Social norms towards smoking and electronic cigarettes among adult smokers in seven European Countries: Findings from the EUREST-PLUS ITC Europe Surveys
Author(s)
Type
Journal Article
Abstract
Introduction: This study explores whether current smokers’ social norms towards smoking and electronic cigarettes (e-cigarettes) vary across seven European countries alongside smoking and e-cigarette prevalence rates. At the time of surveying, England had the lowest current smoking prevalence and Greece the highest. Hungary, Romania and Spain had the lowest prevalence of any e-cigarette use and England the highest. Methods: Respondents were adult (≥18 years) current smokers from the 2016 EUREST-PLUS ITC (Romania, Spain, Hungary, Poland, Greece, Germany) and ITC 4CV England Surveys (N=7779). Using logistic regression, associations between country and (a) smoking norms and (b) e-cigarette norms were assessed, adjusting for age, sex, income, education, smoking status, heaviness of smoking, and e-cigarette status. Results: Compared with England, smoking norms were higher in all countries: reporting that at least three of five closest friends smoke (19% vs 65–84% [AOR=6.9–24.0; Hungary–Greece]), perceiving that people important to them approve of smoking (8% vs 14–57% [1.9–51.1; Spain–Hungary]), perceiving that the public approves of smoking (5% vs 6–37% [1.7–15.8; Spain–Hungary]), disagreeing that smokers are marginalised (9% vs 16–50% [2.3–12.3; Poland–Greece]) except in Hungary. Compared with England: reporting that at least one of five closest friends uses e-cigarettes was higher in Poland (28% vs 36% [2.7]) but lower in Spain and Romania (28% vs 6–14% [0.3–0.6]), perceiving that the public approves of e-cigarettes was higher in Poland, Hungary and Greece (32% vs 36–40% [1.5–1.6]) but lower in Spain and Romania in unadjusted analyses only (32% vs 24–26%), reporting seeing e-cigarette use in public at least some days was lower in all countries (81% vs 12–55% [0.1–0.4]; Spain–Greece). Conclusions: Smokers from England had the least pro-smoking norms. Smokers from Spain had the least pro-e-cigarette norms. Friend smoking and disagreeing that smokers are marginalised broadly aligned with country-level current smoking rates. Seeing e-cigarette use in public broadly aligned with countrylevel any e-cigarette use. Generally, no other norms aligned with product prevalence.
Date Issued
2019-03-22
Online Publication Date
2020-01-14T12:50:28Z
Date Acceptance
2019-02-14
ISSN
1617-9625
Publisher
International Society for the Prevention of Tobacco Induced Diseases
Journal / Book Title
Tobacco Induced Diseases
Volume
16
Copyright Statement
Published by European Publishing on behalf of the International Society for the Prevention of Tobacco Induced Diseases (ISPTID).© 2019 East KA. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License.(https://creativecommons.org/licenses/by/4.0/)
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000467864400015&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Substance Abuse
Public, Environmental & Occupational Health
survey
smoking
Europe
electronic cigarettes
social norms
TOBACCO
RENORMALIZATION
INDUSTRY
Europe
electronic cigarettes
smoking
social norms
survey
EUREST-PLUS consortium
Science & Technology
Life Sciences & Biomedicine
Substance Abuse
Public, Environmental & Occupational Health
survey
smoking
Europe
electronic cigarettes
social norms
TOBACCO
RENORMALIZATION
INDUSTRY
1103 Clinical Sciences
Publication Status
Published
Article Number
ARTN A15