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Association between changes in harm perceptions and e-cigarette use among current tobacco smokers in England: A time series analysis

Perski, O; Beard, E; Brown, J; (2020) Association between changes in harm perceptions and e-cigarette use among current tobacco smokers in England: A time series analysis. BMC Medicine , 18 , Article 98. 10.1186/s12916-020-01565-2. Green open access

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Abstract

Background: There is a decreasing trend in the proportion of individuals who perceive e-cigarettes to be less harmful than conventional cigarettes across the UK, Europe and the US. It is important to assess whether this may influence the use of e-cigarettes. We aimed to estimate, using a time series approach, whether changes in harm perceptions among current tobacco smokers have been associated with changes in the prevalence of e-cigarette use in England, with and without stratification by age, sex and social grade. Methods: Respondents were from the Smoking Toolkit Study, which involves monthly cross-sectional household surveys of individuals aged 16+ years in England. Data were aggregated monthly on ~ 300 current tobacco smokers between 2014 and 2019. The outcome variable was the prevalence of e-cigarette use. The explanatory variable was the proportion of smokers who endorsed the belief that e-cigarettes are less harmful than combustible cigarettes. Covariates were cigarette (vs. non-cigarette combustible) current smoking prevalence, past-year quit attempt prevalence and national smoking mass media expenditure. Unadjusted and adjusted autoregressive integrated moving average with exogeneous variables (ARIMAX) models were fitted. Results: For every 1% decrease in the mean prevalence of current tobacco smokers who endorsed the belief that e-cigarettes are less harmful than combustible cigarettes, the mean prevalence of e-cigarette use decreased by 0.48% (βadj = 0.48, 95% CI = 0.25–0.71, p < .001). Marginal age and sex differences were observed, whereby significant associations were observed in older (but not in young) adults and in men (but not in women). No differences by social grade were detected. Conclusions: Between 2014 and 2019 in England, at the population level, monthly changes in the prevalence of accurate harm perceptions among current tobacco smokers were strongly associated with changes in e-cigarette use.

Type: Article
Title: Association between changes in harm perceptions and e-cigarette use among current tobacco smokers in England: A time series analysis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12916-020-01565-2
Publisher version: https://doi.org/10.1186/s12916-020-01565-2
Language: English
Additional information: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10094064
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