently associated with reduced support for tobacco control policies among never and former smokers but not among current smokers. The implications of these findings for tobacco control are unknown, but the data support concerns that e-cigarette experimentation may affect public support for established tobacco control policies within specific subgroups. Further research is needed to assess potential long-term impacts on tobacco control policies.

CORRESPONDING AUTHOR:
Anthony A. Laverty   
Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
 
REFERENCES (17):
1. Grana R, Benowitz N, Glantz SA. E-Cigarettes: A Scientific Review. Circulation. 2014;129:1972-1986. doi:10.1161/circulationaha.114.007667
2. Filippidis FT, Laverty AA, Gerovasili V, Vardavas CI. Two-year trends and predictors of e-cigarette use in 27 European Union member states. Tob Control. 2017;26:98-104. doi:10.1136/tobaccocontrol-2015-052771
3. Directive of the European Union on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco and related products and repealing Directive 2001/37/EC.
4. Arnott D, Dockrell M, Sandford A, Willmore I. Comprehensive smoke-free legislation in England: how advocacy won the day. Tob Control. 2007;16:423-428. doi:10.1136/tc.2007.020255
5. Institute for Global Tobacco Control (2015). Country laws regulating e-cigarettes: A policy scan. http://globaltobaccocontrol.or.... Accessed May 23, 2017.
6. Gallus S, Lugo A, Fernandez E, Gilmore AB, Leon ME, Clancy L, et al. Support for a tobacco endgame strategy in 18 European countries. Prev Med. 2014;67:255-258. doi:10.1016/j.ypmed.2014.08.001
7. Martínez-Sánchez JM, Ballbè M, Fu M, Martín-Sánchez JC, Gottlieb M, Saltó E, et al. Attitudes towards Electronic Cigarettes Regulation in Indoor Workplaces and Selected Public and Private Places: A Population-Based Cross-Sectional Study. PLoS One. 2014;9:e114256. doi:10.1371/journal.pone.0114256
8. World Health Organization. WHO report on the global tobacco epidemic, 2015. Raising taxes on tobacco. http://www.who.int/tobacco/glo.... Accessed May 23, 2017.
9. Kennedy RD, Awopegba A, De León E, Cohen JE. Global approaches to regulating electronic cigarettes. Tob Control. 2016;26:440-445. doi:10.1136/tobaccocontrol-2016-053179
10. Fairchild AL, Bayer R, Colgrove J. The Renormalization of Smoking? E-Cigarettes and the Tobacco ‘Endgame’. N Engl J Med. 2014;370:293-295. doi:10.1056/NEJMp1313940
11. European Commission. Eurobarometer 77.1, February-March 2012. GESIS Data Archive: ZA5597, dataset version 2.0.0 (2012). Brussels: TNS Opinion & Social; 2012.
12. European Commission. Eurobarometer 82.4, November-December 2014. GESIS Data Archive: ZA5933, dataset version 5.0.0 (2014). Brussels: TNS Opinion & Social; 2014.
13. Special Eurobarometer 429. Attitudes of Europeans towards tobacco. http://ec.europa.eu/public_opi.... Updated, 2015. Accessed September 25, 2015.
14. Special Eurobarometer 385. Attitudes of Europeans towards tobacco. http://ec.europa.eu/public_opi.... Updated, 2012. Accessed September 25, 2015.
15. Macy JT, Chassin L, Presson CC. The Association Between Implicit and Explicit Attitudes Toward Smoking and Support for Tobacco Control Measures. Nicotine Tob Res. 2013;15:291-296. doi:10.1093/ntr/nts117
16. Vardavas C. EUREST PLUS - European Regulatory Science on Tobacco: Policy implementation to reduce lung diseases - Proposal (Horizon2020). Tob Prev Cessat. 2016;2(April Supplement)37. doi:10.18332/tpc/62406
17. Hitchman SC, Brose LS, Brown J, Robson D, McNeill A. Associations Between E-Cigarette Type, Frequency of Use, and Quitting Smoking: Findings From a Longitudinal Online Panel Survey in Great Britain. Nicotine Tob Res. 2015;17:1187-1194. doi:10.1093/ntr/ntv078
eISSN:1617-9625