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  1. Fulltext Correction: Gravely, S., et al. Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project. Int. J. Environ. Res. Public Health 2014, 11, 11691-11704
    Gravely S, Fong GT, Cummings KM, Yan M, Quah AC, Borland R, et al.
    Int J Environ Res Public Health, 2015 May;12(5):4631-7.
    PMID: 25922990 DOI: 10.3390/ijerph120504631
    The authors wish to make the following amendments to their paper published in International Journal of Environmental Research and Public Health.
    Matched MeSH terms: Electronic Cigarettes*
  2. Fulltext Nicotine, propylene glycol and tobacco-specific nitrosamines content in selected e-liquids in Malaysia: the case support for initiation of standards or guidelines
    Aziemah Zulkifli, Emilia Zainal Abidin, Najihah Zainol Abidin, Hasanah Mohd Ghazali, Praveena, Sarva Mangala, Amer Siddiq Amer Nordin, et al.
    Malaysian Journal of Medicine and Health Sciences, 2018;14(102):1-9.
    MyJurnal
    Electronic Cigarette (EC) usage has been gaining acceptance in Malaysia despite its lack of analytical evidence on the chemical constituents of its liquid formulations. This study aims to evaluate the chemical concentrations of nicotine, propylene glycol (PG) and selected Tobacco-Specific Nitrosamines (TSNAs); 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N’-nitrosonornicotine (NNN) in e-liquids locally sourced from the Malaysian market. Methods: A total of 17 e-liquids from a variety of flavours and brands were purchased from local EC retailers in Klang Valley, Malaysia. Nicotine and PG concentrations were assessed using Gas Chromatography-Flame Ionization Detector (GC-FID) while NNK and NNN were quantified using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). The concentrations of nicotine and PG (mg/mL) were described in comparison with the levels indicated on the labels when present while levels of TSNAs were descriptively explained. Results: Nicotine was detected in all e-liquid samples, despite several samples being declared as nicotine-free. The average (standard deviation) level of nicotine, PG, NNN and NNK were 3.26 (1.04) mg/mL, 484.10 (98.24) mg/mL, 0.383(0.288) μg/L and 0.086 (0.057) μg/L, respectively. Labelling discrepancies (when indicated on the label) of nicotine and PG were between the range of 27%-73% and 3%-63%, respectively. Conclusion: The concentrations of nicotine and PG in local e-liquids were varied. There were evidences of labelling discrepancy in that local e-liquids. TSNAs were detected in all samples of e-liquids. This study brought forth strong evidence on the need for the implementation of regulation on e-liquid manufacturing and sales, particularly on the accuracy of labelling and licensing to protect the public health.
    Matched MeSH terms: Electronic Cigarettes*
  3. Fulltext Electronic cigarette experimentation in the Malaysian city of Kuantan: Was there an association with the smoking status?
    Farsalinos KE, Le Houezec J
    J Pharm Bioallied Sci, 2016;8(4):347-348.
    PMID: 28216962 DOI: 10.4103/0975-7406.199341
    Comment on: Elkalmi RM, Bhagavathul AS, Ya’u A, Al-Dubai SA, Elsayed TM, Ahmad A, et al. Familiarity, perception, and reasons for electronic-cigarette experimentation among the general public in Malaysia: Preliminary insight. J Pharm Bioallied Sci. 2016;8:240–7
    Matched MeSH terms: Electronic Cigarettes*
  4. Increase in vaping and e-cigarette use by children in Malaysia
    Das M
    Lancet Oncol, 2022 11;23(11):1360.
    PMID: 36162429 DOI: 10.1016/S1470-2045(22)00596-4
    Matched MeSH terms: Electronic Cigarettes*
  5. Characteristics of second-hand exposure to aerosols from e-cigarettes: A literature review since 2010
    Cui T, Lu R, Liu C, Wu Z, Jiang X, Liu Y, et al.
    Sci Total Environ, 2024 May 20;926:171829.
    PMID: 38537812 DOI: 10.1016/j.scitotenv.2024.171829
    In recent years, the use of electronic vaping products (also named e-cigarettes) has increased due to their appealing flavors and nicotine delivery without the combustion of tobacco. Although the hazardous substances emitted by e-cigarettes are largely found to be much lower than combustible cigarettes, second-hand exposure to e-cigarette aerosols is not completely benign for bystanders. This work reviewed and synthesized findings on the second-hand exposure of aerosols from e-cigarettes and compared the results with those of the combustible cigarettes. In this review, different results were integrated based upon sampling locations such as residences, vehicles, offices, public places, and experimental exposure chambers. In addition, the factors that influence the second-hand exposure levels were identified by objectively reviewing and integrating the impacts of combustible cigarettes and e-cigarettes on the environment. It is a challenge to compare the literature data directly to assess the effect of smoking/vaping on the indoor environment. The room volume, indoor air exchange rate, puffing duration, and puffing numbers should be considered, which are important factors in determining the degree of pollution. Therefore, it is necessary to calculate the "emission rate" to normalize the concentration of pollutants emitted under various experimental conditions and make the results comparable. This review aims to increase the awareness regarding the harmful effects of the second-hand exposure to aerosols coming from the use of cigarettes and e-cigarettes, identify knowledge gaps, and provide a scientific basis for future policy interventions with regard to the regulation of smoking and vaping.
    Matched MeSH terms: Electronic Cigarettes*
  6. Comparison of End Tidal Carbon Monoxide Levels between Conventional Cigarette, Electronic Cigarette and Heated Tobacco Product among Asiatic Smokers
    Nga JDL, Hakim SL, Bilal S
    Subst Use Misuse, 2020;55(12):1943-1948.
    PMID: 32552152 DOI: 10.1080/10826084.2020.1781180
    BACKGROUND: Electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs) are noncombustible tobacco products which have been found to generate aerosols containing lower levels of Harmful and Potentially Harmful Constituents (HPHCs) in comparison to conventional cigarettes. Objective: This quasi experimental study measured and compared the end tidal carbon monoxide (eCO) levels of participants after use of ENDS, HTPs and conventional cigarettes. Methods: In total 45 smokers, each smoking at least 10 conventional cigarettes per day for 5 years participated in the study. Based on their preference, participants used only one of the tobacco products (ENDS, HTPs, or conventional cigarette) and were briefed about the product use based on manufacturer's instructions. The eCO levels were obtained at baseline, followed by 5, 10, 15, 30 and 45 min respectively after the product use. Results: There was significant increase in eCO levels for conventional cigarettes as compared to other modes. Peak eCO levels of 20.2 ± 0.86 ppm, 8.8 ± 1.56 ppm and 6.0 ± 1.36 ppm was achieved at 30 min, 15 min and 10 min for conventional cigarettes, ENDS and HTPs respectively. However, the levels were significantly lower in ENDS and HTPs. Conclusion: Even though ENDS and HTPs may have produced significantly lower eCO than conventional cigarettes, the significantly increasing levels over time from baseline which was not shown before is a cause of concern. As of now, their use as an alternate to cigarettes needs to be considered under regulatory framework.
    Matched MeSH terms: Electronic Cigarettes*
  7. Fulltext E-cigarette use, its impact on tobacco smoking and the intention to quit
    Nurasyikin MS, Leelavathi M, Tohid H
    Medicine & Health, 2019;14(1):78-90.
    MyJurnal
    E-cigarettes have rapidly gained worldwide popularity. Since its use still poses a health risk to the users, it is important to assess their intention to quit this habit. This study aimed to determine the characteristics of e-cigarette use, its effect on cigarette smoking and users’ intention to quit vaping and smoking. A total of 377 e-cigarette users were recruited from three vape retail stores in Bandar Baru Bangi, Selangor. E-cigarette usage pattern, tobacco cigarette consumption and their intention to quit were assessed using a self-administered questionnaire. Most (70%) participants were e-cigarettes only users while 30% were dual users. The median duration of e-cigarette use was 2 (IQR 2) years. Almost all (98.4%) participants used third-generation devices and majority (63.7%) preferred liquid containing 6mg nicotine. About 92% participants, especially heavy smokers, smoked fewer tobacco cigarettes after initiating e-cigarette. Majority (79.6%) of dual users also had reduction in tobacco cigarette consumption with a median current consumption of 5 (IQR 5.0) cigarettes per day. Most (87%) e-cigarette users intend to quit the habit someday. However, many (63.1%) were in the pre-contemplation stage. E-cigarette users of less than 2 years duration tend to have the intention to quit compared to users of more than 2 years (p=0.005). In conclusion, there was more e-cigarette only users than the dual users. E-cigarette use could significantly reduce tobacco smoking, especially among heavy smokers. Most e-cigarette users had the intention to quit vaping but not in the near future and longer e-cigarette use may deter their intention to quit.
    Matched MeSH terms: Electronic Cigarettes*
  8. Fulltext Current e-cigarette use among in-school adolescents in West Malaysia: Examining the interactions between sociodemographic characteristics and lifestyle risk behaviours
    Jane Ling MY, Ahmad N, Mohd Yusoff MF, Lim KH
    PLoS One, 2022;17(1):e0263355.
    PMID: 35100321 DOI: 10.1371/journal.pone.0263355
    BACKGROUND: Adolescent e-cigarette use has increased dramatically. Most e-cigarette liquids contain nicotine, which can harm the developing adolescent brain. Local studies examining the risk factors of adolescent e-cigarette use and interactions between its risk factors are limited. This study was aimed at determining the prevalence of current e-cigarette use and its associated factors among in-school adolescents in West Malaysia. We also examined the possible sociodemographic characteristic, lifestyle risk behaviour and parental factor interactions that affect the probability of current e-cigarette use.

    METHODS: We conducted a cross-sectional study using data from the National Health and Morbidity Survey 2017. Respondents aged 13-18 years were included in the study. The data were analysed using STATA (v.15).

    RESULTS: The prevalence of current e-cigarette use was 9.1%. Male gender, older age, Malay ethnicity, schooling in urban area, current smoking, current alcohol use, current drug use, having parents that are not married and living together and parental tobacco product use were significantly associated with current e-cigarette use. There were significant interactions between: i) gender with age, ethnicity, current smoking, current alcohol use and current drug use, ii) ethnicity with current smoking and current alcohol use, iii) locality with ethnicity, current smoking and current alcohol use, iv) current drug use with age, ethnicity, current smoking and current alcohol use, v) parental marital status with gender, age and ethnicity, and vi) parental tobacco use with ethnicity and current smoking.

    CONCLUSION: Our findings identify significant associations between sociodemographic characteristics, lifestyle risk behaviours and parental factors with current e-cigarette use. They also provide new insight into the interactions between these factors that affect the probability of current e-cigarette use among West Malaysian adolescents. Efforts to tackle e-cigarette use in Malaysian adolescents should target sociodemographic characteristics, lifestyle risk behaviours and parental factors such as smoking cessation intervention for parents.
    Matched MeSH terms: Electronic Cigarettes*
  9. Changes in E-cigarette Use, Cigarette Smoking, and Dual-Use Among the Youth (13-15 Years) in 10 Countries (2013-2019)-Analyses of Global Youth Tobacco Surveys
    Sreeramareddy CT, Acharya K, Manoharan A, Oo PS
    Nicotine Tob Res, 2024 Jan 22;26(2):142-150.
    PMID: 37466212 DOI: 10.1093/ntr/ntad124
    INTRODUCTION: The increasing use of e-cigarettes among the youth is a public health problem that needs surveillance. We report changes in e-cigarette use, cigarette smoking, and "dual use" among youth in 10 countries.

    AIMS AND METHODS: Global Youth Tobacco Survey (GYTS)s from Georgia, Iraq, Italy, Latvia, Montenegro, Paraguay, Peru, Qatar, Romania, and San Marino were analyzed. Changes in prevalence of "awareness of e-cigarettes," "ever use" (even tried a few puffs) and "current use" (during last 30 days) of e-cigarettes and cigarette smoking, and "dual use" (both e-cigarette and cigarette smoking) between baseline (2013 and 2014) and most recent (2017-2019) surveys were estimated.

    RESULTS: "Awareness of e-cigarettes" and "ever e-cigarette use" significantly increased (p  50% in most countries. During the most recent surveys, "current e-cigarette" use was > 10% in five countries Italy (18.3%) and Latvia (18.5%) being the highest. Cigarette smoking significantly declined in Italy, Latvia, Peru, and San Marino (p 

    Matched MeSH terms: Electronic Cigarettes*
  10. Electronic cigarettes: an emerging part of the modern lifestyle or a public health threat?
    Idris IB
    Perspect Public Health, 2020 05;140(3):146-147.
    PMID: 32414314 DOI: 10.1177/1757913919883316
    Matched MeSH terms: Electronic Cigarettes/standards*
  11. Fulltext Familiarity, perception, and reasons for electronic-cigarette experimentation among the general public in Malaysia: Preliminary insight
    Elkalmi RM, Bhagavathul AS, Ya'u A, Al-Dubai SA, Elsayed TM, Ahmad A, et al.
    J Pharm Bioallied Sci, 2016 Jul-Sep;8(3):240-7.
    PMID: 27413354 DOI: 10.4103/0975-7406.180768
    OBJECTIVES: The objectives of this study were to assess the general public views and familiarity toward electronic cigarette (e-cigarette) in Kuantan, Malaysia.
    METHODOLOGY: A total of 277 Kuantan people were involved in this study. The questionnaire was distributed at random in shops, businesses, and public places in Kuantan. Statistical analysis was performed using SPSS (version 17.0).
    RESULTS: From 400 participants, a total number of 277 (160, 57.7% men and 117, 42.4% women) respondents completed the questionnaire. The mean age was 26.89 ± 9.8 years old. The majority of the study participants were male (57.7%), Malay (83.8%), Muslims (83.8%), singles (69%), and employed (75.8%), with about 83 (29.9%) of the respondents were smokers. The prevalence of e-cigarettes smokers was found to be only 1.4% (n = 4). About one-third of the respondents (n = 72, 26%) have tried e-cigarette before. Job status was significantly associated with smoking e-cigarette among the population (P = 0.02). Main factors for a person to start e-cigarette smoking were curiosity (37.5%) and cheaper price (40.8%). Majority of respondents agreed that e-cigarette would not affect health as normal cigarette, and that variety of flavors contribute to better enjoyment (51.6% and 66.7%, respectively).
    CONCLUSION: The results of the current study demonstrate that the prevalence of e-cigarettes smoking and its popularity, familiarity, and knowledge are still insufficient among Kuantan population. Further studies should be done to tackle this problem before it getting worse.
    KEYWORDS: Electronic-cigarette; Malaysia; experimentation; perception; prevalence
    Comment in: Farsalinos KE, Le Houezec J. Electronic cigarette experimentation in the Malaysian city of Kuantan: Was there an association with the smoking status? J Pharm Bioallied Sci. 2016 Oct-Dec;8(4):347-348
    Matched MeSH terms: Electronic Cigarettes*
  12. E-cigarette users' attitudes on the banning of sales of nicotine e-liquid, its implication on e-cigarette use behaviours and alternative sources of nicotine e-liquid
    Wong LP, Alias H, Agha Mohammadi N, Ghadimi A, Hoe VCW
    J Community Health, 2017 Dec;42(6):1225-1232.
    PMID: 28589268 DOI: 10.1007/s10900-017-0374-z
    The banning of sales of nicotine e-liquid in e-cigarette shops has been implemented in several states in Malaysia. The distribution of nicotine e-liquid can only be allowed by licensed pharmacies or registered medical practitioners. This study aimed to evaluate e-cigarette users' responses to the control policy in a cross-sectional survey of 851 e-cigarette users by utilizing a self-report questionnaire that assessed (1) attitudes on regulation policy of e-cigarette banning; (2) e-cigarette use behaviors; and (3) sources of e-liquid after the regulation policy has been implemented. Participants from the state of Selangor where the banning policy was implemented were surveyed. The majority (95.8%) opposed the banning and believed e-cigarettes should be sold to anyone aged 18 years or above as with tobacco cigarettes, only a minority believed that nicotine e-liquid should only be available for sale over the counter in pharmacy stores (14.6%) and in clinics with a doctor's prescription (11.8%). The majority (44.2%) reported that they would continue their e-cigarette use as before the banning policy, while 20% plan to completely stop e-cigarette usage without replacing it with any alternatives. The vast majority (87.9%) was still able to obtained nicotine e-liquid from e-cigarette shops in spite of the ban and the second most common source was from online purchase (63.1%). The sales of nicotine e-liquid from black-market were evidenced as many reported obtaining zero nicotine e-liquid from the black market (54.4%). Self- or home-made (30.8%) nicotine e-liquid was also reported. Majority of respondents that self-made e-liquid were from the average monthly income group (below MYR3000). Obtaining nicotine from the pharmacy was least preferred (21.4%). Provision of professional advice to nicotine e-liquid users along with the ban may lessen the likelihood of users switching to tobacco cigarettes or other nicotine alternatives. Banning of sales of nicotine e-liquid in e-cigarette shops resulted in a boom in the black market supplying nicotine e-liquid and, self- or home-made nicotine e-liquid. Enforcing regulations and monitoring black market sales is warranted. Efforts to educate e-cigarette users of the danger of sourcing nicotine e-liquid from the black market and self- or home-made nicotine e-liquid are essential.
    Matched MeSH terms: Electronic Cigarettes*
  13. Children and e-cigarettes: a new threat to health
    Binns C, Lee MK, Low WY
    Asia Pac J Public Health, 2018 05;30(4):315-320.
    PMID: 29978722 DOI: 10.1177/1010539518783808
    The widespread availability and use of e-cigarettes in many countries has established the need for an assessment of their effect on children. By the end of 2017 the number published annually on e-cigarettes had increased to 2976 and included 171 papers on e-cigarettes and children. The objective of this commentary is to provide a review and public health perspective on the effects of e-cigarettes on children. There are four public health questions to be answered: 1. Are e-cigarettes and replenishing fluids toxic on accidental ingestion? 2. If children smoke e-cigarettes is this harmful? 3. Does exposure to second hand vapour from e-cigarettes cause harm to children? 4. Are children (adolescents) who use e-cigarettes more likely to begin smoking conventional cigarettes? There were 2229 reported exposures to e-cigarette fluids and liquid nicotine in the USA in 2017 causing cardiovascular symptoms of varying severity. No deaths were reported although the potential is always there. Exposure to e-cigarette vapor is less dangerous than cigarette smoke. However it does damage pulmonary endothelium in experimental models. No long term studies are yet available on chronic diseases although vapor does contain carcinogens. Adolescents who use e-cigarettes are more likely to become tobacco smokers. Because of the accumulating evidence of harm to children great caution should be exercised in widening the public promotion and usage of e-cigarettes. Children should avoid any contact with E-cigarettes or their vapour.
    Matched MeSH terms: Electronic Cigarettes*
  14. Knowledge, attitude and willingness to counsel patients regarding e-cigarettes among academic health professionals in Malaysia
    Yaldrum A, Ramachandra SS, Arora S, Gujjar KR, Dicksit DD, Squier CA
    Tob Prev Cessat, 2017;3:6.
    PMID: 32432181 DOI: 10.18332/tpc/68748
    Matched MeSH terms: Electronic Cigarettes*
  15. Nicotine dependence and associated factors among persons who use electronic e-cigarettes in Malaysia - an online survey
    Sreeramareddy CT, Shroff SM, Gunjal S
    Subst Abuse Treat Prev Policy, 2023 Aug 29;18(1):51.
    PMID: 37644524 DOI: 10.1186/s13011-023-00558-7
    BACKGROUND: Nicotine dependence, factors associated with dependence, and self-reported side effects among people who use e-cigarettes are scarce in developing countries.

    METHODS: A sample of 302 persons who currently use e-cigarettes was recruited from discussion forums on Reddit, Facebook, and the forum 'lowyat'. The online Google form survey collected data on demographics, e-cigarette use, and the reasons, for cigarette smoking, Fagerstorm Test for Nicotine Dependence adapted for e-cigarettes (eFTND), and side effects experienced.

    RESULTS: The mean age was 25.5 years (6.5), 60.6% were males and 86% had higher education. About 47% were using e-cigarettes only, 27.8% were currently using dual products (both electronic and conventional cigarettes), and 25.2% had also smoked cigarettes in the past. 'Less harmful than cigarettes' (56.3%), 'because I enjoy it' (46.7%), and 'it has a variety of flavors (40.4%) were the common reasons for e-cigarette use. The mean eFTND score was 3.9 (SD = 2.2), with a median of four side effects (IQR 3-6), sore or dry mouth/throat (41.4%), cough 33.4%, headache (20.5%), dizziness (16.2%) were commonly reported side effects. eFTND score and side effects were higher among persons using dual products. By multiple linear regression analysis, males (β = 0.56 95% CI 0.45, 1.05, p = 0.033), dual-use (β = 0.95 95% CI 0.34, 1.56, p 

    Matched MeSH terms: Electronic Cigarettes*
  16. Fulltext E-Cigarette Markets and Policy Responses in Southeast Asia: A Scoping Review
    van der Eijk Y, Tan Ping Ping G, Ong SE, Tan Li Xin G, Li D, Zhang D, et al.
    Int J Health Policy Manag, 2022 Sep 01;11(9):1616-1624.
    PMID: 33906338 DOI: 10.34172/ijhpm.2021.25
    BACKGROUND: The global e-cigarette market has proliferated and is increasingly dominated by transnational tobacco companies. While Southeast Asian countries have received relatively little attention in e-cigarette research, the region represents an area of potentially untapped growth for the industry. We review the e-cigarette situation in Southeast Asia in terms of the e-cigarette markets, advertising and promotion of e-cigarettes, reported health impacts of e-cigarette use, and policy responses in the region.

    METHODS: We examined e-cigarette market data from the Euromonitor Global Market Information Database (GMID) Passport database, searched in the academic literature, grey literature and news archives for any reports or studies of e-cigarette related diseases or injuries, e-cigarette marketing, and e-cigarette policy responses in Southeast Asian countries, and browsed the websites of online e-cigarette retailers catering to the region's active e-cigarette markets.

    RESULTS: In 2019, e-cigarettes were sold in six Southeast Asian markets with a total market value of $595 million, projected to grow to $766 million by 2023. E-commerce is a significant and growing sales channel in the region, with most of the popular or featured brands in online shops originating from China. Southeast Asian youth are targeted with a wide variety of flavours, trendy designs and point of sale promotions, and several e-cigarette related injuries and diseases have been reported in the region. Policy responses vary considerably between countries, ranging from strict bans to no or partial regulations.

    CONCLUSION: Although Southeast Asia's e-cigarette market is relatively nascent, this is likely to change if transnationals invest more heavily in the region. Populous countries with weak e-cigarette regulations, notably Indonesia, Malaysia, Vietnam and the Philippines, are desirable targets for the transnationals. Regulatory action is needed to prevent e-cigarette use from becoming entrenched into these societies, especially among young people.

    Matched MeSH terms: Electronic Cigarettes*
  17. Fulltext Oral health practices and self-reported adverse effects of E-cigarette use among dental students in 11 countries: an online survey
    Alhajj MN, Al-Maweri SA, Folayan MO, Halboub E, Khader Y, Omar R, et al.
    BMC Oral Health, 2022 Jan 26;22(1):18.
    PMID: 35081945 DOI: 10.1186/s12903-022-02053-0
    OBJECTIVES: E-cigarette use has become popular, particularly among the youth. Its use is associated with harmful general and oral health consequences. This survey aimed to assess self-reported oral hygiene practices, oral and general health events, and changes in physiological functions (including physical status, smell, taste, breathing, appetite, etc.) due to E-cigarette use among dental students.

    METHODS: This online, multicounty survey involved undergraduate dental students from 20 dental schools across 11 different countries. The questionnaire included demographic characteristics, E-cigarette practices, self-reported complaints, and associated physiological changes due to E-cigarette smoking. Data were descriptively presented as frequencies and percentages. A Chi-square test was used to assess the potential associations between the study group and sub-groups with the different factors. Statistical analysis was performed using SPSS at P 
    Matched MeSH terms: Electronic Cigarettes*
  18. Marketing claims, promotional strategies, and product information on Malaysian e-cigarette retailer websites-a content analysis
    Shroff SM, Sreeramareddy CT
    Subst Abuse Treat Prev Policy, 2024 Jan 25;19(1):11.
    PMID: 38273314 DOI: 10.1186/s13011-024-00592-z
    BACKGROUND: Marketing and sales of e-cigarettes are unregulated in Malaysia. We analyzed content displayed on e-cigarette retailer websites to identify marketing claims, promotional strategies, and product details in the year 2022.

    METHODS: We analyzed 30 Malaysia-based retailer websites using a mixed methods approach. Data were extracted as the frequency of occurrences of marketing claims, presence of regulatory information, product types, and flavors of e-juice as per a predefined codebook based on published literature. We also extracted textual details published on the websites about marketing claims, and slogans.

    RESULTS: Most retailer websites provided contact information and physical store addresses (83%) but only half had 'click through' age verification (57%) that seldom needed any identification proof for age (3%). Marketing claims were related to health (47%), smoking cessation (37%), and modernity/trend (37%) and none had health warnings. Promotional strategies were discounts (80%). starter kits (57%) and email subscriptions (53%). Product types displayed were rechargeable (97%) and disposable (87%) devices and e-liquids (90%) of an array of flavors (> 100). Nicotine presence, its concentration, and "nicotine is an addictive chemical" were displayed in 93%, 53%, and 23% of websites respectively.

    CONCLUSION: Surveillance of content displayed online on e-cigarette retailer websites and regulation of online marketing and sales should be implemented by the Ministry of Health, Malaysia. Such measures are needed to prevent access to, and initiation of e-cigarette use among the youth and adults who do not smoke.

    Matched MeSH terms: Electronic Cigarettes*
  19. Intentions to Quit, Quit Attempts, and the Use of Cessation Aids Among Malaysian Adult Smokers: Findings From the 2020 International Tobacco Control (ITC) Malaysia Survey
    Kamaludin IS, How LS, Yee A, Kaai SC, Yan M, Danaee M, et al.
    Asia Pac J Public Health, 2024 Jan;36(1):69-77.
    PMID: 38197364 DOI: 10.1177/10105395231220465
    This study examined quitting behavior and use of cessation aids (CAs) among Malaysian adult smokers aged ≥18 years (n = 1,047). Data were from the 2020 International Tobacco Control (ITC) Malaysia Survey were analyzed. A total of 79.9% of Malaysian smokers attempted to quit in the past 12 months and 85.2% intended to quit in the next 6 months. The most common CAs were e-cigarettes (ECs) (61.4%), medication/nicotine replacement therapies (NRTs; 51.0%), and printed materials (36.7%); the least common CA was infoline/quitline services (8.1%). Multivariable logistic regression analysis was performed to examine the association between sociodemographic variables and CAs use. Male smokers were more likely to use infoline/quitline services (adjusted odds ratio [aOR] = 3.27; P = .034). Malay smokers were more likely to use infoline/quitline services (aOR = 3.36; P = .002), ECs (aOR = 1.90; P = .004), printed materials (aOR = 1.79; P = .009), and in-person services (aOR = 1.75; P = .043). Most Malaysian smokers wanted to quit smoking. Furthermore, ECs were the most popular CAs, highlighting the need to assess the effectiveness of ECs for quitting smoking in Malaysia.
    Matched MeSH terms: Electronic Cigarettes*
  20. Fulltext Electronic cigarettes use and 'dual use' among the youth in 75 countries: estimates from Global Youth Tobacco Surveys (2014-2019)
    Sreeramareddy CT, Acharya K, Manoharan A
    Sci Rep, 2022 Dec 05;12(1):20967.
    PMID: 36470977 DOI: 10.1038/s41598-022-25594-4
    We report the country-level prevalence of awareness about electronic cigarette use, and 'dual use' and its association with age, sex, country income, and e-cigarette regulatory status. We analyzed the most recent Global Youth Tobacco Surveys done on nationally representative samples of school-going youth aged 13-15 years in 75 countries/territories. The weighted prevalence of 'awareness' (heard about e-cigarettes), 'ever use' (even tried a few puffs), 'current use' (during the last 30 days), and 'dual use' (e-cigarette use and cigarette smoking during the last 30 days) were estimated. Awareness was > 80% in 13 countries mostly from Europe Poland being the highest at 95.8% (95% CI 94.8- 96.6). In seven countries, 30-50% of the youth had ever used an e-cigarette, Italy was the highest at 55.1% (95%CI 51-3,58.9). In 30 countries, current e-cigarette use was > 10%, the highest of 35.1% (95%CI 32.4-38.0) in Guam. Awareness and use were highest in the European region (74.6% and 34.5%) and HIC (83.6% and 39.4%). Youth from HIC (compared to lMIC) and countries having restrictive e-cigarette regulations (compared to NRP) had 2.4 times (aOR 2.2.4, 95% CI 2.2, 2.7) and 1.8 times (aOR 1.8, 95% CI 1.6, 2.0) higher odds of being current e-cigarette users respectively. Youth in countries with the most restrictive e-cigarette regulations (compared to NRP) had 0.6 times lower odds of being current e-cigarette users (aOR 0.6, 95% CI 0.6, 0.7). Awareness and e-cigarette use varied by sex, country income level, and region. Continued global surveillance of youth e-cigarette use is needed for the formulation of e-cigarette regulatory policy. Awareness and use of e-cigarettes were higher among boys, in countries in Europe and America regions, and among those with higher income and restrictive policies, whereas it was lower in countries having the most restrictive policies. Higher awareness is strongly correlated with a trial and current use of e-cigarettes. E-cigarette marketing should be restricted, and continued surveillance of e-cigarette use is needed. Most restrictive policies such as the ban on e-cigarettes appear to reduce e-cigarette use among the youth.
    Matched MeSH terms: Electronic Cigarettes*
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