Top

BMC Public Health

Published in:

Open Access 01-12-2019 | Smoking and Nicotine Detoxification | Research article

Support for e-cigarette regulations among Australian young adults

Authors: Michelle I. Jongenelis, Caitlin Kameron, Daniel Rudaizky, Simone Pettigrew

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

Surveying support for various regulatory options relating to e-cigarettes can assist policymakers to identify those that have broad support and are therefore likely to be easier to implement. However, data on support for potential e-cigarette regulations in Australia are limited. To inform regulatory efforts, the present study assessed attitudes to the regulation of e-cigarettes among Australian young adults, the most prevalent users of e-cigarettes and therefore the most likely population segment to be affected by e-cigarette regulations.

Methods

A total of 1116 Australians aged 18 to 25 years (59% female) completed an online survey where they were presented with various statements relating to the regulation of e-cigarettes and asked to report on the extent to which they agreed or disagreed with each. Statements presented either a restrictive or non-restrictive approach to e-cigarette regulation.

Results

Across all statements, 10–22% of respondents responded “don’t know” while 23–35% neither agreed nor disagreed, indicating general ambivalence. There was a moderate level of support (33–37%) for regulating e-cigarette sales/use and treating e-cigarettes like tobacco products. Only 20% of respondents were in favour of allowing the use of e-cigarettes in smoke-free areas. Smokers, e-cigarette users, and those who did not believe in the harms associated with e-cigarettes were typically less likely than other respondents to support restrictive approaches.

Conclusions

The young Australian adults surveyed were somewhat supportive of restrictions around the sale and use of e-cigarettes, but generally opposed outright bans and any need for a prescription from a medical practitioner. Increasing awareness of the harms associated with the use of e-cigarettes represents a potential strategy to gaining regulatory support.

Available only for authorised users

National Academies of Sciences, Engineering, and Medicine: Public health consequences of e-cigarettes. In. Washington, DC: The National Academies Press; 2018.

Webb Hooper M, Kolar SK. Racial/ethnic differences in electronic cigarette use and reasons for use among current and former smokers: findings from a community-based sample. Int J Environ Res Public Health. 2016;13(10). https://doi.org/10.3390/ijerph13101009.

Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2016, online data tables, vol. 2017. Canberra: AIHW.

Levy DT, Chaloupka F, Gitchell J. The effects of tobacco control policies on smoking rates: a tobacco control scorecard. J Public Health Manag Pract. 2004;10(4):338–53. https://doi.org/10.1097/00124784-200407000-00011.CrossRefPubMed

Voigt K. Smoking norms and the regulation of e-cigarettes. Am J Public Health. 2015;105(10):1967–72. https://doi.org/10.2105/AJPH.2015.302764.CrossRefPubMedPubMedCentral

McMillen RC, Gottlieb MA, Shaefer RM, Winickoff JP, Klein JD. Trends in electronic cigarette use among U.S. adults: use is increasing in both smokers and nonsmokers. Nicotine Tob Res. 2015;17(10):1195–202. https://doi.org/10.1093/ntr/ntu213.CrossRefPubMed

World Health Organization. Backgrounder on WHO report on regulation of e-cigarettes and similar products. Geneva: WHO; 2014.

Sutherland R, Sindicich N, Entwistle G, Whittaker E, Peacock A, Matthews A, Bruno R, Alati R, Burns L. Tobacco and e-cigarette use amongst illicit drug users in Australia. Drug Alcohol Depend. 2016;159:35–41. https://doi.org/10.1016/j.drugalcdep.2015.10.035.CrossRefPubMed

Gualano MR, Passi S, Bert F, La Torre G, Scaioli G, Siliquini R. Electronic cigarettes: assessing the efficacy and the adverse effects through a systematic review of published studies. Journal Public Health. 2015;37(3):488–97. https://doi.org/10.1093/pubmed/fdu055.CrossRef

10.

Yong HH, Borland R, Balmford J, McNeill A, Hitchman S, Driezen P, Thompson ME, Fong GT, Cummings KM. Trends in e-cigarette awareness, trial, and use under the different regulatory environments of Australia and the United Kingdom. Nicotine Tob Res. 2015;17(10):1203–11. https://doi.org/10.1093/ntr/ntu231.CrossRefPubMed

11.

Twyman L, Bonevski B, Paul C, Bryant J, Gartner C, Guillaumier A. Electronic cigarettes: awareness, recent use, and attitudes within a sample of socioeconomically disadvantaged Australian smokers. Nicotine Tob Res. 2016;18(5):670–7. https://doi.org/10.1093/ntr/ntv183.CrossRefPubMed

12.

Liquid nicotine and personal importation for use in electronic cigarettes [https://www.tga.gov.au/node/1062]. Accessed 8 May 2018.

13.

NSW Department of Health: Are electronic cigarettes and e-liquids safe?; 2018.

14.

Bahl V, Lin S, Xu N, Davis B, Wang Y, Talbot P. Comparison of electronic cigarette refill fluid cytotoxicity using embryonic and adult models. Reprod Toxicol. 2012;34(4):529–37. https://doi.org/10.1016/j.reprotox.2012.08.001.CrossRefPubMed

15.

Sassano MF, Davis ES, Keating JE, Zorn BT, Kochar TK, Wolfgang MC, Glish GL, Tarran R. Evaluation of e-liquid toxicity using an open-source high-throughput screening assay. PLoS Biol. 2018;16(3). https://doi.org/10.1371/journal.pbio.2003904.

16.

Schober W, Szendrei K, Matzen W, Osiander-Fuchs H, Heitmann D, Schettgen T, Jorres RA, Fromme H. Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. Int J Hyg Environ Health. 2014;217(6):628–37. https://doi.org/10.1016/j.ijheh.2013.11.003.CrossRefPubMed

17.

Schripp T, Markewitz D, Uhde E, Salthammer T. Does e-cigarette consumption cause passive vaping? Indoor Air. 2013;23(1):25–31. https://doi.org/10.1111/j.1600-0668.2012.00792.x.CrossRefPubMed

18.

Henkler F, Luch A. E-cigarettes in Europe: does regulation swing from overcautious to careless? Arch Toxicol. 2014;88(7):1291–4. https://doi.org/10.1007/s00204-014-1293-8.CrossRefPubMed

19.

Canistro D, Vivarelli F, Cirillo S, Marquillas CB, Buschini A, Lazzaretti M, Marchi L, Cardenia V, Rodriguez-Estrada MT, Lodovici M, et al. E-cigarettes induce toxicological effects that can raise the cancer risk. Sci Rep. 2017;7(1). https://doi.org/10.1038/s41598-017-02317-8.

20.

House of Representatives Standing Committee on Health Aged Care and Sport. Report on the Inquiry into the Use and Marketing of Electronic Cigarettes and Personal Vaporisers in Australia. Canberra: Commonwealth of Australia; 2018.

21.

Borland R, Yong HH, Siahpush M, Hyland A, Campbell S, Hastings G, Cummings KM, Fong GT. Support for and reported compliance with smoke-free restaurants and bars by smokers in four countries: findings from the international tobacco control (ITC) four country survey. Tob Control. 2006;15(suppl 3):iii34–41.PubMedPubMedCentral

22.

Adkison SE, O'Connor RJ, Bansal-Travers M, Hyland A, Borland R, Yong HH, Cummings KM, McNeill A, Thrasher JF, Hammond D, et al. Electronic nicotine delivery systems: International tobacco control four-country survey. Am J Prev Med. 2013;44(3):207–15. https://doi.org/10.1016/j.amepre.2012.10.018.CrossRefPubMedPubMedCentral

23.

Brose LS, Partos TR, Hitchman SC, McNeill A. Support for e-cigarette policies: a survey of smokers and ex-smokers in Great Britain. Tob Control. 2017;26(e1):e7–e15.CrossRef

24.

Unger JB, Barker D, Baezconde-Garbanati L, Soto DW, Sussman S. Support for electronic cigarette regulations among California voters. Tob Control. 2017;26(3):334–7. https://doi.org/10.1136/tobaccocontrol-2016-052918.CrossRefPubMed

25.

Wackowski OA, Delnevo CD. Smokers' attitudes and support for e-cigarette policies and regulation in the USA. Tob Control. 2015;24(6):543–6. https://doi.org/10.1136/tobaccocontrol-2014-051953.CrossRefPubMedPubMedCentral

26.

Fraser D, Weier M, Keane H, Gartner C. Vapers’ perspectives on electronic cigarette regulation in Australia. Int J Drug Policy. 2015;26(6):589–94. https://doi.org/10.1016/j.drugpo.2015.01.019.CrossRefPubMed

27.

Tan AS, Lee CJ, Bigman CA. Public support for selected e-cigarette regulations and associations with overall information exposure and contradictory information exposure about e-cigarettes: findings from a national survey of U.S. adults. Prev Med. 2015;81:268–74. https://doi.org/10.1016/j.ypmed.2015.09.009.CrossRefPubMed

28.

Gostin LO, Glasner AY. E-cigarettes, vaping, and youth. JAMA. 2014;312(6):595–6. https://doi.org/10.1001/jama.2014.7883.CrossRefPubMed

29.

Wolfenden L, Stockings E, Yoong SL. Regulating e-cigarettes in Australia: implications for tobacco use by young people. Med J Aust. 2018;208(1):89. https://doi.org/10.5694/mja17.00787.CrossRefPubMed

30.

Kong G, Morean ME, Cavallo DA, Camenga DR, Krishnan-Sarin S. Reasons for electronic cigarette experimentation and discontinuation among adolescents and young adults. Nicotine Tob Res. 2015;17(7):847–54. https://doi.org/10.1093/ntr/ntu257.CrossRefPubMed

31.

Hummel K, Hoving C, Nagelhout GE, de Vries H, van den Putte B, Candel MJ, Borland R, Willemsen MC. 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):601–8. https://doi.org/10.1016/j.drugpo.2014.12.009.CrossRefPubMed

32.

Finney Rutten LJ, Blake KD, Agunwamba AA, Grana RA, Wilson PM, Ebbert JO, Okamoto J, Leischow SJ. Use of e-cigarettes among current smokers: associations among reasons for use, quit intentions, and current tobacco use. Nicotine Tob Res. 2015;17(10):1228–34. https://doi.org/10.1093/ntr/ntv003.CrossRef

33.

Wakefield M, Kloska DD, O'Malley PM, Johnston LD, Chaloupka F, Pierce J, Giovino G, Ruel E, Flay BR. The role of smoking intentions in predicting future smoking among youth: findings from monitoring the future data. Addiction. 2004;99(7):914–22. https://doi.org/10.1111/j.1360-0443.2004.00742.x.CrossRefPubMed

34.

Green SH, Bayer R, Fairchild AL. Evidence, policy, and e-cigarettes-will England reframe the debate? N Engl J Med. 2016;374(14):1301–3.CrossRef

35.

Wadsworth E, Neale J, McNeill A, Hitchman SC. How and why do smokers start using e-cigarettes? Qualitative study of vapers in London, UK. Int J Environ Res Public Health. 2016;13(7). https://doi.org/10.3390/ijerph13070661.

36.

Suris JC, Berchtold A, Akre C. Reasons to use e-cigarettes and associations with other substances among adolescents in Switzerland. Drug Alcohol Depend. 2015;153:140–4. https://doi.org/10.1016/j.drugalcdep.2015.05.034.CrossRefPubMed

37.

Choi K, Forster J. Characteristics associated with awareness, perceptions, and use of electronic nicotine delivery systems among young US Midwestern adults. Am J Public Health. 2013;103(3):556–61. https://doi.org/10.2105/AJPH.2012.300947.CrossRefPubMedPubMedCentral

38.

Lee HY, Lin HC, Seo DC, Lohrmann DK. Determinants associated with E-cigarette adoption and use intention among college students. Addict Behav. 2017;65:102–10. https://doi.org/10.1016/j.addbeh.2016.10.023.CrossRefPubMed

39.

Harrell PT, Simmons VN, Pineiro B, Correa JB, Menzie NS, Meltzer LR, Unrod M, Brandon TH. E-cigarettes and expectancies: why do some users keep smoking? Addiction. 2015;110(11):1833–43. https://doi.org/10.1111/add.13043.CrossRefPubMedPubMedCentral

40.

King AC, Smith LJ, McNamara PJ, Matthews AK, Fridberg DJ. Passive exposure to electronic cigarette (e-cigarette) use increases desire for combustible and e-cigarettes in young adult smokers. Tob Control. 2015;24(5):501–4. https://doi.org/10.1136/tobaccocontrol-2014-051563.CrossRefPubMed

41.

Fairchild AL, Bayer R, Colgrove J. The renormalization of smoking? E-cigarettes and the tobacco “endgame”. N Engl J Med. 2014;370(4):293–5. https://doi.org/10.1056/NEJMp1313940.CrossRefPubMed

42.

World Health Organization Framework Convention on Tobacco Control: Electronic nicotine delivery systems. 2014.

43.

Gartner C, Hall W. A licence to vape: is it time to trial of a nicotine licensing scheme to allow Australian adults controlled access to electronic cigarettes devices and refill solutions containing nicotine? Int J Drug Policy. 2015;26(6):548–53. https://doi.org/10.1016/j.drugpo.2015.02.003.CrossRefPubMed

44.

Huang TT, Cawley JH, Ashe M, Costa SA, Frerichs LM, Zwicker L, Rivera JA, Levy D, Hammond RA, Lambert EV, et al. Mobilisation of public support for policy actions to prevent obesity. Lancet. 2015;385(9985):2422–31. https://doi.org/10.1016/s0140-6736(14)61743-8.CrossRefPubMed

45.

Vardavas CI, Filippidis FT, Agaku IT. Determinants and prevalence of e-cigarette use throughout the European Union: a secondary analysis of 26 566 youth and adults from 27 countries. Tob Control. 2015;24(5):442–8. https://doi.org/10.1136/tobaccocontrol-2013-051394.CrossRefPubMed

46.

Zhu SH, 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). https://doi.org/10.1371/journal.pone.0079332.

47.

Zhu SH, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, Lee M. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control. 2014;23:3–9. https://doi.org/10.1136/tobaccocontrol-2014-051670.CrossRef

48.

Kim H, Lim J, Buehler SS, Brinkman MC, Johnson NM, Wilson L, Cross KS, Clark PI. Role of sweet and other flavours in liking and disliking of electronic cigarettes. Tob Control. 2016;25(2):55–61. https://doi.org/10.1136/tobaccocontrol-2016-053221.CrossRef

49.

Berg CJ. Preferred flavors and reasons for e-cigarette use and discontinued use among never, current, and former smokers. Int J Public Health. 2016;61(2):225–36. https://doi.org/10.1007/s00038-015-0764-x.CrossRefPubMed

50.

Measham F, O’Brien K, Turnbull G. “Skittles & red Bull is my favourite flavour”: E-cigarettes, smoking, vaping and the changing landscape of nicotine consumption amongst British teenagers – implications for the normalisation debate. Drug-Educ Prev Polic. 2016;23(3):224–37. https://doi.org/10.1080/09687637.2016.1178708.CrossRef

51.

Primack BA, Soneji S, Stoolmiller M, Fine MJ, Sargent JD. Progression to traditional cigarette smoking after electronic cigarette use among us adolescents and young adults. JAMA Pediatr. 2015;169(11):1018–23. https://doi.org/10.1001/jamapediatrics.2015.1742.CrossRefPubMedPubMedCentral

52.

World Health Organization Framework Convention on Tobacco Control: Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS). 2016.

53.

Sanders-Jackson A, Tan AS, Bigman CA, Mello S, Niederdeppe J. To regulate or not to regulate? Views on electronic cigarette regulations and beliefs about the reasons for and against regulation. PLoS One. 2016;11(8):e0161124.CrossRef

Title: Support for e-cigarette regulations among Australian young adults
Authors: Michelle I. Jongenelis
Caitlin Kameron
Daniel Rudaizky
Simone Pettigrew
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Smoking and Nicotine Detoxification
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-6410-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Support for e-cigarette regulations among Australian young adults

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

Current prevalence pattern of tobacco smoking in Nigeria: a systematic review and meta-analysis

Cost-effectiveness of childhood pneumococcal vaccination program in Ethiopia: results from a quasi-experimental evaluation

HIV infection among men who have sex with men in Israel: a 35-year epidemiological and clinical overview, 1981–2015

Anemia prevalence and etiology among women, men, and children in Ethiopia: a study protocol for a national population-based survey

How does hard-to-reach status affect antiretroviral therapy adherence in the HIV-infected population? Results from a meta-analysis of observational studies

Cannabis use and the risk of tuberculosis: a systematic review