Electronic Cigarettes in Thailand: Behaviour, Rationale, Satisfaction, and Sex Differences

Abstract

Electronic cigarettes (e-cigarettes) use is trending in Thailand. Electronic cigarettes are banned and illegally imported. This study aimed to investigate the behaviour, rationale, and satisfaction of e-cigarettes users and compared them between males and females. A cross-sectional study was conducted involving 1050 participants using e-cigarettes from December 2019 to February 2020. The participants were recruited by an online questionnaire posted on social media. The participants were current e-cigarettes users aged 18 years and older. Of 1050 participants, 936 were male (89.1%). The average age was 31.2 ± 8.4 years. The participants were from all regions of the country, but most (64.5%) were from central Thailand. Most e-cigarettes users comprised private employees (43.2%). The main source of e-cigarettes in Thailand is online sources such as social media. Tank-style e-cigarettes were popular among users. Amongst e-cigarettes users, the top three rationales for using e-cigarettes were fewer harmful effects from e-cigarettes than conventional cigarettes (81.0%), smoking cessation aids (80.6%), and their lack of attaching cigarette odour (58.2%). The top three reasons for satisfaction were using e-cigarettes as a conventional cigarette cessation aid (5.1 ± 1.3), lessening cravings for conventional cigarettes (5.1 ± 1.3), and reducing conventional cigarettes withdrawal symptoms (5.0 ± 1.3). Online purchase was the main source of e-cigarettes in Thailand. The general rationale for using electronic cigarettes was that they are less harmful and to quit conventional cigarettes. Thai users were satisfied to use e-cigarettes as a conventional cigarette cessation aid. Males and females differed in behaviour, rationale, and satisfaction of e-cigarettes. Public health organisations should provide accurate information about the harm of electronic cigarettes and their efficacy for tobacco cessation.

Vaping in a heavily regulated setting: cross-sectional survey of e-cigarette use, perceptions and social media exposure

“…As in Thailand,6 e-cigarette users in Singapore procure vaping products via their interpersonal networks or online, on social media and e-commerce platforms such as Facebook, Instagram, WhatsApp, Telegram, Carousell and WeChat 29–32. Our study thus highlights issues with compliance, even amidst Singapore’s strict regulations, and the need to effectively enforce regulations with measures that tackle both illegal supply and demand.…”

“…They also described the process of obtaining vaping products as relatively easy, usually via online sellers or social media platforms such as Telegram, Instagram and Facebook 5. Although little else is known on vaping in Singapore, similar issues were reported in Thailand, Japan and Australia, where e-cigarette sales are also banned or heavily regulated 6–9…”

Sex Differences in E-Cigarette Use and Related Health Effects

“…Initiation of e-cigarette use in females is mostly associated with curiosity [125]. However, females who never smoked are less likely to ever become users of e-cigarettes [31].…”

“…Young female vapers tend to engage in low-power, high-nicotineconcentration patterns as opposed to men who choose high-power/lower-nicotine patterns (sub-ohming, cloud chasing) [31]. Males are also more satisfied using e-cigarettes as an aid for smoking cessation than women because they experience less cravings and withdrawal symptoms in comparison to conventional smoking [125].…”

“…Regarding characteristics of device choice, males more frequently use box-shaped tanks, whereas females prefer pen-style devices [43,125]. In this regard, users of open systems (rechargeable, do not use cartridges, and refillable) are mostly likely to be male as opposed to being users of closed systems (not rechargeable, or rechargeable and used cartridges) [34].…”