RESEARCH PAPER
Perceptions and use of electronic cigarettes among young adults in China
Xinsong Wang 1
,  
Xiulan Zhang 1
,  
Xiaoxin Xu 1  
,  
 
 
More details
Hide details
1
School of Social Development and Public Policy, Beijing Normal University, Beijing, China
CORRESPONDING AUTHOR
Xiaoxin Xu   

School of Social Development and Public Policy, Beijing Normal University, New Library Building 2024B,19 Xinjiekouwai St. Haidian District, 100875 Beijing, China
Publish date: 2019-03-04
 
Tob. Induc. Dis. 2019;17(March):17
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Little is known about the perception and use of e-cigarettes by the Chinese, particularly the young people. This study reveals the awareness, attitudes, and use of e-cigarettes among young adults in China, examines the relationship between smoking behavior and e-cigarette perception and use, and demonstrates the phenomenon of e-cigarette gifting.

Methods:
We used results from a mobile app-based survey conducted in November 2015 that included 10477 young Chinese adults aged between 19 and 29 years. Bivariate tests were conducted to analyze perception and use of e-cigarettes by respondents of different smoking status. Multivariate logistic regressions were applied to examine the correlates of e-cigarette use and perception and e-cigarette gifting behavior, particularly the factors of tobacco smoking status and quitting behavior.

Results:
Among the surveyed young adults, 88.40% were aware of e-cigarettes, and nearly a quarter of all respondents had used e-cigarettes by the time of our survey. Multivariate regression results demonstrated that current smokers with quitting experience were more likely to be aware of and to use e-cigarettes than current smokers with no quitting experience. Smokers with quitting experience also were more inclined to promote e-cigarettes to others by either recommending them or giving them as gifts.

Conclusions:
E-cigarettes have gained popularity among young adults in China and smokers, especially those who had tried quitting, were more likely to have known and used e-cigarettes. More empirical research on the relationship between e-cigarette use and smoking cessation is warranted to better inform a potential regulatory framework in China.

CONFLICTS OF INTEREST
The authors have completed and submitted an ICMJE form for disclosure of potential conflicts of interest and they declare that they have no competing interests, financial or otherwise, related to the current work. X Wang, X Zhang, X Xu and Y Gao report grants from the Bill and Melinda Gates Foundation, during the conduct of the study.
FUNDING
This study was supported by the Bill and Melinda Gates Foundation (Grant number OPP1123586). The funder had no role in the study design, collection, analysis, or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. The corresponding author had full access to all data in the study and had final responsibility for the decision to submit the paper for publication.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
REFERENCES (34)
1.
Hartmann‐Boyce J, McRobbie H, Bullen C, Begh R, Stead LF, Hajek P. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2016;(9):CD010216. doi:10.1002/14651858.cd010216.pub3
 
2.
Berridge V. Electronic cigarettes and history. Lancet. 2014;383(9936):2204-2205. doi:10.1016/s0140-6736(14)61074-6
 
3.
Shan J. E-cigarette controls considered for safety. China Daily. January 7, 2015. http://www.chinadaily.com.cn/c.... Accessed November 12, 2018.
 
4.
Liao A. Chinese e-cigarette makers shift to domestic markets. Tobacco Asia. September 1, 2015. http://www.tobaccoasia.com/fea.... Accessed July 7, 2018.
 
5.
Xiao L, Parascandola M, Wang C, Jiang Y. Perception and current use of e-cigarettes among youth in China. Nicotine Tob Res. 2018:1-7. doi:10.1093/ntr/nty145
 
6.
Wang X, Zhang X, Xu X, Gao Y. Electronic cigarette use and smoking cessation behavior among adolescents in China. Addict Behav. 2018;82:129-134. doi:10.1016/j.addbeh.2018.02.029
 
7.
Feng G, Nan Y, Jiang Y. Prevalence of e-cigarette in China: preliminary findings from two surveys. Tob Induc Dis. 2018;16(Suppl 1:A271). doi:10.18332/tid/84231
 
8.
Hartwell G, Thomas S, Egan M, Gilmore A, Petticrew M. E-cigarettes and equity: a systematic review of differences in awareness and use between sociodemographic groups. Tob Control. 2017;26(e2):e85-e91. doi:10.1136/tobaccocontrol-2016-053222
 
9.
Zhao L, Wang J. E-cigarettes use among urban male tobacco smokers age 15 years or older in China. Tob Induc Dis. 2018;16(Suppl 1:A275). doi:10.18332/tid/83891
 
10.
Farsalinos K, Tomaselli V, Polosa R. Frequency of use and smoking status of U.S. adolescent e-cigarette users in 2015. Am J Prev Med. 2018;54(6):814-820. doi:10.1016/j.amepre.2018.03.003
 
11.
Farsalinos KE, Poulas K, Voudris V, Houezec JL. Electronic cigarette use in the European Union: Analysis of a representative sample of 27460 Europeans from 28 countries. Addiction. 2016;111(11):2032-2040. doi:10.1111/add.13506
 
12.
Delnevo CD, Giovenco DP, Steinberg MB, et al. Patterns of electronic cigarette use among adults in the United States. Nicotine Tob Res. 2016;18(5):715-719. doi:10.1093/ntr/ntv237
 
13.
Adkison SE, O'Connor RJ, Bansal-Travers M, et al. Electronic nicotine delivery systems: International Tobacco Control Four-Country Survey. Am J Prev Med. 2013;44(3):207-215. doi:10.1016/j.amepre.2012.10.018
 
14.
Regan AK, Promoff G, Dube SR, Arrazola R. Electronic nicotine delivery systems: adult use and awareness of the ‘e-cigarette’ in the USA. Tob Control. 2013;22(1):19-23. doi:10.1136/tobaccocontrol-2011-050044
 
15.
Hummel K, Hoving C, Nagelhout GE, et al. Prevalence and reasons for use of electronic cigarettes among smokers: Findings from the International Tobacco Control (ITC) Netherlands Survey. Int J Drug Policy. 2015;26(6):601-608. doi:10.1016/j.drugpo.2014.12.009
 
16.
Dockrell M, Morrison R, Bauld L, McNeill A. E-cigarettes: Prevalence and attitudes in Great Britain. Nicotine Tob Res. 2013;15(10):1737-1744. doi:10.1093/ntr/ntt057
 
17.
Zhu S-H, Gamst A, Lee M, Cummins S, Yin L, Zoref L. The use and perception of electronic cigarettes and snus among the U.S. population. PLoS One. 2013;8(10):e79332. doi:10.1371/journal.pone.0079332
 
18.
Lee JA, Kim SH, Cho H-J. Electronic cigarette use among Korean adults. Int J Public Health. 2016;61(2):151-157. doi:10.1007/s00038-015-0763-y
 
19.
Temple JR, Shorey RC, Lu Y, Torres E, Stuart GL, Le VD. E-cigarette use of young adults motivations and associations with combustible cigarette alcohol, marijuana, and other illicit drugs. Am J Addict. 2017;26(4):343-348. doi:10.1111/ajad.12530
 
20.
Wallace LN, Roche MJ. Vaping in context: Links among e-cigarette use, social status, and peer influence for college students. J Drug Educ. 2018;48(1-2):36-53. doi:10.1177/0047237918807706
 
21.
Vogel EA, Ramo DE, Rubinstein ML. Prevalence and correlates of adolescents’ e-cigarette use frequency and dependence. Drug Alcohol Depend. 2018;188:109-112. doi:10.1016/j.drugalcdep.2018.03.051
 
22.
Jeon C, Jung KJ, Kimm H, et al. E-cigarettes, conventional cigarettes, and dual use in Korean adolescents and university students: Prevalence and risk factors. Drug Alcohol Depend. 2016;168:99-103. doi:10.1016/j.drugalcdep.2016.08.636
 
23.
Li J, Newcombe R, Walton D. The prevalence, correlates and reasons for using electronic cigarettes among New Zealand adults. Addict Behav. 2015;45:245-251. doi:10.1016/j.addbeh.2015.02.006
 
24.
Kohrman M. Depoliticizing tobacco's exceptionality: Male sociality, death and memory-making among Chinese cigarette smokers. China J. 2007;58:85-109. doi:10.1086/tcj.58.20066308
 
25.
Wolfson M, Forster JL, Claxton AJ, Murray DM. Adolescent smokers' provision of tobacco to other adolescents. Am J Public Health. 1997;87(4):649-651. doi:10.2105/ajph.87.4.649
 
26.
Hu T-W, Lee AH, Mao Z. WHO Framework Convention on Tobacco Control in China: Barriers, challenges and recommendations. Glob Health Promot. 2013;20(4):13-22. doi:10.1177/1757975913501910
 
27.
Zhang X, Lin S, Hu T-w. The epidemic of cigarette gifting: A social barrier of tobacco control in China. In: Hu T-w, ed. Economics of bobacco control in China: From policy research to practice. Hackensack, NJ: World Scientific; 2016:129-146.
 
28.
Yang Y, Nan Y, Tu M, Wang J, Wang L, Jiang Y. Major finding of 2015 China adults tobacco survery. Chinese Journal of Health Mangement. 2016;10(2):85-87.
 
29.
Garbutt JM, Miller W, Dodd S, Bobenhouse N, Sterkel R, Strunk RC. Parental use of electronic cigarettes. Acad Pediatr. 2015;15(6):599-604. doi:10.1016/j.acap.2015.06.013
 
30.
Fotiou A, Kanavou E, Stavrou M, Richardson C, Kokkevi A. Prevalence and correlates of electronic cigarette use among adolescents in Greece: A preliminary cross-sectional analysis of nationwide survey data. Addict Behav. 2015;51:88-92. doi:10.1016/j.addbeh.2015.07.021
 
31.
Polosa R, Caponnetto P, Morjaria J, Papale G, Campagna D, Russo C. Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study. BMC Public Health. 2011;11(11):786. doi:10.1186/1471-2458-11-786
 
32.
Adriaens K, Van Gucht D, Declerck P, Baeyens F. Effectiveness of the electronic cigarette: An eight-week flemish study with six-month follow-up on smoking reduction, craving and experienced benefits and complaints. Int J Environ Res Public Health. 2014;11(11):11220-11248. doi:10.3390/ijerph111111220
 
33.
Bullen C, Howe C, Laugesen M, et al. Electronic cigarettes for smoking cessation: A randomised controlled trial. Lancet. 2013;382(9905):1629-1637. doi:10.1016/s0140-6736(13)61842-5
 
34.
Borderud SP, Li Y, Burkhalter JE, Sheffer CE, Ostroff JS. Electronic cigarette use among patients with cancer: characteristics of electronic cigarette users and their smoking cessation outcomes. Cancer. 2014;120(22):3527-3535. doi:10.1002/cncr.28811
 
eISSN:1617-9625