Social norms for e-cigarettes and smoking: associations with initiation of e-cigarette use, intentions to quit smoking and quit attempts: findings from the EUREST-PLUS ITC Europe Surveys
Author:
McDermott Máirtín S1, East Katherine A12, Hitchman Sara C12, McNeill Ann12, Tountas Yannis3, Demjén Tibor4, Fernández Esteve567, Mons Ute8, Trofor Antigona C910, Herbeć Aleksandra1112, Janik-Koncewicz Kinga11, Fong Geoffrey T1314, Vardavas Constantine I151617, Vardavas Constantine I, Glahn Andrea, Kyriakos Christina N, Nguyen Dominick, Nikitara Katerina, Radu-Loghin Cornel, Starchenko Polina, Tsatsakis Aristidis, Girvalaki Charis, Igoumenaki Chryssi, Papadakis Sophia, Papathanasaki Aikaterini, Tzatzarakis Manolis, Vardavas Alexander I, Bécuwe Nicolas, Deaconu Lavinia, Goudet Sophie, Hanley Christopher, Rivière Oscar, Demjén Tibor, Kiss Judit, Kovacs Anna Piroska, Fernández Esteve, Castellano Yolanda, Fu Marcela, Nogueira Sarah O, Tigova Olena, McNeill Ann, East Katherine, Hitchman Sara C, Mons Ute, Kahnert Sarah, Tountas Yannis, Behrakis Panagiotis, Filippidis Filippos T, Gratziou Christina, Katsaounou Paraskevi, Peleki Theodosia, Petroulia Ioanna, Tzavara Chara, Trofor Antigona Carmen, Eremia Marius, Lotrean Lucia, Mihaltan Florin, Rohde Gernot, Asano Tamaki, Cichon Claudia, Far Amy, Genton Céline, Jessner Melanie, Hedman Linnea, Janson Christer, Lindberg Ann, Maguire Beth, Ravara Sofia, Vaccaro Valérie, Ward Brian, Willemsen Marc, de Vries Hein, Hummel Karin, Nagelhout Gera E, Zatoński Witold A, Herbeć Aleksandra, Janik-Koncewicz Kinga, Przewoźniak Krzysztof, Zatoński Mateusz, Fong Geoffrey T, Agar Thomas K, Driezen Pete, Gravely Shannon, Quah Anne C K, Thompson Mary E,
Affiliation:
1. National Addiction Centre, King’s College London, London, UK 2. Shaping Public Health Policies to Reduce Inequalities and Harm (SPECTRUM), Nottingham, UK 3. Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens (UoA), Athens, Greece 4. Smoking or Health Hungarian Foundation (SHHF), Budapest, Hungary 5. Tobacco Control Unit, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat (Barcelona), Catalonia, Spain 6. Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Catalonia, Spain 7. School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, L’Hospitalet de Llobregat, Catalonia, Spain 8. German Cancer Research Center (DKFZ), Cancer Prevention Unit & WHO Collaborating Centre for Tobacco Control, Heidelberg, Germany 9. Aer Pur Romania, Bucharest, Romania 10. University of Medicine and Pharmacy ‘Grigore T.Popa’, Iasi, Romania 11. Health Promotion Foundation (HPF), Warsaw, Poland 12. UCL Tobacco and Alcohol Research Group, London, UK 13. Departments of Psychology and School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada 14. Ontario Institute for Cancer Research, Toronto, Canada 15. European Network on Smoking and Tobacco Prevention (ENSP), Brussels, Belgium 16. Laboratory of Toxicology, School of Medicine, University of Crete (UoC), Heraklion, Greece 17. European Respiratory Society, Lausanne, Switzerland
Abstract
Abstract
Background
Social norms have received little attention in relation to electronic cigarettes (EC). The current study examine social norms for EC use and smoking tobacco, and their associations with (i) initiation of EC use, (ii) intention to quit smoking and (iii) attempts to quit smoking.
Methods
Cross-sectional and longitudinal data analysis from Waves 1 and 2 of the ITC 6 European Country Survey and corresponding waves from England (the ITC Four Country Smoking and Vaping Survey). Current smokers at baseline, who heard of ECs and provided data at both waves were included (n = 3702). Complex samples logistic regression examined associations between the outcomes and descriptive (seeing EC use in public, close friends using ECs/smoking) and injunctive (public approves of ECs/smoking) norms, adjusting for country, demographics, EC use and heaviness of smoking.
Results
In longitudinal analyses, seeing EC use in public at least some days was the only social norm that predicted initiation of EC use between waves (OR = 1.66, 95%CI = 1.08–2.56). In the cross-sectional analysis, having an intention to quit was associated with seeing EC use in public (OR = 1.37, 95%CI = 1.04–1.81) and reporting fewer than three close friends smoke (OR = 0.59, 95%CI = 0.44–0.80). There was no association between any social norm and making a quit attempt between waves.
Conclusions
Initiation of EC use is predicted by seeing EC use in public, which was also associated with greater intention to quit smoking. Friends’ smoking was associated with lower intention to quit. These findings may allay concerns that increased visibility of ECs is renormalizing smoking amongst current smokers.
Funder
European Union’s Horizon 2020 University of Waterloo GTF Canadian Institutes of Health Research Ontario Institute for Cancer Research Ministry of Universities and Research, Government of Catalonia Instituto Carlos III European Regional Development Fund FEDER National Cancer Institute Department of Health and Social Care
Publisher
Oxford University Press (OUP)
Subject
Public Health, Environmental and Occupational Health
Cited by
10 articles.
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