Factors influencing Electronic Cigarette use among Young Adults in Sarawak, Malaysia:  A Hierarchical analysis

Sivanandhan Selleyitoreea; Md Mizanur Rahman

doi:10.56338/jphp.v5i3.6765

Sivanandhan Selleyitoreea Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, 94300 Kota Samarahan, Sarawak, Malaysia https://orcid.org/0009-0002-3791-5274
Md Mizanur Rahman Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, 94300 Kota Samarahan, Sarawak, Malaysia https://orcid.org/0000-0002-0706-2920

DOI: https://doi.org/10.56338/jphp.v5i3.6765

Keywords: Electronic Cigarettes, Smoking, Psychosocial Factors, Sarawak

Abstract

Introduction: The rapid global rise in electronic cigarette (e-cigarette) use has led to increasing research interest, yet factors influencing its adoption remain underexplored in Malaysia. This study investigates sociodemographic and psychosocial determinants of e-cigarette use in the Samarahan and Kuching divisions of Sarawak, Malaysia.

Methods: A cross-sectional study was conducted among smokers aged 18 and above. A total of 474 participants were recruited using cluster sampling. Data collection was performed through face-to-face interviews using a structured questionnaire. Hierarchical multinomial logistic regression was applied to identify key predictors of e-cigarette use.

Results: Among participants, 27.8% were e-smokers, 25.8% were switchers, and 46.4% were dual smokers. The analysis revealed that females were more likely to be e-smokers (AOR = 5.889, p < .001) and switchers (AOR = 2.647, p = .021) than males. Additionally, degree holders were more likely to be e-smokers than dual smokers (AOR = 4.106, p = .025). Psychosocial factors, such as subjective norms (AOR = 1.435, p = .023) and perceived usefulness (AOR = 1.616, p = .016), were significant predictors of e-cigarette use.

Conclusion: Sociodemographic and psychosocial factors, such as gender and education, influence e-cigarette use in Sarawak. These findings provide valuable insights for designing targeted public health strategies to regulate e-cigarette use and support smoking cessation efforts in Malaysia.

References

Hamdy Hafez S. Electronic Cigarette Usage Prevalence, Patterns, and Dependency Among the General Population in Egypt. 2023;14(4):947-57.

Eijk Yvd, Ping GTP, Ong SE, Xin GTL, Li D, Zhang D, et al. E-Cigarette Markets and Policy Responses in Southeast Asia: A Scoping Review. International Journal of Health Policy and Management. 2021.

Patil S, Arakeri G, Patil S, Baeshen HA, Raj T, Sarode SC, et al. Are Electronic Nicotine Delivery Systems (ENDs) Helping Cigarette Smokers Quit?—Current evidence. Journal of Oral Pathology and Medicine. 2019;49(3):181-9.

Giovenco DP, Delnevo CD. Prevalence of Population Smoking Cessation by Electronic Cigarette Use Status in a National Sample of Recent Smokers. Addictive Behaviors. 2018;76:129-34.

Rahman MA, Hann N, Wilson A, Worrall?Carter L. Electronic Cigarettes: Patterns of Use, Health Effects, Use in Smoking Cessation and Regulatory Issues. Tobacco Induced Diseases. 2014;12(1):21.

Pinho-Gomes A-C, Santos JA, Jones A, Thout SR, Pettigrew S. E-Cigarette Attitudes and Behaviours Amongst 15-30-Year-Olds in the UK. Journal of Public Health. 2023;45(4):e763-e75.

Rahman JA, Yusoff MFM, Mohamed MHN, Naidu BM, Lim KH, Tee GH, et al. The Prevalence of E-Cigarette Use Among Adults in Malaysia. Asia Pacific Journal of Public Health. 2019;31(7_suppl):9S-21S.

Palipudi K, Mbulo L, Morton J, Bunnell R, Blutcher-Nelson G, Kosen S, et al. Awareness and Current Use of Electronic Cigarettes in Indonesia, Malaysia, Qatar, and Greece: Findings From 2011–2013 Global Adult Tobacco Surveys. Nicotine & Tobacco Research. 2015;18(4):501-7.

Kim H, Davis AH, Dohack JL, Clark PI. E-Cigarettes Use Behavior and Experience of Adults: Qualitative Research Findings to Inform E-Cigarette Use Measure Development. Nicotine & Tobacco Research. 2016;19(2):190-6.

Harrell PT, Simmons VN, Piñeiro B, Correa JB, Menzie NS, Meltzer LR, et al. E?cigarettes and Expectancies: Why Do Some Users Keep Smoking? Addiction. 2015;110(11):1833-43.

Fan J, Mao T, Zhen S, Xu Y, Qu C. Comparative Analysis of E-Cigarette Prevalence and Influencing Factors Among Adolescents in Jiangsu Province, China. Frontiers in Public Health. 2023;11.

Kong G, Morean ME, Cavallo DA, Camenga DR, Krishnan?Sarin S. Reasons for Electronic Cigarette Experimentation and Discontinuation Among Adolescents and Young Adults. Nicotine & Tobacco Research. 2014;17(7):847-54.

Vrinten C, Parnham JC, Radó M, Filippidis FT, Creese H, Hopkinson NS. Patterns of Cigarette and E-Cigarette Use Among UK Adolescents: A Latent Class Analysis of the Millennium Cohort Study. European Journal of Public Health. 2023;33(5):857-63.

Driezen P, Nordin ASA, Hairi FM, Yee A, Tajuddin NAA, Hasan SI, et al. E-cigarette prevalence among Malaysian adults and types and flavors of e-cigarette products used by cigarette smokers who vape: Findings from the 2020 ITC Malaysia Survey. Tob Induc Dis. 2022;20:32.

Institute for Public Health NIoH, Ministry of Health Malaysia. Survey Among Malaysian Adolescents (TECMA). 2016:148.

James R L. Comparison of Four TAM Item Formats: Effect of Response Option Labels and Order. Journal of Usability Studies. 2019;14(4):224-36.

Simpson EEA, Davison J, Doherty J, Dunwoody L, McDowell C, McLaughlin M, et al. Employing the theory of planned behaviour to design an e-cigarette education resource for use in secondary schools. BMC Public Health. 2022;22(1):276.

Regan AK, Promoff G, Dube SR, Arrazola R. Electronic nicotine delivery systems: adult use and awareness of the 'e-cigarette' in the USA. Tob Control. 2013;22(1):19-23.

Pearson JL, Richardson A, Niaura RS, Vallone DM, Abrams DB. e-Cigarette awareness, use, and harm perceptions in US adults. Am J Public Health. 2012;102(9):1758-66.

Lee S, Grana R, Glantz SA. Electronic Cigarette Use Among Korean Adolescents: A Cross-Sectional Study of Market Penetration, Dual Use, and Relationship to Quit Attempts and Former Smoking. Journal of Adolescent Health. 2014;54(6):684-90.

Coleman B, Rostron BL, Johnson SE, Persoskie A, Pearson J, Stanton CA, et al. Transitions in Electronic Cigarette Use Among Adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 1 and 2 (2013–2015). Tobacco Control. 2018:tobaccocontrol-2017-054174.

Coleman B, Rostron B, Johnson SE, Persoskie A, Pearson J, Stanton C, et al. Transitions in electronic cigarette use among adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 1 and 2 (2013–2015). Tobacco Control. 2019;28(1):50.

Goniewicz M?, Lingas EO, Hájek P. Patterns of Electronic Cigarette Use and User Beliefs About Their Safety and Benefits: An Internet Survey. Drug and Alcohol Review. 2012;32(2):133-40.

Perialathan K, Rahman AB, Lim KH, Adon Y, Ahmad A, Juatan N, et al. Prevalence and Associated Factors of Ever Use of Electronic Cigarettes: Findings From a Hospitals and Health Clinics Study Based in Malaysia. Tobacco Induced Diseases. 2018;16(November).

Chang Y, Cho S, Kim I, Khang YH. Socioeconomic Inequalities in e-Cigarette Use in Korea: Comparison with Inequalities in Conventional Cigarette Use Using Two National Surveys. Int J Environ Res Public Health. 2019;16(22).

Jankowski M, Krzystanek M, Zejda J, Majek P, Luba?ski J, Lawson J, et al. E-Cigarettes Are More Addictive Than Traditional Cigarettes—A Study in Highly Educated Young People. International Journal of Environmental Research and Public Health. 2019;16(13):2279.

Topa G, León JAM. Theory of Planned Behavior and Smoking: Meta-Analysis and SEM Model. Substance Abuse and Rehabilitation. 2010:23.

Martínez?Sánchez JM, Fu M, Martín?Sánchez JC, Ballbè M, Saltó E, Fernández E. Perception of Electronic Cigarettes in the General Population: Does Their Usefulness Outweigh Their Risks? BMJ Open. 2015;5(11):e009218.

Gaiha SM, Halpern-Felsher B. Public Health Considerations for Adolescent Initiation of Electronic Cigarettes. Pediatrics. 2020;145(Suppl 2):S175-s80.

Barnes C, Yoong SL, Hodder RK, Hall AE, Bialek C, Stockings E, et al. Interventions to prevent or cease electronic cigarette use in children and adolescents. LID - CD015511. (1469-493X (Electronic)).

McCausland K, Booth S, Leaversuch F, Freeman B, Wolf K, Leaver T, et al. Socio-ecological factors that influence youth vaping: perspectives from Western Australian school professionals, parents and young people. International Journal of Qualitative Studies on Health and Well-being. 2024;19(1):2322753.

Aisyah WN, Rahayu AC, Jasmine D, Ciptaningrum AD, Herbawani CK. Factor Influencing E-Cigarette Use and Its Impact on Adolescent Lung Health: Literature Review. Miracle Journal of Public Health. 2024;7(2):176-90.

Deng H, Fang L, Zhang L, Li J, Wang J, Wang F, et al. Susceptibility to e-cigarette among high school students: a study based on the ecological model of health behavior. Front Public Health. 2024;12:1395717.

Yong H-H, Chow R, East K, Thrasher JF, Hitchman SC, Borland R, et al. Do Social Norms for Cigarette Smoking and Nicotine Vaping Product Use Predict Trying Nicotine Vaping Products and Attempts to Quit Cigarette Smoking Amongst Adult Smokers? Findings From the 2016–2020 International Tobacco Control Four Country Smoking and Vaping Surveys. Nicotine & Tobacco Research. 2022;25(3):505-13.

Lin M, Chu M, Li X, Ma H, Fang Z, Mao L, et al. Factors influencing adolescent experimental and current smoking behaviors based on social cognitive theory: A cross-sectional study in Xiamen. Frontiers in Public Health. 2023;11.

McNeill A, Brose, L., Robson, D., Calder, R., Simonavicius, E., East, K., Taylor, E., & Zuikova, E. Nicotine vaping in England: An evidence update including health risks and perceptions. 2022.

Factors influencing Electronic Cigarette use among Young Adults in Sarawak, Malaysia: A Hierarchical analysis

Abstract

References

Instruction for Author

Instruction for Author

SCImago Journal Rank (SJR)

Collaboration