EC Pulmonology and Respiratory Medicine

Research Article Volume 12 Issue 5 - 2023

Electronic Cigarettes and their Knowledge, Attitude and Practices among Pakistani Population: A Multi-City Study Across Pakistan

Ayesha Nasir Hameed1, Muhammad Talha Nawaz1, Meher Angez1, Khujasta Gul2, Amal Farrukh1, Alveena Zafar1, Muhmmad Saad Abbass1 and Javaid Ahmed Khan3*

1Medical College, Aga Khan University, Pakistan

2Medical College, Multan Medical and Dental College, Multan, Pakistan

3Department of Medicine, Section of Pulmonary and Critical Care Medicine, Aga Khan University Hospital, Karachi, Pakistan

*Corresponding Author: Javaid Ahmed Khan, Consultant Pulmonologist, Professor, Section of Pulmonology and Critical Care Medicine, Department of Medicine, Aga Khan University Hospital, Karachi, Sindh, Pakistan.
Received: May 01, 2023; Published:June 15, 2023



Introduction: E-cigarettes are devices that are powered by a battery, are portable, and can be used repeatedly. These devices utilize a piezo-electric component to convert a solution into vapor that is then inhaled by the user via a refillable cartridge and mouthpiece. Although there is limited information regarding the safety and composition of e-cigarettes, they have become popular among young people worldwide due to their discreet nature and availability in a wide variety of flavors. Despite this, they are being marketed and used extensively. Given that tobacco consumption is common in Pakistan, our research aims to investigate the knowledge, attitudes, and practices (KAP) of the Pakistani population regarding e-cigarettes.

Methods: An anonymous online survey in the form of a Google form was utilized to conduct a substantial cross-sectional study. The survey consisted of questions that inquired about the use of e-cigarettes, demographics, knowledge about e-cigarettes, and attitudes towards e-cigarettes. Aside from descriptive analysis, univariate and multivariate analyses were conducted to determine any correlations between sociodemographic factors as exposure variables and KAP scores as outcome variables.

Results: A total of 695 participants were included in the final analysis. The mean age of the respondents was 29.6 years, with a majority of responders from the Punjab province (44.4%) Majority (96.7%) of the participants had adequate knowledge while 56.3% had a negative attitude towards E-cigarettes. Three hundred and eighty-four (43.4%) of the respondents reported using E-cigarettes. A concurrent use of cigarette smoking, and e-cigarettes was also recorded (19.3%).

Conclusion: Our study concluded that the prevalence of e-cigarette use was 43.4% and that most of the population had sufficient knowledge and a negative attitude. This study also highlights the perception among the youth that e-cigarette smoking is socially desirable and that certain provinces in the country have a lack of awareness regarding the devices.

Keywords: Electronic Cigarettes; E-cigs; Cigarette Smoking; Tobacco; Nicotine; Smoking

  1. Pepper J., et al. “Healthcare providers’ beliefs and attitudes about electronic cigarettes and preventive counseling for adolescent patients” 54.6 (2014): 678-683.
  2. Abo-Elkheir OI and Sobh E. “Knowledge about electronic cigarettes and its perception: A community survey, Egypt”. Respiratory Research1 (2016).
  3. Farsalinos K., et al. “Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review”. Journals2 (2014): 67-86.
  4. Grana R., et al. “E-cigarettes: A scientific review”. Circulation19 (2014): 1972-1986.
  5. Brożek G., et al. The prevalence of cigarette and e-cigarette smoking among students in Central and Eastern Europe-results of the YUPESS study (2019).
  6. Hongying Dai., et al. “Prevalence of e-cigarette use among adults in the United States, 2014-2018” (2019).
  7. Jiang N., et al. “Perceptions and use of e-cigarettes among young adults in Hong Kong”. BMC Public Health1 (2019).
  8. Rahman JA., et al. “The Prevalence of E-Cigarette Use Among Adults in Malaysia: Findings From the 2016 National E-Cigarette Survey”. 31.7S (2019): 9-21.
  9. Iqbal N., et al. “Prevalence and knowledge of electronic cigarettes amongst medical students, A cross sectional survey from Karachi, Pakistan” (2017).
  10. Pitriyanti L., et al. “Factors affecting the use of electronic cigarettes in Udayana University students” 6.2 (2018).
  11. Choi K., et al. “Trends in awareness, use of, and beliefs about electronic cigarette and snus among a longitudinal cohort of US Midwest young adults” (2018).
  12. Kanchustambham V., et al. “The knowledge, concerns and healthcare practices among physicians regarding electronic cigarettes”. Taylor and Francis3 (2017): 144-150.
  13. Hilton S., et al. “E-cigarettes, a safer alternative for teenagers? A UK focus group study of teenagers’ views” 6.11 (2016): 13271.
  14. Corsi D., et al. “An examination of the shift in school-level clustering of US adolescent electronic cigarette use and its multilevel correlates, 2011-2013” (2016).
  15. Palipudi K., et al. “Awareness and current use of electronic cigarettes in Indonesia, Malaysia, Qatar, and Greece: findings from 2011-2013 global adult tobacco surveys” (2023).
  16. Russell MAH. “The future of nicotine replacement”. British Journal of Addiction5 (1991): 653-658.
  17. Hubbard R., et al. “Use of nicotine replacement therapy and the risk of acute myocardial infarction, stroke, and death” 14 (2005): 416-421.
  18. Satghare P., et al. “A Qualitative Study of Perceptions of E-Cigarettes Among Youth Smokers and Parents of Youth in Singapore” (2018).
  19. Dautzenberg B., et al. “E-cigarette: a new tobacco product for schoolchildren in Paris”. 3 (2013): 21-24.
  20. Lee S., et al. “Electronic cigarette use among Korean adolescents: a cross-sectional study of market penetration, dual use, and relationship to quit attempts and former” (2014).
  21. Jiang N., et al. “Electronic cigarette use among adolescents: A cross-sectional study in Hong Kong”. BMC Public Health1 (2016).
  22. Ramamurthi D., et al. “Exploitation of the COVID-19 pandemic by e-cigarette marketers”. 30 (2021): 56-59.
  23. Shaikh A., et al. “Knowledge and attitude of teenagers towards electronic cigarettes in Karachi, Pakistan” (2023).
  24. Vassey J., et al. “E-cigarette brands and social media influencers on Instagram: a social network analysis” (2022).
  25. Pakistan Sales Age | Tobacco Control Laws (2023).
  26. Azeem N., et al. “Vaping and smokeless tobacco control in South Asia: A policy review” (2022).
  27. Use of e-cigarettes rising at alarming rate (2013).
  28. Smoking: a 100-Year Story That Doesn’t End Here (2013).
  29. Sarfraz M., et al. Awareness, use and perceptions about E-cigarettes among adult smokers in Karachi, Pakistan 68.1 (2018): 147-153.
  30. Alexander J., et al. Youth who use e-cigarettes regularly: A qualitative study of behavior, attitudes, and familial norms (2019).
  31. Brown J., et al. Prevalence and characteristics of e-cigarette users in Great Britain: findings from a general population survey of smokers (2014).
  32. Seiler-Ramadas R., et al. “Health effects of electronic cigarette (e‑cigarette) use on organ systems and its implications for public health”. Wiener klinische Wochenschrift19-20 (2021): 1020-1027.
  33. Alotaybi M., et al. “E-cigarettes and Vaping: A Smoking Cessation Method or Another Smoking Innovation?” Cures (2022).
  34. Iqbal N., et al. “Electronic cigarettes use and perception amongst medical students: A cross sectional survey from Sindh, Pakistan”. BMC Research Notes1 (2018).
  35. Country’s internet penetration stands at 54% (2013).

Javaid Ahmed Khan., et al. "Electronic Cigarettes and their Knowledge, Attitude and Practices among Pakistani Population: A Multi-City Study Across Pakistan". EC Pulmonology and Respiratory Medicine  12.5 (2023): 31-46.