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. 2018 Aug 5:16:A1.
doi: 10.18332/tid/93545. eCollection 2018.

Characteristics and correlates of electronic cigarette product attributes and undesirable events during e-cigarette use in six countries of the EUREST-PLUS ITC Europe Surveys

Christina N Kyriakos  1   2 , Filippos T Filippidis  3 , Sara Hitchman  4 , Charis Girvalaki  2 , Chara Tzavara  3 , Tibor Demjén  5 , Esteve Fernandez  6   7 , Ute Mons  8 , Antigona Trofor  9   10 , Yannis Tountas  3 , Mateusz Zatoński  11   12 , Witold A Zatoński  11 , Geoffrey T Fong  13   14 , Constantine I Vardavas  1   2 ; EUREST-PLUS consortium
Affiliations

Characteristics and correlates of electronic cigarette product attributes and undesirable events during e-cigarette use in six countries of the EUREST-PLUS ITC Europe Surveys

Christina N Kyriakos et al. Tob Induc Dis. .

Abstract

Introduction: This study assessed characteristics and correlates associated with e-cigarette product attributes and identified correlates of experiencing undesirable events during e-cigarette use among adult smokers across six European Union (EU) Members States (MS) prior to the implementation of the Tobacco Products Directive (TPD) in 2016.

Methods: We conducted a cross-sectional survey with a nationally representative sample of adult cigarette smokers from six EU MS (Germany, Greece, Hungary, Poland, Romania, Spain) reporting e-cigarette use; randomly selected through a multistage cluster sampling design from June to September 2016. Stepwise logistic regressions were used to identify factors associated with use of flavors, noticing health warnings, mixing e-liquids, experiencing 'dry puff', e-liquid leaking during use and e-liquid spilling during refill.

Results: Current daily or weekly prevalence of e-cigarette use among this sample of adult smokers was 7.5%. The most common attributes of e-cigarettes used included those that are flavored, contain nicotine, and are of tank style. Noticing health warnings on e-cigarette packaging and leaflets, respectively, was low (10.2% and 28%, respectively). Use of e-liquid refill nozzle caps, described as easy for a child to open, was associated with spilling during refill (OR=6.73; 95% CI: 2.02-22.37). Participants who adjusted occasionally or regularly the power (voltage) or temperature of their e-cigarette had greater odds of ever experiencing a 'dry puff' (OR=6.01; 95% CI: 2.68-13.46). Mixing different e-liquids was associated with leaking during use (OR=7.78; 95% CI: 2.45-24.73) and spilling during refill (OR=8.54; 95% CI: 2.29-31.88).

Conclusions: Ongoing evaluation of factors associated with e-cigarette attributes and of the correlates of experiencing e-cigarette undesirable events during use, related to product design, is crucial to monitoring the impact of the implementing Acts of the EU TPD.

Keywords: cross-sectional study; e-cigarettes; electronic cigarette; regulatory science; tobacco products directive.

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Conflict of interest statement

C. I. Vardavas reports that he is the Strategic Development Editor of TID and that there are no conflicts of interest with this current work. The rest of the authors have also completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work.

References

    1. Filippidis FT, Laverty AA, Gerovasili V, Vardavas CI. Two-year trends and predictors of e-cigarette use in 27 European Union member states. Tob Control. 2017;26(1):98–104. doi: 10.1136/tobaccocontrol-2015-052771. - DOI - PMC - PubMed
    1. Vardavas CI, Filippidis FT, Agaku IT. Determinants and prevalence of e-cigarette use throughout the European union: A secondary analysis of 26 566 youth and adults from 27 countries. Tob Control. 2015;24(5):442–448. doi: 10.1136/tobaccocontrol-2013-051394. - DOI - PubMed
    1. East K, Hitchman SC, Bakolis I, et al. The Association Between Smoking and Electronic Cigarette Use in a Cohort of Young People. Journal of Adolescent Health. 2018;62(5) doi: 10.1016/j.jadohealth.2017.11.301. - DOI - PMC - PubMed
    1. Mcneill A, Brose LS, Calder R, Hitchman SC, Hajek P, McRobbie H. E-cigarettes: an evidence update A report commissioned by Public Health England. London: Public Heal Engl; 2015. p. 111. www.gov.uk/government/uploads/system/uploads/attachment_data/file/454516.... Accessed May 2, 2018.
    1. Benowitz NL, Goniewicz ML. The Regulatory Challenge of Electronic Cigarettes. JAMA. 2013;310(7):685. doi: 10.1001/jama.2013.109501. - DOI - PubMed