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E-cigarette and Combustible Cigarette Single Use, Ever Dual Use Pattern, and Amount of Nicotine Consumed among Korean College Students
J Korean Soc Res Nicotine Tob 2022; 13(3): 93-104
Published online September 30, 2022
© 2022 The Korean Society for Research on Nicotine and Tobacco.

Young Hwa Lim1,2, Keum Ji Jung1, Jakyoung Lee1,3, Jiwoo Baek1, Heejin Kimm1*

1Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, 2Health Insurance Review & Assessment Service, Wonju, 3Graduate School of Public Health, Ajou University, Suwon, Korea
Correspondence to: 김희진
연세대학교 보건대학원 역학건강증진학과, 국민건강증진연구소
E-mail: heejink@yuhs.ac
ORCID: https://orcid.org/0000-0003-4526-0570
Received September 14, 2022; Revised September 28, 2022; Accepted September 29, 2022.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: E-cigarettes are tobacco products that contain e-liquid with various nicotine contents. There are few studies on the behaviors and factors related to nicotine usage among e-cigarette users.
Methods: Among 2,387 college students who participated in a nationwide survey of 14 universities of Korea in 2015, 759 ever-smokers were analyzed. Ever dual users of combustible cigarettes and e-cigarettes (EDUs) were defined as current users of combustible cigarettes and ever-users of liquid e-cigarettes. The “total daily tobacco use” was the sum of “cigarettes smoked” and “the number of e-cigarette inhalations converted to the number of cigarettes.” Simple linear regression for the “monthly amount of e-liquid (mg/month)” was performed.
Results: A total of 322, 162, and 94 participants were EDUs, single cigarette users, and single e-cigarette users, respectively. EDUs used more cigarettes and less e-cigarettes. In terms of total daily tobacco use, 83.9% of dual users and 18.7% of e-cigarette users smoked more than 10 cigarettes daily (P<0.001). Many EDUs wanted to quit smoking cigarettes but not e-cigarettes. The nicotine dependence of EDUs was 3.2 (standard deviation [SD] 2.2) by cigarette amount and 4.0 (SD 2.3) by total daily tobacco use, including e-cigarettes. After adjusting for sex and age, e-liquid nicotine concentration (mg/ml, β=373.11, P=0.003) and e-liquid nicotine amount (mg, P<0.001) were significantly associated with the monthly amount of e-liquid.
Conclusion: We calculated the amount of nicotine consumed by e-cigarette users. EDUs had a higher total amount of tobacco use with e-liquid. Public awareness and education programs should be conducted to increase awareness of e-liquid nicotine consumption among the youth.
Keywords : Tobacco use behavior; E-cigarette liquids; Nicotine; Nicotine dependence; Dual use
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