Skip to main content

Advertisement

SpringerLink
Log in

Knowledge and Beliefs of Jordanian Community Toward E-cigarettes: A National Survey

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Electronic nicotine delivery systems were promoted publically as a healthier replacement for conventional cigarettes. Knowledge and beliefs of the public can drive their behaviours to adapt or reject the new habit. No previous research was conducted in Jordan to assess electronic cigarettes (e-cigarettes) prevalence, and limited data are available on public opinions and orientation toward this new habit. To assess prevalence of, knowledge, attitude and beliefs about e-cigarettes, and examine factors associated with plans of quitting or initiating e-cigarettes among adults in Jordan. A large cross-sectional face-to-face survey on a random sample of adult population aged ≥ 18 years was conducted over two months to include 1820 adults in Jordan. A representative sample was collected using proportionate random sampling technique, which enabled us to geographically categorise the study population. Reliability and validity measures were taken to ensure a comprehensive and appropriate study tool. The Statistical Package for Social Science (SPSS®) version 24 was used to conduct descriptive analysis, logistic regression, and Rao–Scott chi-square. Findings were considered statistically significant at p value < 0.05 (with a confidence limit at 95%). Of 2164 adults approached, 1820 completed the questionnaire (84.1% response rate). The prevalence of current e-cigarette smokers and dual smokers were 11.7% and 4.0%, respectively. Quitting conventional smoking (38.8%) and enjoying the flavour (32.5%) were the most common reasons to start vaping. Friends were the major source of information about e-cigarettes. There was evidence that adults aged 45–59 years were less likely to be dual smokers (OR 0.51; 95%CI 0.29–0.66; p = 0.03). Poor knowledge about the content (23.7%) and types of e-cigarettes (14.5%) was reported. Plans to reduce or quit e-cigarettes were significantly associated with three factors: smokers’ knowledge about its content, social impression, smokers’ satisfaction with e-cigarettes. Social impression was also associated with plans of initiating e-cigarettes. Most participants thought vaping cannot be harmful to children and pregnant women (73.1%) and cannot be addictive (58.2%). Electronic cigarettes were considered helpful in smoking cessation by 69.1% of participants. The proportions of adults who were currently electronic cigarette and dual smokers were 11.7% and 4.0%, respectively. Our research may provide insight to product and individual factors that were associated with plans to sustain, quit or initiate electronic smoking.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Maciej, L., & Goniewicz, P. (2014). Patterns of electronic cigarette use and user beliefs about their safety and benefits: An internet survey. Drug and Alcohol Review, 32(2), 133–140.

    Google Scholar 

  2. Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-rohani, H., et al. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380, 1990–2010.

    Article  Google Scholar 

  3. Harrell, P. T., Simmons, V. N., Correa, J. B., Padhya, T. A., Brandon, T. H., Correa, J. B., et al. (2014). Electronic nicotine delivery systems ( “E-cigarettes”): Review of safety and smoking cessation efficacy. Otolaryngology-Head and Neck Surgery, 151, 1–13.

    Article  Google Scholar 

  4. Hajek, P. E. (2015). Electronic cigarettes: Review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 4, 616–629.

    Google Scholar 

  5. Bin, L. H., & Kim, S. H. (2014). Inhallation of e-cigarette cartridge solution aggravates allergen-induced airway inflammation and hyper-responsiveness in mice. Toxicological Research, 30(1), 13–18.

    Article  Google Scholar 

  6. Constantine, I., & Vardavas, M. K. (2013). Short-term pulmonary effects of using an electronic cigarette impact on respiratory flow resistance, impedance, and exhaled nitric oxide. Chest, 14(16), 1–6.

    Google Scholar 

  7. Do, L. M., Markin, C., & Hosmer, D. (2012). An unexpected consequence of electronic. Chest, 141(4), 1110–1113. https://doi.org/10.1378/chest.11-1334.

    Article  Google Scholar 

  8. Harrell, P. T., Simmons, V. N., Piñeiro, B., Correa, J. B., Menzie, N. S., Meltzer, L. R., et al. (2014). E-cigarettes and expectancies: Why do some users keep smoking? Addiction, 110, 1833–1843.

    Article  Google Scholar 

  9. Rutten, L. J. F., Scd, K. D. B., Agunwamba, A. A., Grana, R. A., Mph, P. M. W., Ebbert, J. O., et al. (2015). Original investigation use of e-cigarettes among current smokers: Associations among reasons for use, quit intentions, and current tobacco use. Nicotine & Tobacco Research, 17(10), 1228–1234.

    Article  Google Scholar 

  10. Trumbo, C. W., & Harper, R. (2015). Orientation of US young adults toward e-cigarettes and their use in public. Health Behavior and Policy Review, 2(2), 163–170.

    Article  Google Scholar 

  11. Giovenco, D. P., Lewis, M. J., & Delnevo, C. D. (2014). Factors associated with e-cigarette use: A national population survey of current and former smokers. American Journal of Preventive Medicine, 47, 1–5. https://doi.org/10.1016/j.amepre.2014.04.009.

    Article  Google Scholar 

  12. Pepper, J. K., Ribisl, K. M., & Brewer, N. T. (2016). Adolescents ’ interest in trying fl avoured e-cigarettes. Tobacco Control, 25, 62–66.

    Article  Google Scholar 

  13. Pericot-valverde, I., Gaalema, D. E., Priest, J. S., & Higgins, S. T. (2017). E-cigarette awareness, perceived harmfulness, and ever use among US adults. Preventive Medicine (Baltimore), 104, 92–99. https://doi.org/10.1016/j.ypmed.2017.07.014.

    Article  Google Scholar 

  14. Ba, M. D., Morrison, R., Bauld, L., & Mcneill, A. (2013). E-Cigarettes: Prevalence and attitudes in Great Britain. Nicotine & Tobacco Research, 15(10), 1737–1744.

    Article  Google Scholar 

  15. Conner, M., Grogan, S., Simms-ellis, R., Flett, K., Sykes-muskett, B., Cowap, L., et al. (2018). Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study. Tobacco Control, 27, 365–372.

    Article  Google Scholar 

  16. Wadsworth, E., Neale, J., Mcneill, A., & Hitchman, S. C. (2016). How and why do smokers start using e-cigarettes? Qualitative study of vapers in London, UK. The International Journal of Environmental Research and Public Health, 13, 661–667.

    Article  Google Scholar 

  17. Vasconcelos, V., & Gilbert, H. (2018). Smokers ’ knowledge and perception of electronic cigarettes ( e-cigarettes ): A qualitative study of non-quitting smokers in a North London general practice. Primary Health Care Research & Development, 20, 38–45.

    Article  Google Scholar 

  18. Martínez-sánchez, J. M., Fu, M., Ballbè, M., Martín-sánchez, J. C., Saltó, E., & Fernández, E. (2015). Conocimiento y percepción de la nocividad del cigarrillo electrónico en población adulta de Barcelona. Gaceta Sanitaria, 29, 1–4. https://doi.org/10.1016/j.gaceta.2015.01.014.

    Article  Google Scholar 

  19. Ng, D. H. L., Roxburgh, S. T. D., & Sanjay, S. (2010). Awareness of smoking risks and attitudes towards graphic health warning labels on cigarette packs: A cross-cultural study of two populations in Singapore and Scotland. Eye, 24, 864–868.

    Article  CAS  Google Scholar 

  20. Maciej, A., & Goniewicz, L. (2020). Electronic cigarette use among teenagers and young adults in Poland. Pediatrics, 130(4), 879–885.

    Google Scholar 

  21. Shaikh, A., Ansari, H. T., Ahmad, Z., Shaikh, M. Y., & Khalid, I. (2017). Knowledge and attitude of teenagers towards electronic cigarettes in Karachi. Cureus, 9(7), 1–13.

    Google Scholar 

  22. Abo-elkheir, O. I., & Sobh, E. (2016). Knowledge about electronic cigarettes and its perception: A community survey, Egypt. Respiratory Research, 17, 1–7. https://doi.org/10.1186/s12931-016-0365-0.

    Article  Google Scholar 

  23. Filippidis, F. T., Laverty, A. A., Gerovasili, V., & Vardavas, C. I. (2017). Two-year trends and predictors of e-cigarette use in 27 European Union member states. Tobacco Control, 26, 98–104.

    Article  Google Scholar 

  24. Ahmad, M., Ahmad, A. H., Adel, A. A. A., & Nesheiwat, I. (2015). Epidemiology, attitudes and perceptions toward cigarettes and hookah smoking amongst adults in Jordan. Environmental Health and Preventive Medicine, 20, 422–433.

    Article  Google Scholar 

  25. Belbeisi, A., Al Nsour, M., Batieha, A., Brown, D. W., & Walke, H. T. (2009). A surveillance summary of smoking and review of tobacco control in Jordan. Globalization and Health, 6, 1–6.

    Article  Google Scholar 

  26. Rostkowska, O., & Wierzba, W. (2019). Knowledge and beliefs of e-cigarettes among physicians in Poland. Medical Science Monitor, 25, 6322–6330.

    Article  Google Scholar 

  27. Bergen, A. W., & Caporaso, N. (1999). Cigarette smoking. JNCI, 91(16), 1365–1375.

    Article  CAS  Google Scholar 

  28. Noble, H., & Smith, J. (2015). Issues of validity and reliability in qualitative research. Nursing, 18(2), 34–36.

    Google Scholar 

  29. Bolarinwa, O. A. (2015). Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. Nigerian Postgraduate Medical Journal, 22, 195–201.

    Article  Google Scholar 

  30. Mchugh, M. L. (2012). Lessons in biostatistics Interrater reliability: The kappa statistic. Biochemia Medica, 22, 276–282.

    Article  Google Scholar 

  31. Rao, J. N. K. S. A. (1987). On simple adjustments to chi-square tests with sample survey data. Annals of Statistics, 15, 385–397.

    Article  Google Scholar 

  32. Jaghbir, M. T., & Ahram, M. (2014). Pattern of cigarette and waterpipe smoking in the adult population of Jordan. EMHJ, 20(December), 529–537.

    CAS  PubMed  Google Scholar 

  33. Zindah, M., Belbeisi, A., & Walke, H. (2004). Mokdad AH (2008) Obesity and diabetes in Jordan: Findings from the behavioral risk factor surveillance system. Preventing Chronic Disease, 5(1), 119–123.

    Google Scholar 

  34. Noel, J. K., Rees, V. W., & Connolly, G. N. (2011). Electronic cigarettes: A new ‘ tobacco ’ industry? Tobacco Control, 20(1), 81.

    Article  Google Scholar 

  35. Yamin, C. K., Bitton, A., & Bates, D. W. (2014). E-cigarettes: A rapidly growing internet phenomenon. Annals of Internal Medicine, 2010(153), 607–609.

    Google Scholar 

  36. Regan, A. K., Promoff, G., Dube, S. R., & Arrazola, R. (2013). Electronic nicotine delivery systems: Adult use and awareness of the ‘ e-cigarette ’ in the USA. Tobacco Control, 22, 19–23.

    Article  Google Scholar 

  37. Karbouji, M. A., Abduldaem, A. M., Muslim, A., Alharbi, A. S., Alnozha, O., & Al Zalabani, A. H. (2018). Awareness and attitude toward smoking e-cigarettes (vape) among smokers in Saudi Arabia 2017. The Egyptian Journal of Hospital Medicine, 70(January), 1346–1351.

    Article  Google Scholar 

  38. Melin, K., Conte-schmidt, N., Martínez-arroyo, K., Rosa-pérez, K., Soto-avilés, A. E., & Hernández-muñoz, J. J. (2018). Knowledge and perceptions of e-cigarettes and the motivations for their use: Talking to smokers (e-cigarettes and/or conventional cigarettes) and non-smokers in Puerto Rico. Puerto Rico Health Sciences Journal, 37(3), 133–139.

    Google Scholar 

  39. Kozlowski, L. T., Homish, D. L., & Homish, G. G. (2017). Daily users compared to less frequent users find vape as or more satisfying and less dangerous than cigarettes, and are likelier to use non-cig-alike vaping products. Preventive Medicine Reports, 6, 111–114. https://doi.org/10.1016/j.pmedr.2017.02.026.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Wagner, N. J., Methodology, Q., Camerota, M., & Propper, C. (2018). Prevalence and perceptions of electronic cigarette use during pregnancy. Maternal and Child Health Journal, 21(8), 1655–1661.

    Article  Google Scholar 

  41. the Surgeon General’s report. Adult smoking cessation—The use of e-cigarettes. Centres Dis Control Prev. https://www.cdc.gov/tobacco/data_statistics/sgr/2020-smoking-cessation/fact-sheets/adult-smoking-cessation-e-cigarettes-use/index.html.

  42. Lee, H., Park, S., Weng, M., Wang, H., Huang, W. C., & Lepor, H. (2017). E-cigarette smoke damages DNA and reduces repair activity in mouse lung, heart, and bladder as well as in human lung and bladder cells. Proceedings of the National Academy of Sciences, 115(5), 1–10.

    Google Scholar 

  43. Qasim, H., Karim, Z. A., Rivera, J. O., Khasawneh, F. T., & Alshbool, F. Z. (2017). Impact of electronic cigarettes on the cardiovascular system. Journal of the American Heart Association, 6(9), 32–38.

    Article  Google Scholar 

Download references

Acknowledgements

We thank the University of Petra for facilitating our research. Our thanks go to pharmacy students for their efforts and cooperation.

Funding

The authors received no specific funding for this work.

Author information

Authors and Affiliations

  1. Faculty of Pharmacy & Medical Sciences, University of Petra, Amman, Jordan

    Derar H. Abdel-Qader & Ahmad Z. Al Meslamani

Authors
  1. Derar H. Abdel-Qader
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmad Z. Al Meslamani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmad Z. Al Meslamani.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics Approval

The study was approved by the Institutional Review Board (IRB) at the University of Petra (No. 13H-11-2019).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abdel-Qader, D.H., Al Meslamani, A.Z. Knowledge and Beliefs of Jordanian Community Toward E-cigarettes: A National Survey. J Community Health 46, 577–586 (2021). https://doi.org/10.1007/s10900-020-00896-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-020-00896-8

Keywords

Search

Navigation