Umeå University's logo

Background: E-cigarettes or vaping are currently increasing in popularity among smokers globally. This study aims to compare e-cigarette users between a developed country and a developing country to identify similarities/differences regarding perceptions of use and associated harm.

Methods: A cross sectional survey was conducted during July 2017 among members of different popular online forums in Australia and Bangladesh, who were current or ex-users of e-cigarettes. Data were collected anonymously using Qualtrics.

Results: There were 452 study participants, mean age was 39(±13.2) years and 80%(n=356) were men. Daily or occasional smoking in the last 30 days was more frequent among the Bangladeshi participants than their Australian counterparts (38% vs. 18%, p< 0.001, ORs 2.85, 95%CIs 1.76-4.62). Endeavour to quit smoking was also more common among the current smokers in Bangladesh (90% vs. 72%, p=0.013, ORs 3.69, 95%CIs 1.16-11.7). Almost all of the participants in both countries were using e-cigarettes daily and had nicotine in the e-liquid. The average amount of e-liquid used, nicotine strengths and duration of use in Australia and Bangladesh were 9(±7.9) vs. 5.9(±3.5) ml/day, 6.8(±6.4) vs. 4.6(±1.8) mg/ml, and 22.9(±22.3) vs. 15.9(±12.8) months respectively. The most commonly cited reason for using e-cigarettes in both countries was to reduce/quit cigarette smoking, although there was a significant difference between Australia and Bangladesh (95% vs. 83%, p< 0.001, ORs 3.89, 95%CIs 1.84-8.21). More than three quarters of respondents in both countries perceived e-cigarettes as less harmful and more than two thirds perceived them as less addictive. The majority of respondents did not try to stop using e-cigarettes, however, intention to discontinue in the next five years was more in Bangladesh than Australia (85% vs. 74%, p=0.006, ORs 1.99, 95%CIs 1.15-3.46).

Conclusions: E-cigarettes were primarily used for reducing/quitting cigarettes in both countries, which supports prior evidence regarding the effectiveness of e-cigarettes for smoking cessation.