Use of electronic cigarettes across 13 ITC countries with different regulatory environments
More details
Hide details
University of Waterloo, Canada
King’s College London, Psychology & Neuroscience, Addiction, United Kingdom
King’s College London, United Kingdom
Medical University of South Carolina, United States of America
Cancer Council Victoria, Australia
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A229
Download abstract book (PDF)

Electronic cigarettes have become an international phenomenon, although few studies have compared e-cigarette use across countries. This paper presents prevalence estimates of self-reported e-cigarette awareness, trial (ever-tried), current use (daily/weekly/monthly), and daily use from 13 countries that vary on the strictness of e-cigarette policies/regulations.

Cross-sectional analyses of representative samples of adult (≥18-years) current and former smokers participating in International Tobacco Control Project (ITC) surveys in 13 countries from the most recent ITC survey wave (2013-2017). Countries were categorized into those with no e-cigarette policies (NP), less restrictive policies (LRP), or more restrictive policies (MRP).

Weighted prevalence estimates of four key measures were computed:
1. Awareness: for NP countries: Zambia (2014): 3%, Bangladesh (2014/15): 7%, China (2013/15): 59%; LRP countries: Netherlands (2017): 92%, Republic of Korea (2016): 94%, United States (US) and England (2016): 99%; MRP countries: Uruguay (2014): 52%, Mexico (2014/15): 61%, Brazil (2016): 73%, Malaysia (2013/2014): 86%, Australia and Canada (2016): 99%.
2. Trial:
for NP countries: Zambia (0%), Bangladesh (1%), China (11%); LRP countries: Netherlands (39%), Korea (44%), England (52%). US (58%); MRP countries: Uruguay (7%), Mexico (10%), Malaysia (38%), Australia (45%), Canada (49%).
3. Daily/weekly/monthly use:
for NP countries: Zambia and Bangladesh (< 1%); China (1%); LRP countries: Korea (6%), Netherlands, US, England (7%); MRP countries: Uruguay (0%), Brazil (1%), Mexico (2%), Australia and Canada (6%), Malaysia (12%).
4. Daily use: for NP countries: Zambia, Bangladesh, China (all 0%); LRP countries: Korea (3%), Netherlands (3%), US (3%), England (4%); MRP countries: Uruguay and Brazil (0%), Mexico (1%), Canada (2%), Australia (3%), Malaysia (4%).

[E-cigarette Trial, Current Use, and Daily Use]

With minor exceptions (e.g. Australia), awareness, trial, and use of e-cigarettes across the 13 countries generally reflected the de facto environment rather than the statutory environment implied by the law(s). Country income classification and survey year also appear to be strongly associated with use.

Exposure to and perceptions of health warning labels on nicotine vaping products: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey
Máirtín McDermott, Grace Li, Ann McNeill, David Hammond, James Thrasher, Richard O'Connor, K. Cummings, Ron Borland, Geoffrey Fong, Sara Hitchman
Nicotine Dependence Evaluated by Urinary Cotinine and Heaviness of Smoking Index among Smokers, Vapers, and Dual Users: A Cross-Sectional Study Using the Korea National Health and Nutrition Examination Survey Data
Ju Hwang, Cheol Lee, Kiheon Lee, Choon-Young Kim
Korean Journal of Family Medicine
Social connections influencing e-cigarette use and intentions in Australia: a survey
Amin, Samia, Laranjo, Liliana, Dunn, G. Adam
Journal of Addictive Diseases
News framing of e-cigarettes: A cross-national study of the US, UK, and Korea
Jin-Ae Kang, Peter Schulz, Glenn Hubbard, Jooyun Hwang, Adrienne Muldrow, Brenna Barber, Catherine Lochner
Communication Studies
Portrayals of Electronic Cigarette Use; A Content Analysis of News Coverage by Online News Sites in Africa
Chimwemwe Ngoma
Journals System - logo
Scroll to top