Skip to main content

Reasons for Using Electronic Cigarettes and Intentions to Quit Among Electronic Cigarette Users in Malaysia

Journal of Community Health volume 41, pages 1101–1109 (2016)Cite this article

Abstract

The rapidly increasing uptake of e-cigarettes in Malaysia as of late demands a study to identify factors leading to its increased popularity and user intentions to quit smoking e-cigarettes. A convenience sample of e-cigarette smokers visiting e-cigarette retail shops in Selangor and Kuala Lumpur was recruited. The majority of e-cigarette smokers were youth in colleges or universities (39 %), and young professionals and managers (36 %). The main reasons for using e-cigarettes were to help the user quit tobacco cigarettes (88 %), the perception that e-cigarettes are not as intrusive as tobacco cigarettes (85 %) and can be used in public areas (70 %), the perception that e-cigarettes are healthier than tobacco cigarettes (85 %), and its relatively lower cost compared to tobacco cigarettes (65 %). A total of 65.3 % of respondents expressed intentions to quit e-cigarettes. In a multivariate analysis, the respondents who earned monthly income of RM1000 or less were significantly more likely to intend to quit smoking e-cigarettes [OR 1.551; 95 % CI 1.022–2.355; p = 0.015] compared to the respondents who earned a monthly income of more than RM2000. The respondents who disagreed with the statement ‘Smoking e-cigs is relatively cheaper compared to tobacco cigarettes’ were significantly more likely to intend to quit smoking e-cigarettes [OR 1.548; 95 % CI 1.045–2.293; p = 0.027] compared to respondents who did not agree. e-cigarette preventive interventions should target areas related to the identified main reasons for using e-cigarettes, namely as an aid for quitting tobacco cigarettes, the perception that e-cigarettes are not as intrusive as tobacco cigarettes and can be used in public areas, the idea that e-cigarettes are healthier than tobacco cigarettes, and its relatively lower cost compared to tobacco cigarettes.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Gravely, S., Fong, G. T., Cummings, K. M., et al. (2014). Awareness, trial, and current use of electronic cigarettes in 10 countries: Findings from the ITC project. International journal Of Environmental Research and Public Health, 11(11), 11691–11704.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Sumisha, N. (2015). Malaysia to regulate sale of e-cigarette liquids. The New York Times. http://www.channelnewsasia.com/news/asiapacific/malaysia-to-regulate-sale/2248560.html.

  3. Lokman, H.S. Ministry of Health, Malaysia. (2015). Ministry of Health will act on electronic cigarette containing nicotine using The Poison Act 1952 [Press release]. http://www.moh.gov.my/english.php/file_manager/dl_item/6132567565574630595734675957746f596d46794c30746c626e6c6864474668626c39426132686959584a6654553949583239755832557459326c6e59584a6c6448526c583246755a4639325958426c587a41304d5445784e563946626d647361584e6f4c6e426b5a673d3d

  4. Scawen, S. (2015). E-cigarette bans in Malaysia spark debate. Al Jazeera. https://en-maktoob.news.yahoo.com/e-cigarette-bans-malaysia-spark-debate-215744469–finance.html?nhp=1.

  5. Barbeau, A. M., Burda, J., & Siegel, M. (2013). Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: A qualitative approach. Addiction Science & Clinical Practice, 8(1), 1. doi:10.1186/1940-0640-8-5.

    Article  Google Scholar 

  6. Pepper, J. K., Ribisl, K. M., Emery, S. L., & Brewer, N. T. (2014). Reasons for starting and stopping electronic cigarette use. International Journal Environmental Research Public Health, 11(10), 10345–10361. doi:10.3390/ijerph111010345.

    Article  Google Scholar 

  7. Etter, J. F., & Bullen, C. (2011). Electronic cigarette: Users profile, utilization, satisfaction and perceived efficacy. Addiction, 106(11), 2017–2028. doi:10.1111/j.1360-0443.2011.03505.x.

    Article  PubMed  Google Scholar 

  8. Goniewicz, M. L., Knysak, J., Gawron, M., et al. (2014). Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tobacco Control, 23, 133–139.

    Article  PubMed  Google Scholar 

  9. Dawkins, L., Turner, J., Roberts, A., & Soar, K. (2013). ‘Vaping’ profiles and preferences: An online survey of electronic cigarette users. Addiction, 108(6), 1115–1125.

    Article  PubMed  Google Scholar 

  10. Berg, C. J., Barr, D. B., Stratton, E., Escoffery, C., & Kegler, M. (2014). Attitudes toward e-cigarettes, reasons for initiating e-cigarette use, and changes in smoking behaviour after initiation: A pilot longitudinal study of regular cigarette smokers. Open Journal Of Preventive Medicine, 4(10), 789.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Adkison, S. E., O’Connor, R. J., Bansal-Travers, M., et al. (2013). Electronic nicotine delivery systems: International tobacco control four-country survey. American Journal Preventive Medicine, 44, 207–215.

    Article  Google Scholar 

  12. Bhatnagar, A., Whitsel, L. P., Ribisl, K. M., et al. (2014). Electronic cigarettes: A policy statement from the American Heart Association. Circulation, 130(16), 1418–1436. doi:10.1161/CIR.0000000000000107.13.

    Article  PubMed  Google Scholar 

  13. Grana, R. A., Popova, L., & Ling, P. M. (2014). A longitudinal analysis of electronic cigarette use and smoking cessation. JAMA International Medicine, 174(5), 812–813. doi:10.1001/jamainternmed.2014.187.

    Article  Google Scholar 

  14. Britton J, Bogdanovica, I. (2014). Electronic cigarettes. A report commissioned by Public Health England. UK Centre for Tobacco and Alcohol Studies Division of Epidemiology and Public Health, University of Nottingham.

  15. Foulds, J., Veldheer, S., & Berg, A. (2011). Electronic cigarettes (e-cigs): Views of aficionados and clinical/public health perspectives. International Journal of Clinical Practice, 65(10), 1037–1042.

    CAS  Article  PubMed  Google Scholar 

  16. Dockrell, M., Morison, R., Bauld, L., & McNeill, A. (2013). E-cigarettes: Prevalence and attitudes in Great Britain. Nicotine & Tobacco Research, 15(10), 1737–1744.

    Article  Google Scholar 

  17. Kong, G., Morean, M. E., Cavallo, D. A., Camenga, D. R., & Krishnan-Sarin, S. (2014). Reasons for electronic cigarette experimentation and discontinuation among adolescents and young adults. Nicotine & Tobacco Research, 17(7), 847–854.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Farsalinos, K. E., Romagna, G., Tsiapras, D., Kyrzopoulos, S., Spyrou, A., & Voudris, V. (2013). Impact of flavour variability on electronic cigarette use experience: An internet survey. International Journal Environmental Research and Public Health, 10(12), 7272–7282.

    Article  Google Scholar 

  19. U.S. Department of Health and Human Services. (2004). The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

  20. Caponnetto, P., Campagna, D., Cibella, F., et al. (2013). Efficiency and Safety of an electronic cigarette (ECLAT) as tobacco cigarettes substitute: A prospective 12-month randomized control design study. PLoS One, 8(6), e66317. doi:10.1371/journal.pone.0066317.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  21. Etter, J. F., & Bullen, C. (2014). A longitudinal study of electronic cigarette users. Addictive Behaviour, 39(2), 491–494. doi:10.1016/j.addbeh.2013.10.028.

    Article  Google Scholar 

  22. Bullen, C., McRobbie, H., Thornley, S., Glover, M., Lin, R., & Laugesen, M. (2010). Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: Randomised cross-over trial. Tobacco Control, 19(2), 98–103.

    CAS  Article  PubMed  Google Scholar 

  23. Vansickel, A. R., Cobb, C. O., Weaver, M. F., & Eissenberg, T. E. (2010). A clinical laboratory model for evaluating the acute effects of electronic ‘cigarettes’: Nicotine delivery profile and cardiovascular and subjective effects. Cancer Epidemiology, Biomarkers and Prevention, 19(8), 1945–1953.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Grana, R., Benowitz, N., & Glantz, S. A. (2014). E-cigarettes: A scientific review. Circulation, 129(19), 1972–1986. doi:10.1161/CIRCULATIONAHA.114.007667.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kalkhoran, S., & Glantz, S. A. (2016). E-cigarettes and smoking cessation in real-world and clinical settings: A systematic review and meta-analysis. The Lancet Respiratory Medicine.

  26. Nelson, V. A., Goniewicz, M. L., Beard, E., et al. (2015). Comparison of the characteristics of long-term users of electronic cigarettes versus nicotine replacement therapy: A cross-sectional survey of English ex-smokers and current smokers. Drug and Alcohol Dependence, 153, 300–305. doi:10.1016/j.drugalcdep.2015.05.005.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Mello, S., Bigman, C. A., Sanders-Jackson, A., & Tan, A. S. (2015). Perceived harm of secondhand electronic cigarette vapors and policy support to restrict public vaping: Results from a National Survey of US Adults. Nicotine & Tobacco Research. doi:10.1093/ntr/ntv232.

    Google Scholar 

  28. Kosmider, L., Sobczak, A., Fik, M., et al. (2014). Carbonyl compounds in electronic cigarette vapors: Effects of nicotine solvent and battery output voltage. Nicotine & Tobacco Research, 16(10), 1319–1326. doi:10.1093/ntr/ntu078.

    Article  Google Scholar 

  29. Westenberger, B. J. (2009). Evaluation of e-cigarettes (pp. 1–8). St Louis, MO: Food and Drug Administration.

    Google Scholar 

  30. Williams, M., Villarreal, A., Bozhilov, K., Lin, S., & Talbot, P. (2013). Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS One, 8(3), e57987. doi:10.1371/journal.pone.0057987.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  31. Chen, I. L. (2013). FDA summary of adverse events on electronic cigarettes. Nicotine & Tobacco Research, 15(2), 615–616. doi:10.1093/ntr/nts145.

    Article  Google Scholar 

  32. Etter, J. F. (2010). Electronic cigarettes: A survey of users. BMC Public Health, 10(1), 1.

    Article  Google Scholar 

  33. Chaloupka, F. J., & Warner, K. E. (2000). The economics of smoking. Handbook of Health Economics (pp. 1539–1627). New York: Elsevier.

    Google Scholar 

  34. Chaloupka, F. J., Jha, P., Corrao, M. A., et al. (2003). Global efforts for reducing the burden of smoking. Disease Management & Health Outcomes, 11(10), 647–661.

    Article  Google Scholar 

  35. Ross, H., Blecher, E., Yan, L., & Hyland, A. (2011). Do cigarette prices motivate smokers to quit? New evidence from the ITC survey. Addiction, 106(3), 609–619. doi:10.1111/j.1360-0443.2010.03192.x.

    Article  PubMed  Google Scholar 

  36. Blecher, E. H., & Van Walbeek, C. P. (2004). An international analysis of cigarette affordability. Tobacco Control, 13(4), 339–346.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  37. Grace, R. C., Kivell, B. M., & Laugesen, M. (2015). Estimating cross-price elasticity of e-cigarettes using a simulated demand procedure. Nicotine & Tobacco Research, 17(5), 592–598. doi:10.1093/ntr/ntu268.

    Article  Google Scholar 

Download references

Acknowledgments

The study was funded by University of Malaya Research Grant (UMRG) RP030 (A)-14HTM.

Author’s Contribution

Wong Li Ping conceived the study and wrote the manuscript. Mohamed Shakir Sharina Mahavera and Alias Haridah performed the data collection. Agha Mohammadi Nasrin and Hoe Victor Chee Wai revised the manuscript and gave approval of the version to be published. All authors read and approved the final manuscript.

Author information

Affiliations

  1. Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia

    Li Ping Wong PhD, Sharina Mahavera Mohamad Shakir MSc, Haridah Alias MSc, Nasrin Aghamohammadi PhD & Victor CW Hoe PhD

Authors
  1. Li Ping Wong PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sharina Mahavera Mohamad Shakir MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haridah Alias MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nasrin Aghamohammadi PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Victor CW Hoe PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Li Ping Wong PhD.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wong, L.P., Mohamad Shakir, S.M., Alias, H. et al. Reasons for Using Electronic Cigarettes and Intentions to Quit Among Electronic Cigarette Users in Malaysia. J Community Health 41, 1101–1109 (2016). https://doi.org/10.1007/s10900-016-0196-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-016-0196-4

Keywords

  • Electronic cigarette
  • Intention to quit
  • e-cig