Gender Differences in Reasons for Using Electronic Cigarettes and Product Characteristics: Findings From the 2018 ITC Four Country Smoking and Vaping Survey

Abstract

Introduction Little is known about why males are more likely to use electronic cigarettes (ECs) compared to females. This study examined gender differences in reasons for vaping and characteristics of EC used (device type, device capacity, e-liquid nicotine strength, and flavour). Methods Data from 3938 current adult (18+ years) at-least-weekly EC users who participated in Wave 2 (2018) ITC Four Country Smoking and Vaping Survey in Canada, the United States, England, and Australia. Results Of the sample, 54% were male. The most commonly cited reasons for vaping in females were ‘less harmful to others’ (85.8%) and in males were ‘less harmful than cigarettes’ (85.5%), with females being more likely to cite ‘less harmful to others’ (adjusted odds ratio (aOR)=1.64, p=0.001) and ‘help cut down on cigarettes’ (aOR=1.60, p=0.001) than males. Significant gender differences were found in EC device type used (χ2=35.05, p=0.043). Females were less likely to report using e-liquids containing >20 mg/ml of nicotine, and tank devices with >2ml capacity (aOR=0.41, p<0.001 and aOR=0.65, p=0.026, respectively) than males. There was no significant gender difference in use of flavoured e-liquids, with fruit being the most common flavour for both males (54.5%) and females (50.2%). Conclusion There were some gender differences in reasons for vaping and characteristics of the product used. Monitoring of gender differences in patterns of EC use would be useful to inform outreach activities and interventions for EC use. Implications Our findings provide some evidence of gender differences in reasons for vaping and characteristics of EC used. The most common reason for vaping reported by females was ‘less harmful to others’, which may reflect greater concern by female vapers about the adverse effects of second-hand smoke compared to male vapers. Gender differences might be considered when designing gender sensitive smoking cessation policies. Regarding characteristics of EC products used, we found gender differences in preferences for e-liquid nicotine strength and device capacity. Further studies should examine whether the observed gender differences in EC use reasons and product characteristics are predictive of smoking cessation. Furthermore, studies monitoring gender-based marketing of ECs may be considered.

Association between socioecological factors and electronic cigarette use among Thai youth: an institution-based cross-sectional study

“…About 50% of respondents believed that e-cigarettes contained less nicotine than conventional cigarettes and intended to use e-cigarettes to assist in quitting smoking. This finding is consistent with previous studies 16 25 26. Earlier studies in Qatar25 and Thailand16 26 found that fewer e-cigarette users believed in the health harm caused by e-cigarettes than non-users 16 25–27…”

Dripping Technology Use Among Young Adult E-Cigarette Users

“…Our results comport with previous research showing males to be more likely to vape, and use ENDS devices. 34 Results also align with previous research linking the prevalence of dripping with other tobacco-product use. 16 However, our findings on race and ethnicity depart from previous findings on health-risk behaviors among young adults.…”

Reasons for Regularly Using Heated Tobacco Products among Adult Current and Former Smokers in Japan: Finding from 2018 ITC Japan Survey

“…We compared the reasons for current smokers using HTPs in Japan with a recent ITC study of the reasons for current smokers using nicotine vaping products (NVPs; e.g., e-cigarettes) in the 2018 ITC Four Country Smoking and Vaping Survey, conducted in the United States, Canada, England, and Australia [30]. Some of the most common reasons for using NVPs were similar to the reasons for current smokers using HTPs in the present study, including the belief that NVPs were "less harmful to me": 74.3% among male and 74.5% among female concurrent smokers compared to 88% of current HTP-cigarette dual users in Japan, and that vaping was less harmful to others: 69.8% among male and 77.8% among female concurrent NVP-cigarette users compared to 83.8% among concurrent HTP-cigarette users in Japan.…”

“…This may be due to the presence of strong and enforced smoke-free laws in those four countries, which would highlight the perceived benefits of vaping, relative to the weak and weakly enforced smoke-free laws in Japan [31]. Second, concurrent NVP-cigarette users were much more likely to cite saving money as a reason for using NVPs (64.7% among males, 64.9% among females) vs. concurrent HTP-cigarette users in Japan (20.3%), reflecting both the relatively lower cost of vaping vs. smoking in the four countries and the nearly equal cost of using HTPs vs. smoking in Japan and elsewhere [30], and the overall marketing and positioning of HTPs as a high-end product [28,32].…”