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Original article
peer-reviewed

Knowledge and Attitude of Teenagers Towards Electronic Cigarettes in Karachi, Pakistan



Abstract

Introduction

Studies have shown that electronic cigarettes have gained immense popularity and their use has increased dramatically all over the world. However, little is known about the knowledge and attitudes towards e-cigarettes in third world countries such as Pakistan. The aim of this study was to determine the perceptions of teenagers in Karachi regarding e-cigarettes and whether the differences in said perceptions were affected by gender and level of education.

Methods

We conducted a cross-sectional study in January 2017 using convenience sampling and interviewed 441 young individuals, aged 13 to 19 years, to determine their knowledge, attitudes, and practices regarding e-cigarettes. The participants were questioned about their knowledge and its source. Attitudes were judged using four and five-point Likert scales while questions regarding practices focused on single and current use. Chi-square and Mann-Whitney tests were applied to compare the knowledge, attitudes, and practices of teenagers with gender and level of schooling.

Results

The majority of participants knew what e-cigarettes were (n=277, 68.7%) but did not know about their contents (n=225, 55.8%) and had learned about them from either friends or the internet (n=245, 60.%). Almost half of them (n=190, 47.2%) believed that the reason for e-cigarette use was either peer pressure or to quit smoking conventional cigarettes. An overwhelming majority also stated that; it was either easy or very easy to obtain e-cigarettes (n=277, 68.7%), they would not try smoking e-cigarettes even if a good friend of theirs recommended them (n=287, 71.2%), they were not current e-cigarette smokers (n=370, 91.8%) and they would never promote e-cigarette use (n=371, 92.1%). Statistically significant differences were found with males knowing more about e-cigarettes (p=0.006) and being more common to either have smoked (p <0.001) or be current e-cigarette smokers (p <0.001). Furthermore, middle school students were more likely to have negative attitudes towards e-cigarettes believing they were more harmful (p=0.003) and more addictive (p <0.001) than conventional cigarettes.

Conclusion

Many people were aware of what electronic cigarettes are but still, it was evident that there was the lack of proper knowledge along with negative attitudes towards e-cigarette use among teenagers in Pakistan due to cultural and social stigmas and lack of advertising. Males and females had considerable differences in their opinions regarding e-cigarette use owing to such social practices being considered taboo by females and males having greater freedom due to patriarchal, familial and cultural systems.



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Original article
peer-reviewed

Knowledge and Attitude of Teenagers Towards Electronic Cigarettes in Karachi, Pakistan


Author Information

Asim Shaikh

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Hamza T. Ansari Corresponding Author

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Zeerak Ahmad

Ziauddin Medical College, Ziauddin University

Mahnoor Y. Shaikh

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Ilma Khalid

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Maha Jahangir

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Amna Majeed

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Nimra Shakeel

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Arsalan Ahmed

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Roha Saeed Memon

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Eleze Tariq

Aga Khan University, The Aga Khan University

Rafia Irfan

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Dania Madni

Ziauddin University


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Original article
peer-reviewed

Knowledge and Attitude of Teenagers Towards Electronic Cigarettes in Karachi, Pakistan


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Original article
peer-reviewed

Knowledge and Attitude of Teenagers Towards Electronic Cigarettes in Karachi, Pakistan

  • Author Information
    Asim Shaikh

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Hamza T. Ansari Corresponding Author

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Zeerak Ahmad

    Ziauddin Medical College, Ziauddin University

    Mahnoor Y. Shaikh

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Ilma Khalid

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Maha Jahangir

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Amna Majeed

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Nimra Shakeel

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Arsalan Ahmed

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Roha Saeed Memon

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Eleze Tariq

    Aga Khan University, The Aga Khan University

    Rafia Irfan

    Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

    Dania Madni

    Ziauddin University


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: July 13, 2017

    DOI

    10.7759/cureus.1468

    Cite this article as:

    Shaikh A, Ansari H T, Ahmad Z, et al. (July 13, 2017) Knowledge and Attitude of Teenagers Towards Electronic Cigarettes in Karachi, Pakistan. Cureus 9(7): e1468. doi:10.7759/cureus.1468

    Publication history

    Received by Cureus: May 06, 2017
    Peer review began: May 15, 2017
    Peer review concluded: July 04, 2017
    Published: July 13, 2017

    Copyright

    © Copyright 2017
    Shaikh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction

Studies have shown that electronic cigarettes have gained immense popularity and their use has increased dramatically all over the world. However, little is known about the knowledge and attitudes towards e-cigarettes in third world countries such as Pakistan. The aim of this study was to determine the perceptions of teenagers in Karachi regarding e-cigarettes and whether the differences in said perceptions were affected by gender and level of education.

Methods

We conducted a cross-sectional study in January 2017 using convenience sampling and interviewed 441 young individuals, aged 13 to 19 years, to determine their knowledge, attitudes, and practices regarding e-cigarettes. The participants were questioned about their knowledge and its source. Attitudes were judged using four and five-point Likert scales while questions regarding practices focused on single and current use. Chi-square and Mann-Whitney tests were applied to compare the knowledge, attitudes, and practices of teenagers with gender and level of schooling.

Results

The majority of participants knew what e-cigarettes were (n=277, 68.7%) but did not know about their contents (n=225, 55.8%) and had learned about them from either friends or the internet (n=245, 60.%). Almost half of them (n=190, 47.2%) believed that the reason for e-cigarette use was either peer pressure or to quit smoking conventional cigarettes. An overwhelming majority also stated that; it was either easy or very easy to obtain e-cigarettes (n=277, 68.7%), they would not try smoking e-cigarettes even if a good friend of theirs recommended them (n=287, 71.2%), they were not current e-cigarette smokers (n=370, 91.8%) and they would never promote e-cigarette use (n=371, 92.1%). Statistically significant differences were found with males knowing more about e-cigarettes (p=0.006) and being more common to either have smoked (p <0.001) or be current e-cigarette smokers (p <0.001). Furthermore, middle school students were more likely to have negative attitudes towards e-cigarettes believing they were more harmful (p=0.003) and more addictive (p <0.001) than conventional cigarettes.

Conclusion

Many people were aware of what electronic cigarettes are but still, it was evident that there was the lack of proper knowledge along with negative attitudes towards e-cigarette use among teenagers in Pakistan due to cultural and social stigmas and lack of advertising. Males and females had considerable differences in their opinions regarding e-cigarette use owing to such social practices being considered taboo by females and males having greater freedom due to patriarchal, familial and cultural systems.



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Asim Shaikh

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Hamza T. Ansari

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

For correspondence:
hamza.tahir17@yahoo.com

Zeerak Ahmad, Medical Student

Ziauddin Medical College, Ziauddin University

Mahnoor Y. Shaikh

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Ilma Khalid

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Maha Jahangir, Medical Student

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Amna Majeed

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Nimra Shakeel

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Arsalan Ahmed

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Roha Saeed Memon

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Eleze Tariq

Aga Khan University, The Aga Khan University

Rafia Irfan

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Dania Madni, Medical Student

Ziauddin University

Asim Shaikh

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Hamza T. Ansari

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

For correspondence:
hamza.tahir17@yahoo.com

Zeerak Ahmad, Medical Student

Ziauddin Medical College, Ziauddin University

Mahnoor Y. Shaikh

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Ilma Khalid

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Maha Jahangir, Medical Student

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Amna Majeed

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Nimra Shakeel

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Arsalan Ahmed

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Roha Saeed Memon

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Eleze Tariq

Aga Khan University, The Aga Khan University

Rafia Irfan

Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Dania Madni, Medical Student

Ziauddin University