Electronic cigarette use in China: Awareness, prevalence and regulation
ZiAn He 1
Nannan Feng 1
Yuyang Cai 1, 2  
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School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, China
Yuyang Cai   

School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, 200025 Shanghai, China
Publish date: 2019-04-16
Tob. Induc. Dis. 2019;17(April):30
E-cigarettes were invented in China, and most of the world’s e-cigarettes have been produced in China. However, awareness and use of e-cigarettes in China are lower than in Europe and America. Against the backdrop of the increasing use of e-cigarettes, the supervision of e-cigarettes in China has been almost non-existent.

A literature search was carried out in five popular Chinese and English databases. These databases were PubMed, EMBASE, the Cochrane Library, China national knowledge infrastructure (CNKI), and Wan-fang database.

Twenty-one studies were identified, and a comprehensive analysis of e-cigarette awareness ratio was conducted for different regions of China and according to gender, age group, and smoking status. We also examined e-cigarette use and associated risk factors, and the relationship between e-cigarette use and smoking cessation. In 2015, the prevalence of ‘ever use’ and ‘current use’ of e-cigarettes in China were 3.1% and 0.5%, respectively. The review indicates that the awareness ratio of e-cigarettes was about 66% in Hong Kong, whereas the ratio for Tianjin was lower (43.6%). Online sales were the main channel for selling e-cigarettes to 80% of the users. Awareness of e-cigarettes has been increasing in China. Awareness was higher in men compared to women in all age groups. Nevertheless, e-cigarette use in China was lower than in developed countries. E-cigarette users were more likely to try to quit smoking, but the relationship between e-cigarette use and smoking cessation is still unclear. Governance is necessary for e-cigarette use and marketing effort.

This study investigated the awareness and use of e-cigarettes in China and the existing regulations for e-cigarette use and marketing. The lack of regulations for e-cigarette use and the unrestricted practice encourage the increase in adoption of e-cigarettes and misconceptions of the benefits of using e-cigarettes. Hence, it is crucial that the government of China prioritize the establishment and implementation of regulations for e-cigarette use and marketing.

Authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
This work was supported by the open project of NHC Key Laboratory of Health Economics and Policy Research (NHC-HEPR2018005), and the Philosophy and Social Science Foundation of Shanghai (Grant No. 2015BGL011).
Not commissioned; externally peer reviewed.
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