TY - JOUR
T1 - Prevalence of awareness, ever-use and current use of nicotine vaping products (NVPs) among adult current smokers and ex-smokers in 14 countries with differing regulations on sales and marketing of NVPs
T2 - cross-sectional findings from the ITC Project
AU - Gravely, Shannon
AU - Driezen, Pete
AU - Ouimet, Janine
AU - Quah, Anne C. K.
AU - Cummings, K. Michael
AU - Thompson, Mary E.
AU - Boudreau, Christian
AU - Hammond, David
AU - McNeill, Ann
AU - Borland, Ron
AU - Thrasher, James F.
AU - Edwards, Richard
AU - Omar, Maizurah
AU - Hitchman, Sara C.
AU - Yong, Hua-Hie
AU - Barrientos-Gutierrez, Tonatiuh
AU - Willemsen, Marc C.
AU - Bianco, Eduardo
AU - Boado, Marcelo
AU - Goma, Fastone Mathew
AU - Seo, Hong Gwan
AU - Nargis, Nigar
AU - Jiang, Yuan
AU - Perez, Cristina De Abreu
AU - Fong, Geoffrey T.
N1 - Funding Information:
The ITC country data in this paper were supported by grants from the US National Cancer Institute (P01CA138389, P01CA200512, R01 TW010652), the Canadian Institutes of Health Research (MOP 115016, FDN 148477), the National Health and Medical Research Council of Australia (APP1106451), the Korean Ministry of Health and Welfare, the Dutch Cancer Foundation (KWF) (UM 2014-7210), the National Cancer Institute of Brazil (INCA), Pan-American Health Organization (PAHO), Brazil Funda??o do C?ncer (BR/LOA/1500048.001), the Chinese Centre for Disease Control and Prevention, the Health Research Council of New Zealand (GA215F 15/072), the New Zealand Ministry of Health and the Mexican Consejo Nacional de Ciencia y Tecnolog?a (Salud-2007-C01-70032 and Salud-2013-01-202671). S.G. was supported by a Canadian Cancer Society (CCS) Career Development Award in Cancer Prevention (no. 703858). G.T.F. was supported by a Senior Investigator Award from the Ontario Institute for Cancer Research and a Prevention Scientist Award from the Canadian Cancer Society Research Institute. The authors would also like to gratefully acknowledge the reviewers for their insightful comments and suggestions which served to strengthen this paper.
Funding Information:
The ITC country data in this paper were supported by grants from the US National Cancer Institute (P01CA138389, P01CA200512, R01 TW010652), the Canadian Institutes of Health Research (MOP 115016, FDN 148477), the National Health and Medical Research Council of Australia (APP1106451), the Korean Ministry of Health and Welfare, the Dutch Cancer Foundation (KWF) (UM 2014-7210), the National Cancer Institute of Brazil (INCA), Pan-American Health Organization (PAHO), Brazil Fundação do Câncer (BR/LOA/1500048.001), the Chinese Centre for Disease Control and Prevention, the Health Research Council of New Zealand (GA215F 15/072), the New Zealand Ministry of Health and the Mexican Consejo Nacional de Ciencia y Tecnología (Salud-2007-C01-70032 and Salud-2013-01-202671). S.G.
Funding Information:
was supported by a Canadian Cancer Society (CCS) Career Development Award in Cancer Prevention (no. 703858). G.T.F. was supported by a Senior Investigator Award from the Ontario Institute for Cancer Research and a Prevention Scientist Award from the Canadian Cancer Society Research Institute. The authors would also like to gratefully acknowledge the reviewers for their insightful comments and suggestions which served to strengthen this paper.
Publisher Copyright:
© 2019 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
PY - 2019/6
Y1 - 2019/6
N2 - Aims This paper presents updated prevalence estimates of awareness, ever-use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements A cross-sectional analysis of adult (>= 18 years) current smokers and ex-smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013-17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country-specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non-daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever- and current use of NVPs were lower in MRP countries (ever-use = 7.1-48.9%; current use = 0.3-3.5%) relative to LRP countries (ever-use = 38.9-66.6%; current use = 5.5-17.2%) and RP countries (ever-use = 10.0-62.4%; current use = 1.4-15.5%). NVP use was highest among high-income countries, followed by upper-middle-income countries, and then by lower-middle-income countries. Conclusions With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products.
AB - Aims This paper presents updated prevalence estimates of awareness, ever-use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements A cross-sectional analysis of adult (>= 18 years) current smokers and ex-smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013-17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country-specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non-daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever- and current use of NVPs were lower in MRP countries (ever-use = 7.1-48.9%; current use = 0.3-3.5%) relative to LRP countries (ever-use = 38.9-66.6%; current use = 5.5-17.2%) and RP countries (ever-use = 10.0-62.4%; current use = 1.4-15.5%). NVP use was highest among high-income countries, followed by upper-middle-income countries, and then by lower-middle-income countries. Conclusions With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products.
KW - E-cigarettes
KW - global
KW - income classification
KW - nicotine vaping products (NVPs)
KW - smoking
KW - international
KW - regulations
KW - policies
KW - survey
KW - ELECTRONIC CIGARETTE USE
KW - EUROPEAN-UNION ANALYSIS
KW - HARM
KW - PERCEPTIONS
KW - SMOKING
KW - TRENDS
KW - TRIAL
U2 - 10.1111/add.14558
DO - 10.1111/add.14558
M3 - Article
C2 - 30681215
SN - 0965-2140
VL - 114
SP - 1060
EP - 1073
JO - Addiction
JF - Addiction
IS - 6
ER -