E-Cigarettes Use Behaviors in Japan: An Online Survey

Electronic cigarette (e-cigarette) use has become increasingly widespread throughout the world, including in Japan. However, little is known about how e-cigarettes are used in Japan, a country with heavy restrictions on nicotine-containing e-liquids and/or vaping products. This study examined e-cigarette use (e-cigarette use duration, frequency of use, device type, electrical resistance, nicotine use, favorite e-liquid flavors) among users in Japan, through an online survey using a web-based self-reported questionnaire which included questions about sex, age, combustible cigarette and heated tobacco product (HTP) use behaviors. Of 4689 e-cigarettes users analyzed, 93.5% were men and 52.9% had been using e-cigarettes for 1–3 years. Over 80% used e-cigarettes every day; 62.3% used nicotine liquid, and half of the nicotine liquid users used nicotine salt. The most popular liquid flavor was fruit (prevalence: 68.1%), followed by tobacco (prevalence: 48.4%). While 50.9% were e-cigarette single users, 35.2% were dual users (e-cigarettes and cigarettes or HTPs) and 13.8% were triple user (e-cigarettes, cigarettes and HTPs). This is the first comprehensive survey of Japanese e-cigarette users and our finding suggest more than half use nicotine liquid, although e-cigarettes containing nicotine liquid have been prohibited by the Pharmaceutical Affairs Act since 2010 in Japan. The study also showed 49.1% of participants used cigarettes and/or HTPs concurrently (dual or triple users).

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E-cigarettes use behaviors among heavy users in Japan: An online survey (Preprint)

10.2196/preprints.35327 ◽

2021 ◽

Author(s):

Shihoko Koyama ◽

Takahiro Tabuchi ◽

Isao Miyashiro

Keyword(s):

Electrical Resistance ◽

Online Survey ◽

Tobacco Product ◽

Cigarette Use ◽

Web Based ◽

Concurrent Use ◽

Frequency Of Use ◽

The World ◽

Device Type ◽

Comprehensive Survey

BACKGROUND Electronic cigarette (e-cigarette) use has become increasingly widespread throughout the world, including Japan. However, little is known about how e-cigarettes are used in Japan, a country with heavy restrictions on nicotine-containing e-liquids, vaping products. OBJECTIVE This study comprehensively examined e-cigarette use, including e-cigarette use duration, frequency of use, device type, electrical resistance, nicotine use, favorite e-liquid flavors and concurrent use with cigarettes and/or HTPs in Japan. METHODS This study examined the detail of e-cigarette use (e-cigarette use duration, frequency of use, device type, electrical resistance, nicotine use, favorite e-liquid flavors) among users in Japan, through an online survey using a web-based self-reported questionnaire which included questions about sex, age, combustible cigarette and heated tobacco product (HTP) use behaviors. RESULTS Of 4,689 e-cigarettes users analyzed, 93.5% were men and 52.9% had been using e-cigarettes for 1-3 years. Over 80% used e-cigarettes every day; 62.4% used nicotine liquid, and half of the nicotine liquid users used nicotine salt. The most popular liquid flavor was fruit (prevalence: 68.1%), followed by tobacco (prevalence: 48.4%). While 9.0% were e-cigarette single users, 35.2% were dual users (e-cigarettes and cigarettes or HTPs) and 13.8% were triple user (e-cigarettes, cigarettes and HTPs). CONCLUSIONS This is the first comprehensive survey of Japanese e-cigarette users and our finding suggest more than half use nicotine liquid, although e-cigarettes containing nicotine liquid have been prohibited by the Pharmaceutical Affairs Act since 2010 in Japan. The study also showed 49.1% of participants used cigarettes and/or HTPs concurrently (dual or triple users).

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‘Ice’ flavoured e-cigarette use among young adults

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056416 ◽

2021 ◽

pp. tobaccocontrol-2020-056416

Author(s):

Adam Leventhal ◽

Hongying Dai ◽

Jessica Barrington-Trimis ◽

Steve Sussman

Keyword(s):

Young Adults ◽

Los Angeles ◽

Tobacco Use ◽

Cross Sectional Study ◽

Cigarette Use ◽

Cross Sectional ◽

Web Based ◽

The Past ◽

Frequency Of Use ◽

Exposure Variable

Background‘Ice’ e-cigarette flavours—marketed as a combination of fruity/sweet and cooling flavours (eg, ‘blueberry ice’ or ‘melon ice’)—recently entered the US market. The prevalence and correlates of ice flavoured e-cigarette use in young adults are unknown.MethodsThis cross-sectional study of a Los Angeles, California, USA, cohort analysed data from the past 30-day e-cigarette (current) users (n=344; M (SD)=21.2 (0.4) years old) who completed web-based surveys from May–August 2020. The exposure variable was self-reported e-cigarette flavour used most often in the past month (menthol/mint, fruit/sweet or ice). Outcomes included self-reported combustible tobacco use, vaping dependence symptoms, frequency of use and device type used.ResultsAmong current e-cigarette users, 48.8% reported using ice flavours most often, 33.7% predominately used fruit/sweet and 17.4% used menthol/mint. Using primarily ice-flavour was associated with reporting more past-30-day vaping days (vs menthol/mint: b=4.4, 95% CI (1 to 7.7); vs fruit/sweet: b=3.6, 95% CI (0.8 to 6.4)) and more episodes per vaping day versus fruit/sweet users (b=2.4, 95% CI (0.5 to 4.3)). Ice-flavour users were less likely than menthol/mint users to use JUUL/cartridge-based rechargeable (OR=0.1, 95% CI (0.03 to 0.45)) and more likely than sweet/fruit users to use disposable non-cartridge (OR=3.9, 95% CI (2.1 to 7.4)) devices than refillable/rechargeable tank/pen or other devices. Ice users had greater odds of past 30-day combustible tobacco use versus menthol/mint users (OR=2.7, 95% CI (1.3 to 5.7)) and vaping dependence symptoms than versus sweet/fruit users (OR=2.6, 95% CI (1.5 to 4.4)).ConclusionYoung adult use of ice flavoured e-cigarettes may be common and positively associated with combustible tobacco use, nicotine vaping frequency and dependence and use of disposable e-cigarette devices. Further study of the prevalence, determinants and health effects of ice flavoured e-cigarette use is warranted.

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Effect of a hypothetical modified risk tobacco product claim on heated tobacco product use intention and perceptions in young adults

Tobacco Control ◽

10.1136/tobaccocontrol-2021-056479 ◽

2021 ◽

pp. tobaccocontrol-2021-056479

Author(s):

Julia C Chen-Sankey ◽

Afton Kechter ◽

Jessica Barrington-Trimis ◽

Rob McConnell ◽

Evan A Krueger ◽

...

Keyword(s):

Young Adults ◽

Tobacco Product ◽

Cigarette Use ◽

Dual Use ◽

Cigarette Smokers ◽

Web Based ◽

Experimental Effect ◽

Current Cigarette ◽

Product Claim ◽

Related Harm

IntroductionModified risk tobacco product (MRTP) claims for heated tobacco products (HTPs) that convey reduced exposure compared with conventional cigarettes may promote product initiation and transition among young people. We assessed the effects of a hypothetical MRTP claim for HTPs on young adults’ intention and perceptions of using HTPs and whether these effects differed by their current cigarette and e-cigarette use.MethodsWe embedded a randomised between-subjects experiment into a web-based survey administered among a cohort of 2354 Southern California young adults (aged 20–23) in 2020. Participants viewed depictions of HTPs with an MRTP claim (n=1190) or no claim (n=1164). HTP use intention and HTP-related harm and use perceptions relative to cigarettes and e-cigarettes were assessed.ResultsOverall, participants who viewed versus did not view the claim did not differ in HTP use intention (28.5% vs 28.7%) but were more likely to perceive HTPs as less harmful than cigarettes (11.4% vs 7.0%; p<0.001). The experimental effect on HTP use intention did not differ among past 30-day cigarette smokers versus non-smokers (interaction adjusted OR (AOR)=0.78, 95% CI 0.36 to 1.76) but differed among past 30-day e-cigarette users versus non-users (interaction AOR=1.67, 95% CI 1.02 to 2.68).DiscussionThe hypothetical MRTP claim may lower young adults’ HTP harm perceptions compared with cigarettes but may not change HTP use intention overall or differentially for cigarette smokers. The larger effect on HTP use intention among e-cigarette users than non-users raises the question of whether MRTP claims may promote HTP use or HTP and e-cigarette dual use among young e-cigarette users.

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Web-Based Machine Learning Application for Heart Disease Prediction

10.4018/978-1-7998-7709-7.ch022 ◽

2022 ◽

pp. 383-393

Author(s):

Lokesh M. Giripunje ◽

Tejas Prashant Sonar ◽

Rohit Shivaji Mali ◽

Jayant C. Modhave ◽

Mahesh B. Gaikwad

Keyword(s):

Machine Learning ◽

Heart Disease ◽

Random Forest ◽

Web Application ◽

Machine Learning Algorithms ◽

World Health ◽

Web Based ◽

The World ◽

Comprehensive Survey ◽

Health Organization

Risk because of heart disease is increasing throughout the world. According to the World Health Organization report, the number of deaths because of heart disease is drastically increasing as compared to other diseases. Multiple factors are responsible for causing heart-related issues. Many approaches were suggested for prediction of heart disease, but none of them were satisfactory in clinical terms. Heart disease therapies and operations available are so costly, and following treatment, heart disease is also costly. This chapter provides a comprehensive survey of existing machine learning algorithms and presents comparison in terms of accuracy, and the authors have found that the random forest classifier is the most accurate model; hence, they are using random forest for further processes. Deployment of machine learning model using web application was done with the help of flask, HTML, GitHub, and Heroku servers. Webpages take input attributes from the users and gives the output regarding the patient heart condition with accuracy of having coronary heart disease in the next 10 years.

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JUUL electronic cigarette use patterns, other tobacco product use, and reasons for use among ever users: Results from a convenience sample

Addictive Behaviors ◽

10.1016/j.addbeh.2019.02.011 ◽

2019 ◽

Vol 95 ◽

pp. 178-183 ◽

Cited By ~ 19

Author(s):

Eleanor L.S. Leavens ◽

Elise M. Stevens ◽

Emma I. Brett ◽

Emily T. Hébert ◽

Andrea C. Villanti ◽

...

Keyword(s):

Tobacco Product ◽

Electronic Cigarette ◽

Cigarette Use ◽

Convenience Sample ◽

Use Patterns ◽

Product Use ◽

Reasons For Use

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Association of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USA

Tobacco Control ◽

10.1136/tobaccocontrol-2020-055999 ◽

2021 ◽

pp. tobaccocontrol-2020-055999

Author(s):

Alyssa F Harlow ◽

Jessica L Fetterman ◽

Craig S Ross ◽

Rose Marie Robertson ◽

Aruni Bhatnagar ◽

...

Keyword(s):

Cigarette Smoking ◽

Multinomial Logistic Regression ◽

Sociodemographic Factors ◽

Tobacco Product ◽

Electronic Cigarette ◽

Health Study ◽

Cigarette Use ◽

Use Patterns ◽

The Usa ◽

Former Smokers

BackgroundFew studies assess whether electronic cigarette (e-cigarette) device characteristics or flavours impact longitudinal patterns of cigarette and e-cigarette use.DesignWe examined data from waves 2–4 of the Population Assessment of Tobacco and Health Study (2014–2018). Among adult (≥18 years) current e-cigarette users at wave 2 who were current smokers (dual users; n=1759) and former smokers (exclusive e-cigarette users; n=470), we classified participants into four use patterns at wave 3 (~12 months later) and wave 4 (~24 months later): (1) dual use of e-cigarettes and cigarettes; (2) exclusive cigarette smoking; (3) exclusive e-cigarette use; (4) non-use of both products. We used multinomial logistic regression to assess correlates of changing use patterns at 24 months, relative to no change, adjusting for sociodemographic factors.ResultsAt 24 months, 26.5% of baseline exclusive e-cigarette users, and 9% of baseline dual users, abstained from both vaping and smoking. Participants who vaped non-tobacco flavours (vs tobacco flavours), and used refillable tank or modifiable devices (vs disposable, cartridges and other devices) were less likely to transition to non-use of both products and to exclusive cigarette smoking. Baseline daily vaping (vs non-daily) was positively associated with exclusive e-cigarette use at 24 months for baseline daily cigarette smokers, but negatively associated with exclusive e-cigarette use and non-use of both products at 24 months for baseline non-daily smokers.ConclusionsNon-tobacco flavours, daily vaping and modifiable e-cigarette devices may help some smokers abstain from cigarette smoking via transitioning to exclusive e-cigarette use, but are also associated with ongoing exclusive e-cigarette use.

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First e-cigarette flavor and device type used: Associations with vaping persistence, frequency, and dependence in young adults

Nicotine & Tobacco Research ◽

10.1093/ntr/ntab172 ◽

2021 ◽

Author(s):

James D Sargent ◽

Mike Stoolmiller ◽

Hongying Dai ◽

Jessica L Barrington-Trimis ◽

Rob McConnell ◽

...

Keyword(s):

Los Angeles ◽

Nicotine Dependence ◽

Cross Sectional Study ◽

Cigarette Use ◽

Cross Sectional ◽

Web Based ◽

Device Type ◽

Continued Use ◽

Adjusted Rate ◽

Rate Ratios

Abstract Introduction Type of e-cigarette flavoring and device during first use might differentiate later e-cigarette use and dependence. This retrospective cross-sectional study examined associations of recalled first nicotine vaping device and flavor used with current vaping frequency/dependence. Methods A young adult cohort from Los Angeles, California, USA completed web-based surveys (N=2553). Using cross-sectional data from 971 reporting ever vaping nicotine, multivariable hurdle regressions tested associations between recalled first flavor (fruit/sweet, menthol/mint, other) and device (Juul, disposable, mod, box, pod, pen, other) vaped with past-30-day vaping status (yes/no) and frequency (1-30 days), and with any vaping dependence symptoms (yes/no) and count (1-10 symptoms). Results The most common first-flavor was sweet (71%); the most common first-device was a vape pen (37%), then Juul (22%). First-flavor of mint/menthol (vs. other; adjusted odds ratio [AOR]: 2.22[95%CI=1.16-4.25]), and first-device mod (AOR=2.40[95%CI=1.34-4.31]) and non-Juul pod (2.64[95% CI=1.41-4.92]) (vs. pen) were associated with past-30-day vaping, and twice as many vaping days (ARRs [Adjusted rate ratios] range: 1.96-2.12;ps<0.05). First flavor of mint/menthol (vs. other; AOR: 1.95[95% CI=1.003-3.79) and first device mod, box, non-juul pod and other (AORs range: 2.36-4.01;ps<0.05) were associated with nicotine dependence. First device Juul, mod, box and non-Juul pod were also associated with more dependence symptoms (ARRs range:1.38-1.59;ps<0.05). Conclusions Exposure to mint/menthol and certain devices (mod, box, Juul and non-juul pods) at first e-cigarette use may be associated with more frequent e-cigarette use and nicotine dependence symptoms in young adulthood. Mint/menthol and certain devices warrant consideration in regulation of e-cigarettes based on product characteristics. Implications Characteristics (flavor and device type) of first e-cigarette product used were associated with higher usage and more dependence. Pending replication with prospective designs, the findings suggest certain flavors (mint/menthol) and devices (pods, mods) merit consideration in regulation because of their possible link with continued use and dependence among young people.

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Profile and patterns of dual use of e-cigarettes and combustible cigarettes among Mexican adults

Salud Pública de México ◽

10.21149/12365 ◽

2021 ◽

pp. 1-12

Author(s):

Luis Zavala-Arciniega ◽

Inti Barrientos-Gutiérrez ◽

Edna Arillo-Santillán ◽

Katia Gallegos-Carrillo ◽

Rosibel Rodríguez-Bolaños ◽

...

Keyword(s):

Online Survey ◽

Logistic Models ◽

Risk Profile ◽

Cigarette Use ◽

Dual Use ◽

Quit Smoking ◽

Frequency Of Use ◽

Mexican Adults ◽

Binomial Models ◽

Dual User

Objective. To describe the profile and patterns of dual uses (n=954) and exclusive cigarette users (n=2 070) and determine the correlates of more frequent e-cigarette use among dual users and their reasons for e-cigarette use. Materials and methods. An online survey of Mexican adult smokers. Logistic models regressed dual-use (exclusive smoking vs. dual user) on sociodemographic, smoking variables and substance use behaviors. We conducted censorial binomial models to estimate the correlates of frequency of e-cigarette use among dual users. Results. Dual users were younger had higher education (AOR=2.22) and higher levels of smoking dependence (AOR=1.31), preferred cigarettes with flavor capsules (AOR=1.58) and had recently attempted to quit smoking (AOR=1.38). Marijuana use and being daily smokers were correlates of higher frequency of use among dual users. Conclusion. Dual users had a higher risk profile than exclusive smokers, which was even more prominent in dual-users who used e-cigarettes frequently.

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E-Cigarette Health Harm Awareness and Discouragement: Implications for Health Communication

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz194 ◽

2019 ◽

Vol 22 (7) ◽

pp. 1131-1138 ◽

Cited By ~ 4

Author(s):

Jacob A Rohde ◽

Seth M Noar ◽

Jennifer R Mendel ◽

Marissa G Hall ◽

Sabeeh A Baig ◽

...

Keyword(s):

Health Communication ◽

Online Survey ◽

Respiratory Health ◽

The United States ◽

Tobacco Product ◽

Current Evidence ◽

Cigarette Use ◽

Health Warnings ◽

Convenience Sample ◽

Chemical Exposures

Abstract Introduction Evidence for the health harms of e-cigarettes is growing, yet little is known about which harms may be most impactful in health messaging. Our study sought to identify which harms tobacco product users were aware of and which most discouraged them from wanting to vape. Methods Participants were a convenience sample of 1,872 U.S. adult e-cigarette-only users, cigarette-only smokers, and dual users recruited in August 2018. In an online survey, participants evaluated 40 e-cigarette harms from seven categories: chemical exposures, device explosions, addiction, cardiovascular harm, respiratory harm, e-liquid toxicity, and other harms. Outcomes were awareness of the harms (“check all that apply”) and the extent to which the harms discouraged vaping (5-point scale; (1) “not at all” to (5) “very much”). Results Awareness of most e-cigarette harms was modest, being highest for harms in the device explosions category of harms (44%) and lowest for the e-liquid toxicity category (16%). The harms with the highest mean discouragement from wanting to vape were the respiratory harm (M = 3.82) and exposure to chemicals (M = 3.68) categories. Harms in the addiction category were the least discouraging (M = 2.83) compared with other harms (all p < .001). Findings were similar for e-cigarette-only users, cigarette-only smokers, and dual users. Conclusions Addiction was the least motivating e-cigarette harm, a notable finding given that the current FDA e-cigarette health warning communicates only about nicotine addiction. The next generation of e-cigarette health warnings and communication campaigns should highlight other harms, especially respiratory harms and the chemical exposures that may lead to health consequences. Implications E-cigarette health harms related to respiratory effects, chemical exposures, and other health areas most discouraged vaping among tobacco users. In contrast, health harms about addiction least discouraged use. Several countries have begun implementing e-cigarette health warnings, including the United States, and many others are considering adopting similar policies. To increase impact, future warnings and other health communication efforts should communicate about health harms beyond addiction, such as the effects of e-cigarette use on respiratory health. Such efforts should communicate that e-cigarette use is risky and may pose less overall risk to human health than smoking, according to current evidence.

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