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QuickStats: Cigarette Smoking Status Among Current Adult E-cigarette Users, by Age Group

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Study finds perception of e-cigarette harm growing among US adults

The proportion of American adults who perceive e-cigarettes to be equally or more harmful than traditional cigarettes has tripled over the last few years, highlighting the need for more accurate public health messaging, according to a study led by tobacco researchers in the School of Public Health at Georgia State University.

“Although the impact of long-term use of e-cigarettes on health is still unknown,” the study stated, “the available scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes, and that smokers switching to e-cigarettes could benefit from a decrease in health risks related to smoking combustible cigarettes.”

Researchers looked at data from the Tobacco Products and Risk Perception surveys from 2012 through 2015 to examine changes in how adults in the United States perceived the relative harm and addictiveness of e-cigarettes. The surveys were conducted nationally in 2012, 2014 and 2015 by the Tobacco Center of Regulatory Science (TCORS) at the School of Public Health. Nearly 16,000 adults completed the surveys.

The study results are published in the American Journal of Preventive Medicine in an article titled “Changing Perceptions of Harm of E-Cigarettes among U.S. Adults, 2012-2015.” The study’s lead author is Dr. Ban Majeed, a postdoctoral research associate with TCORS in the School of Public Health.

According to the survey, 35 percent of adult smokers perceived e-cigarettes to be equally or more harmful than combustible cigarettes in 2015—a sizeable increase over the nearly 12 percent who reported that perception in 2012. Also, the proportion of adult smokers who thought e-cigarettes were addictive more than doubled from 25 percent in 2012 to nearly 57 percent in 2015. Similar trends were seen in non-smoking adults.

“The findings underscore the urgent need to convey accurate information to the public, especially adult smokers, about the available scientific evidence of the harm of e-cigarettes compared to combustible cigarettes,” the study stated.

“Our public health messages should accurately convey to cigarette smokers that switching completely to e-cigarettes would reduce their risks even if e-cigarettes are addictive and not risk-free,” said one of the study’s authors, Dr. Michael Eriksen, dean of Georgia State’s School of Public Health and a globally recognized expert in tobacco control.

Association between use of flavoured tobacco products and quit behaviours

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Survey of small retailers in Great Britain

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Tobacco use and second-hand smoke exposure in young adolescents aged 12–15 years

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15.6 million Vietnamese spend $1.4bn on smoking: survey

About 15.6 million adults in Vietnam consumed tobacco last year, the Ministry of Health announced Tuesday, citing findings of a global survey.

Vietnamese smokers spent VND31 trillion (US$1.39 billion) on cigarettes, or VND2.7 million ($121) per person per year, according to the Global Adult Tobacco Survey (GATS) 2015.

The GATS, a World Health Organization-backed initiative, was conducted last year in Vietnam by the Hanoi Medical University and the General Statistics Office.

The survey found that besides traditional cigarettes, there is an increase in using e-cigarettes, sisha, and chewing tobacco among adults in the country, the health ministry confirmed at a conference to announce its results in Hanoi.

The percentage of adults smoking e-cigarettes has risen to 0.4 percent in men and 0.1 percent in women. About 0.1 percent of adults also consume sisha, while 1.4 percent of the population use chewing tobacco, according to the survey.

The good news is that only 45.3 percent of men aged 15 and above smoked in 2015, compared to 47.4 percent a year earlier.

The smoking rate among men in urban areas also decreased from 45 percent in 2010 to 38.7 percent last year.

The survey also said that raising tobacco taxes proved to be an effective solution in reducing smoking.

The Ministry of Health’s spokesperson said that many countries had banned e-cigarettes due to the density of nicotine stored in the devices, which is more harmful than traditional cigarettes.

The Global Adult Tobacco Survey (GATS) is a nationally representative household survey launched in February 2007 as a new component of the ongoing Global Tobacco Surveillance System (GTSS), the WHO said on its website.

The GATS enables countries to collect data on adult tobacco use and key tobacco control measures.

Topics covered in GATS include the prevalence of tobacco use, knowledge, attitudes as well as perceptions, economics, and more.

Concerns over survey on benefits of e-cigs

Experts have expressed their concerns over a recent survey on the implied benefits of e-cigs or vaping.

A researcher said 95% of Malaysian vapers surveyed have either quit, or cut down on smoking, while more than 80% of them reported improved health.

“More than two-thirds stopped smoking altogether.

“Among the 27% that didn’t quit, the average consumption of cigarettes dropped from 19 to four cigarettes per day,” Greek cardiologist Dr Konstantinos Farsalinos, a researcher at the Onassis Cardiac Surgery Center and University of Patras, told The Star.

Over the 7,000 adult vapers – 97% of them males – participated in the online survey. The average age of the respondents was 30.

Universiti Malaya nicotine addiction specialist Assoc Prof Dr Amer Siddiq Amer Nordin voiced his concern that a single survey conducted on mainly Internet users was inadequate to change the understanding on the dangers or benefits of e-cigs.

“Let’s see the ongoing national study findings and compare with Dr Farsalinos’ data.

“If e-cigs are found to be a useful quit-smoking agent in future, it should be regulated as a medicinal device.

“Still, abstinence is the best way to quit,” he said, adding that nicotine was under the Poison Act and its distribution should be controlled.

Over 5,500 ex-smokers and more than 1,500 smokers, who are also vapers, were asked about their experiences with e-cigs and the results were consistent with those in the US and Europe.

Prof Datuk Dr Abdul Razak Muttalif, chairman of the Health Ministry’s technical committee on e-cigs and shisha, said the long-term effect of e-cigs was still unknown.

“As doctors, we’re very careful,” said Dr Abdul Razak, who is also a senior consultant chest physician at the KL Hospital Institute of Respiratory Medicine.

He warned that e-cigs had long-term effects and could lead to other addictions.

The committee had recommended that e-cigs be strictly regulated as a pharmaceutical product in Malaysia.

Describing the move as a “big step backwards”, Dr Farsalinos said whether e-cigs were a pharmaceutical, tobacco or consumer product, was dealt with in Europe three years ago.

“E-cigs are not medicinal so that argument was thrown out.

“The EU (European Union) regulates it under the Tobacco Products Directive but there’s a separate category for e-cigs where it’s treated as a consumer product,” he said.

He added that e-cigs should be regulated as a consumer product but with restrictions like banning its sale to minors.

Calling for a ban on e-cigs, Consumers Association of Penang (CAP) said instead of helping smokers to quit, e-cigs are causing them to spend more on a new habit.

CAP education officer N.V. Subbarow said many vapers were still smoking. “Worse, teachers and parents are at a loss because kids who have never smoked are vaping now.”

Removal of tobacco displays helps reduce smoking, says study

Removal of point-of-sale (POS) tobacco displays from shops including convenience stores and gas stations has helped reduce smoking among New Zealand school students to record low levels, according to a recent University of Otago study.

The research, published in the international journal Tobacco Control, used an annual classroom-based survey of around 25,000 Year 10 students in the country and compared findings from an earlier study conducted before the tobacco display ban took effect in the country in 2012.

“The proportion of children who had tried smoking but were not regular smokers fell, from 23-24% in 2011 and 2012 before the changes, to 17% in 2014. The proportion of smoking students who were buying or trying to buy cigarettes from stores also declined,” stated the research.

The reductions both in experimental and regular smoking considered at their lowest level for two decades were attributed to “the removal of point-of-sale (POS) tobacco displays, accompanied by increased enforcement measures and penalties for selling tobacco to minors.”

E.U. Survey Finds E-Cigarettes Helped 15 Million Smokers Quit or Cut Back

There was little evidence that vaping leads to smoking.

A large survey of Europeans indicates that more than 6 million have quit smoking with the help of e-cigarettes, while more than 9 million have cut back, according to a study recently published by the journal Addiction. “These are probably the highest rates of smoking cessation and reduction ever observed in such a large population study,” says the lead researcher, Konstantinos Farsalinos, a cardiologist at the Onassis Cardiac Surgery Center in Athens. “The European Union data show that the use of electronic cigarettes seems to have a positive impact on public health for two main reasons: 1) High smoking cessation and reduction rates are observed, and 2) electronic cigarette use is largely confined to smokers (current and former), with minimal use by nonsmokers.”

The study, based on responses from 27,460 participants in the Eurobarometer survey, found that 48.5 million citizens of E.U. countries have tried e-cigarettes, while 7.5 million are current vapers. Within the latter group, 35 percent reported that e-cigarettes helped them quit smoking, while 32 percent said they were smoking less thanks to e-cigarettes. Such self-reports are not conclusive, since the study did not independently verify smoking status, smokers who try to quit by vaping are probably different from those who don’t, and it’s possible these outcomes could have been achieved without e-cigarettes. But policy makers and regulators should not lightly dismiss the experiences of millions who say e-cigarettes helped them make changes that dramatically reduced the health hazards they face.

Critics of vaping say the risk that it will lead to smoking in people who otherwise never would have used tobacco products must be weighed against the success stories of people who believe they’d still be smoking if it weren’t for e-cigarettes. But this study found very little evidence of such a risk. Just 0.8 percent of respondents who had ever tried tobacco products said they had tried e-cigarettes first (which does not necessarily mean that the latter led to the former). Only 1.3 percent of never-smokers reported using e-cigarettes with nicotine-containing liquids, and only 0.09 percent did so every day. “In nonsmokers we observed some experimentation with electronic cigarettes, but regular use is minimal,” says one of Farsalinos’ collaborators, Jacques Le Houezec, a neuroscientist at the French National Research Institute for Health and Medical Research. “The concern that electronic cigarettes can be a gateway to smoking is largely rejected by our findings.”

More than half of EU citizens questioned now think e-cigarettes are harmful

More than half of Europeans now think that e-cigarettes are harmful–a proportion that has nearly doubled in two years–show the latest results of a European Union (EU)-wide survey, published online in the journal Tobacco Control.

Yet use of these devices across member states has continued to surge within the same timeframe, the findings show.

The researchers analysed responses to two Eurobarometer for Tobacco surveys carried out in early 2012 and late 2014, on the perceptions and use of e-cigarettes, among a representative sample of adults (15+ years) from 27 EU member states, excluding Croatia.

In all, just under 27,000 people in both years answered questions on frequency of use; reasons for use; perception of harms; current tobacco use; and provided information on age, sex, educational attainment, and household financial security.

The proportion of people who said they had ever tried an e-cigarette rose from 7.2% in 2012 to 11.6% in 2014 across member states, although this figure varied widely by country, ranging from 5.7% of respondents in Portugal to 21.3% in France, for example.

And in Malta, survey respondents were more than five times as likely to say they had tried an e-cigarette in 2014 as they were in 2012.

Furthermore, in 2014, around one in seven people who said they had ever tried an e-cigarette defined themselves as a current user of these devices, indicating that they had shifted from experimentation to use, say the researchers. But once again, this varied by country, ranging from 1.7% in Slovenia to 28.9% in Portugal.

Current smokers were 23 times more likely to say that they had ever tried an e-cigarette while ex-smokers were more than 6.5 times as likely to have done so.

Being in the age range 18-24, living in a town/city, and being more highly educated were also linked to increased odds of ever having tried an e-cigarette.

Those who defined themselves as current vapers were more likely to be older. And they were nearly three times as likely to say they had started vaping because they thought e-cigarettes could help them quit smoking, and more than twice as likely to say they had done so to get round smoking bans.

The attractiveness of e-cigarettes had no bearing on the decision to become a regular vaper, the responses showed.

But despite the rising overall popularity of e-cigarettes, the proportion of those who felt these devices posed a health risk nearly doubled between 2012 and 2014.

In 2012, around one in four people (just over 27%) believed them to pose a health risk. By 2014 this figure had risen to more than 51.5%.

Yet again, this figure varied widely, from just over 31% of respondents in Hungary to just over 78% in The Netherlands. The UK had one of the lowest proportions of citizens who thought e-cigarettes were harmful.

Nevertheless, almost a third of all respondents (29%) said they didn’t know whether e-cigarettes were harmful, which indicates prevailing levels of uncertainty about their safety, suggest the researchers.

They point out that as their study was cross-sectional, meaning that data were collected from each participant at a single point in time, caution should be applied to any assumptions about causal relationships.

Variations in responses may be partly explained by the differing rates of smoking across EU member states as current and former smokers were much more likely to have tried e-cigarettes, they say.

Other factors, such as the way in which e-cigarettes are advertised and/or promoted as a smoking cessation aid, and their affordability, are also likely to have a role, they add.

“A better understanding of the population-level use and impact of e-cigarettes within the EU is needed, especially of the potential impact on smoke-free laws, smoking initiation and cessation,” they conclude.