Cent Eur J Public Health 2023, 31(4):271-278 | DOI: 10.21101/cejph.a7963

Perceived relative harm of e-cigarettes among Ukrainian adults

Giorgi Mzhavanadze
Healthy Initiatives (Ringgold GO), Tbilisi, Georgia

Objectives: Emerging evidence suggests that the use of safer nicotine products (SNPs), such as e-cigarettes and heated tobacco products (HTPs) poses significantly lower health risks than continued smoking, particularly over the short and medium term. However, it remains uncertain whether the public has been adequately informed about these relative risks. This study assesses the perceived relative harm of e-cigarettes compared to conventional cigarettes in Ukraine.

Methods: Two nationally representative surveys were conducted in February 2021 and December 2022. Participants, irrespective of their smoking status, were asked whether they agreed with the statement that "using e-cigarettes is more harmful than smoking conventional cigarettes". The surveys also included questions about tobacco product usage, the most dangerous substances in cigarettes, and smoking cessation methods. The data were statistically analysed by deriving design-based weighted point estimates and 95% confidence intervals for the proportions within each response category.

Results: In 2022, 38.1% (95% CI: 35.3-40.9) of adults believed that e-cigarettes were more harmful than cigarettes and the perception of relative harm remained relatively unchanged between the two surveys. Furthermore, 56.2% (95% CI: 50.0-62.2) of current cigarette smokers agreed with this statement, while only a small percentage of vapers (e-cigarette users) 7.4% (95% CI: 1.5-30.0) perceived e-cigarettes as more harmful than conventional cigarettes. Among non-smokers and dual users the share was 33.4% (95% CI: 30.0-36.9) and 32.7% (95% CI: 25.1-41.5), respectively.

Conclusion: Our findings indicate that in Ukraine the perception that e-cigarettes are more harmful than cigarettes, or the lack of knowledge regarding relative risks, prevails. This highlights the importance of accurate risk communication to promote a harm reduction approach to tobacco use.

Klíčová slova: smoking, e-cigarettes, tobacco harm reduction, SNPs, perceived harm

Vloženo: 9. červenec 2023; Revidováno: 15. prosinec 2023; Přijato: 15. prosinec 2023; Zveřejněno: 30. prosinec 2023  Zobrazit citaci

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Mzhavanadze G. Perceived relative harm of e-cigarettes among Ukrainian adults. Cent Eur J Public Health. 2023;31(4):271-278. doi: 10.21101/cejph.a7963. PubMed PMID: 38309705.
Stáhnout citaci

Reference

  1. Singh S, Windle SB, Filion KB, Thombs BD, O'Loughlin JL, Grad R, et al. E-cigarettes and youth: patterns of use, potential harms, and recommendations. Prev Med. 2020;133:106009. doi: 10.1016/j.ypmed.2020.106009. Přejít k původnímu zdroji... Přejít na PubMed...
  2. Wang JB, Olgin JE, Nah G, Vittinghoff E, Cataldo JK, Pletcher MJ, et al. Cigarette and e-cigarette dual use and risk of cardiopulmonary symptoms in the Health eHeart Study. PLoS One. 2018;13(7):e0198681. doi: 10.1371/journal.pone.0198681. Přejít k původnímu zdroji... Přejít na PubMed...
  3. Eaton DL, Kwan LY, Stratton K, editors. Public health consequences of e-cigarettes. Washington, DC: National Academies Press; 2018.
  4. US Department of Health and Human Services. The health consequences of smoking-50 years of progress: a report of the surgeon general. Atlanta: CDC; 2014.
  5. Sobczak A, Kośmider L, Koszowski B, Goniewicz ML. E-cigarettes and their impact on health: from pharmacology to clinical implications. Pol Arch Intern Med. 2020;130:668-75. Přejít k původnímu zdroji... Přejít na PubMed...
  6. Cassidy RN, Tidey JW, Colby SM. Exclusive e-cigarette users report lower levels of respiratory symptoms relative to dual e-cigarette and cigarette users. Nicotine Tob Res. 2020 Dec 15;22(Suppl 1):S54-60. Přejít k původnímu zdroji... Přejít na PubMed...
  7. Polosa R, Morjaria JB, Prosperini U, Busà B, Pennisi A, Malerba M, et al. COPD smokers who switched to e-cigarettes: health outcomes at 5-year follow up. Ther Adv Chronic Dis. 2020 Oct 10;11:2040622320961617. doi: 10.1177/2040622320961617. Přejít k původnímu zdroji... Přejít na PubMed...
  8. Lucchiari C, Masiero M, Mazzocco K, Veronesi G, Maisonneuve P, Jemos C, et al. Benefits of e-cigarettes in smoking reduction and in pulmonary health among chronic smokers undergoing a lung cancer screening program at 6 months. Addict Behav. 2020 Apr;103:106222. doi: 10.1016/j.addbeh.2019.106222. Přejít k původnímu zdroji... Přejít na PubMed...
  9. Mendez D, Warner KE. A magic bullet? The potential impact of e-cigarettes on the toll of cigarette smoking. Nicotine Tob Res. 2021 Mar 19;23(4):654-61. Přejít k původnímu zdroji... Přejít na PubMed...
  10. Mzhavanadze G, Yanin D. The potential impact of e-cigarettes on the life-years lost from conventional smoking in the Russian Federation. J Consum Policy 2023;46:253-74. Přejít k původnímu zdroji...
  11. Murkett R, Rugh M, Ding B. Nicotine products relative risk assessment: an updated systematic review and meta-analysis. F1000Research. 2022;9:1225. doi: 10.12688/f1000research.26762.2. Přejít k původnímu zdroji...
  12. Kozlowski LT, Sweanor D. Withholding differential risk information on legal consumer nicotine/tobacco products: the public health ethics of health information quarantines. Int J Drug Policy. 2016;32:17-23. Přejít k původnímu zdroji... Přejít na PubMed...
  13. Public Health Center of the Ministry of Health of Ukraine. [International no smoking day: the best decision for your health - quit smoking today!] [Internet]. Kyiv: Public Health Center of the Ministry of Health of Ukraine; 2022 [cited 2023 Mar 2]. Available from: https://www.phc.org.ua/news/mizhnarodniy-den-vidmovi-vid-kurinnya-naykrasche-rishennya-dlya-vashogo-zdorovya-pripiniti. Ukrainian.
  14. Slovic P. Smoking: risk, perception, and policy. Thousand Oaks: SAGE Publications Inc; 2021.
  15. Campbell BK, Le T, Gubner NR, Guydish J. Health risk perceptions and reasons for use of tobacco products among clients in addictions treatment. Addict Behav. 2019;91:149-55. Přejít k původnímu zdroji... Přejít na PubMed...
  16. Romer D, Jamieson P. The role of perceived risk in starting and stopping smoking. In: Slovic P, editor. Smoking: risk, perception, and policy. Thousand Oaks: SAGE Publications Inc; 2021.
  17. Hyland A, Li Q, Bauer JE, Giovino GA, Steger C, Cummings KM. Predictors of cessation in a cohort of current and former smokers followed over 13 years. Nicotine Tob Res. 2004;6(suppl 3):S363-9. Přejít k původnímu zdroji... Přejít na PubMed...
  18. Farsalinos KE, Romagna G, Tsiapras D, Kyrzopoulos S, Voudris V. Characteristics, perceived side effects and benefits of electronic cigarette use: a worldwide survey of more than 19,000 consumers. Int J Environ Res Public Health. 2014 Apr 22;11(4):4356-73. Přejít k původnímu zdroji... Přejít na PubMed...
  19. Pepper JK, Ribisl KM, Emery SL, Brewer NT. Reasons for starting and stopping electronic cigarette use. Int J Environ Res Public Health. 2014 Oct 3;11(10):10345-61. Přejít k původnímu zdroji... Přejít na PubMed...
  20. Czoli CD, Fong GT, Mays D, Hammond D. How do consumers perceive differences in risk across nicotine products? A review of relative risk perceptions across smokeless tobacco, e-cigarettes, nicotine replacement therapy and combustible cigarettes. Tob Control. 2017;26(e1):e49-58. Přejít k původnímu zdroji... Přejít na PubMed...
  21. Brose LS, Brown J, Hitchman SC, McNeill A. Perceived relative harm of electronic cigarettes over time and impact on subsequent use: a survey with 1-year and 2-year follow-ups. Drug Alcohol Depend. 2015;157:106-11. Přejít k původnímu zdroji... Přejít na PubMed...
  22. Kyiv International Institute of Sociology. About us [Internet]. Kyiv: KIIS [cited 2023 Mar 2]. Available from: https://www.kiis.com.ua/?lang=eng&cat=about.
  23. Huang J, Feng B, Weaver SR, Pechacek TF, Slovic P, Eriksen MP. Changing perceptions of harm of e-cigarette vs cigarette use among adults in 2 US national surveys from 2012 to 2017. JAMA Netw Open. 2019;2(3):e191047. doi: 10.1001/jamanetworkopen.2019.1047. Přejít k původnímu zdroji... Přejít na PubMed...
  24. Gravely S, Driezen P, Kyriakos CN, Thompson ME, Balmford J, Demjén T, et al. European adult smokers' perceptions of the harmfulness of e-cigarettes relative to combustible cigarettes: cohort findings from the 2016 and 2018 EUREST-PLUS ITC Europe Surveys. Eur J Public Health. 2020 Jul 1;30(Suppl_3):iii38-45. Přejít k původnímu zdroji... Přejít na PubMed...
  25. Mzhavanadze G. Smoking behavior and risk perceptions in Georgia: results of 2022 survey. Tbilisi: Georgia Today; 2023 [cited 2023 Apr 15]. Available from: https://georgiatoday.ge/smoking-behavior-and-risk-perceptions-in-georgia-results-of-2022-survey/.
  26. Environics Research. Vapers Panel Baseline Survey 2022: final report [Internet]. Ottawa: Health Canada; 2022 [cited 2023 Mar 2]. Available from: https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2022/097-21-e/097-21-report.pdf.
  27. Guiney H, Oakly A, Martin G. E-cigarette use and perceptions among current and ex-smokers in New Zealand [Internet]. Wellington: Health Promotion Agency; 2019 [cited 2023 Mar 2]. Available from: https://www.hpa.org.nz/research-library/research-publications/e-cigarette-use-and-perceptions-among-current-and-ex-smokers-in-new-zealand.
  28. Wilson S, Partos T, McNeill A, Brose LS. Harm perceptions of e-cigarettes and other nicotine products in a UK sample. Addiction. 2019;114:879-88. Přejít k původnímu zdroji... Přejít na PubMed...
  29. Pokhrel P, Fagan P, Kehl L, Herzog TA. Receptivity to e-cigarette marketing, harm perceptions, and e-cigarette use. Am J Health Behav. 2015;39(1):121-31. Přejít k původnímu zdroji... Přejít na PubMed...
  30. Alzahrani T, Pena I, Temesgen N, Glantz SA. Association between electronic cigarette use and myocardial infarction. Am J Prev Med. 2018;55(4):455-61. Přejít k původnímu zdroji... Přejít na PubMed...
  31. Perez M, Atuegwu N, Mead E, Oncken C, Mortensen E. Adult e-cigarettes use associated with a self-reported diagnosis of COPD. Int J Environ Res Public Health. 2019;16(20):3938. doi: 10.3390/ijerph16203938. Přejít k původnímu zdroji... Přejít na PubMed...
  32. Chun LF, Moazed F, Calfee CS, Matthay MA, Gotts JE. Pulmonary toxicity of e-cigarettes. Am J Physiol Lung Cell Mol Physiol. 2017;313(2):L193-206. Přejít k původnímu zdroji... Přejít na PubMed...
  33. Public Health Center of the Ministry of Health of Ukraine. [Electronic cigarettes kill! The Lives of 7 patients could not be saved] [Internet]. Kyiv: Public Health Center of the Ministry of Health of Ukraine; 2019 [cited 2023 Mar 2]. Available from: https://phc.org.ua/news/elektronni-sigareti-vbivayut-zhittya-7-pacientiv-vryatuvati-ne-vdalosya. Ukrainian.
  34. Odesa Regional Public Health Center. [Dangerous vaping: why electronic cigarettes don't help to quit Smoking?] [Internet]. Odesa: Odesa Regional Public Health Center; 2021 [cited 2023 Mar 2]. Available from: https://healthcenter.od.ua/2021/02/04/nebezpechnyj-vejping/. Ukrainian.
  35. Rackham A, Bailey E. [Why is Vaping Dangerous?] [Internet]. BBC News Ukraine; 2022 [cited 2023 Mar 2]. Available from: https://www.bbc.com/ukrainian/features-63120447. Ukrainian.
  36. Public Space. [Why are electronic cigarettes a serious threat to cardiovascular health?] [Internet]. Public Space; 2022 [cited 2023 Mar 2]. Available from: https://www.prostir.ua/?news=chomu-elektronni-syharety-serjozna-zahroza-zdorovyu-sertsevo-sudynnoji-systemy. Ukrainian.