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Reasons for using e-cigarettes among adults who smoke: comparing the findings from the 2016 and 2020 ITC Korea Surveys
  1. Wonjeong Yoon1,
  2. Hong Gwan Seo2,3,
  3. Sungkyu Lee4,
  4. Eon Sook Lee5,
  5. Steve S Xu6,
  6. Gang Meng6,
  7. Anne C K Quah6,
  8. Geoffrey T Fong6,7,8,
  9. Sujin Lim9,
  10. Gil-yong Kim9,
  11. Su Young Kim9,
  12. Sung-il Cho1,10
  1. 1 Department of Public Health Science, Seoul National University Graduate School of Public Health, Seoul, Korea
  2. 2 Department of Family Medicine, National Cancer Center, Goyang, Korea
  3. 3 Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
  4. 4 Korea Center for Tobacco Control Research and Education, Seoul, Korea
  5. 5 Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
  6. 6 Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
  7. 7 Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  8. 8 School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
  9. 9 National Tobacco Control Center, Korean Health Promotion Institute, Seoul, Korea
  10. 10 Seoul National University Institute of Health and Environment, Seoul, Korea
  1. Correspondence to Dr Sung-il Cho, Department of Public Health Science, Seoul National University Graduate School of Public Health, Seoul, Korea; persontime{at}hotmail.com

Abstract

Introduction Dual use of e-cigarettes and cigarettes is a growing usage pattern in adults, but little is known about the motivations underlying this trend. We investigated the reasons for e-cigarette use among adults who smoke, considering variation in sociodemographic subgroups.

Methods This repeated cross-sectional study analysed adults who smoked at least weekly and vaped at any frequency. Data were from the International Tobacco Control Korea Surveys conducted in 2016 (n=164) and 2020 (n=1088). Fourteen reasons for e-cigarette use were assessed in both waves. Subgroup analyses were performed by age, sex and educational level.

Results The top reasons for e-cigarette use in 2020 were curiosity (62.8%), less harmful than smoking (45.4%) and taste (43.2%). Curiosity was the most cited across age, sex and education subgroups. Significant differences were observed in 2020 compared with 2016, with lower percentages in goal-oriented reasons: helping quit smoking (36.3% vs 48.9%; p=0.017), helping cut down smoking (35.3% vs 52.7%; p=0.001), less harmful to others (39.0% vs 54.6%; p=0.003) and more acceptable (31.6% vs 61.2%; p<0.001). By contrast, non-goal-oriented reasons showed higher percentages in 2020, such as curiosity (62.8% vs 27.9%; p<0.001), taste (43.2% vs 22.1%; p<0.001) and enjoyment (26.8% vs 8.6%; p<0.001). In 2020, a majority of adults who smoked and vaped (53.3%) reported no intention to quit or reduce smoking.

Conclusions E-cigarette use for curiosity and pleasure predominated among adults who smoked. The reasons for dual use in adults have shifted from goal-oriented to non-goal-oriented.

  • Electronic nicotine delivery devices
  • Cessation
  • Co-substance use
  • Disparities

Data availability statement

Data may be obtained from a third party and are not publicly available. In each country participating in the International Tobacco Control Policy Evaluation (ITC) Project, the data are jointly owned by the lead researcher(s) in that country and the ITC Project at the University of Waterloo. Data from the ITC Project are available to approved researchers 2 years after the date of issuance of cleaned data sets by the ITC Data Management Centre. Researchers interested in using ITC data are required to apply for approval by submitting an International Tobacco Control Data Repository (ITCDR) request application and subsequently to sign an ITCDR Data Usage Agreement. The criteria for data usage approval and the contents of the Data Usage Agreement are described online (http://www.itcproject.org).

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Data availability statement

Data may be obtained from a third party and are not publicly available. In each country participating in the International Tobacco Control Policy Evaluation (ITC) Project, the data are jointly owned by the lead researcher(s) in that country and the ITC Project at the University of Waterloo. Data from the ITC Project are available to approved researchers 2 years after the date of issuance of cleaned data sets by the ITC Data Management Centre. Researchers interested in using ITC data are required to apply for approval by submitting an International Tobacco Control Data Repository (ITCDR) request application and subsequently to sign an ITCDR Data Usage Agreement. The criteria for data usage approval and the contents of the Data Usage Agreement are described online (http://www.itcproject.org).

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Footnotes

  • X @gfong570

  • Contributors SC is the guarantor for the content of this manuscript. WY conceptualised the study, conducted the statistical analyses and drafted the manuscript. SC and GM advised on the data analyses. SSX and ACKQ contributed to review and editing. All authors interpreted the findings and commented and approved the final version of the manuscript.

  • Funding The 2016 ITC Korea (KOR) Project was supported by a grant from the Republic of Korea Ministry of Health and Welfare Fund and the Canadian Institutes of Health Research Grant (MOP-115016). Additional support for GTF a Senior Investigator Grant from the Ontario Institute for Cancer Research and a Senior Prevention Scientist Award from the Canadian Cancer Society Research Institute. The 2020 ITC Korea (KRA) Project was supported by a grant from the Republic of Korea National Health Promotion Fund and the Canadian Institutes of Health Research Foundation Grant (FDN-148477). Additional support to GTF is provided by a Senior Investigator Grant from the Ontario Institute for Cancer Research (IA-004). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

  • Competing interests GTF has served as an expert witness or consultant for governments defending their country’s policies or regulations in litigation. All other authors have no competing interest to declare.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.