E-cigarette in Malaysia: Reasons for Initiating of Electronic Cigarettes Among Hospital and Clinic Patients and Visitors

The prevalence of electronic cigarettes (e-cigarettes) use has been increased and became a global concern. This cross-sectional study among adults in Malaysia determined the knowledge of e-cigarettes, the association between the factors of initiating e-cigarettes use and usage status, the predicting factors of initiating e-cigarettes use and the reasons for the users to stop using it. A total of 1254 respondents completed a self-constructed questionnaire on socio-demographics, knowledge, reasons for e-cigarettes initiation and cessation. Results showed that the majority of them (73.6%) were aware of e-cigarette's existence, while 13.2% were e-cigarettes users. A significant association was found between curiosity to try and usage status in which former user has a higher curiosity to try (55.7%) than the currents users (p=0.004). A variety of flavours has a significant association between usage status as current users (58.8%) used e-cigarettes due to a variety of flavours than the former users (38.6%) (p=0.044). The findings showed that curiosity to try and e-cigarettes are safer are the predictors of initiating e-cigarettes. The respondents who believe that e-cigarettes are safer than tobacco cigarettes have 6.12 times chance to initiate using e-cigarette when considering other factors (OR=6.12, p=0.018). Meanwhile, those who used e-cigarettes because of the curiosity to try had 0.32 times the chance to initiate e-cigarettes use (OR=0.32, p=0.018). This study observed a low knowledge related to e-cigarettes and the significant predicting factor of initiating were a curiosity to try and e-cigarettes is safer. This study reported the main reason smokers quit using e-cigarettes was it did not give satisfaction compared to conventional cigarettes, while for non-smoker was due to worry about the danger of e-cigarettes. Therefore, appropriate information on e-cigarettes should be adequately disseminated to the general population to promote healthy behaviours and positive attitudes toward smoking.