Disagreement on electronic cigarette regulation was associated with less support for tobacco control policy in Hong Kong

Abstract

INTRODUCTION: Electronic cigarette (EC) is increasingly popular and may undermine support for tobacco control policies. We investigated if disagreement on EC regulation was associated with less support for stronger tobacco control policies in Hong Kong. METHODS: In 2015, 4517 subjects (males 48.5%; mean age 50.4, SD 17.7 years) with oversampling of current and ex-smokers were interviewed through landline random digit dialing. Disagreements on 4 proposed EC regulations on publicity, use in smokefree area, sales to minors, and nicotine- free EC sales were recorded. Support for 8 stronger tobacco control policies were assessed. Logistic regression yielded adjusted odds ratios (AORs) of support for stronger tobacco control in relation to disagreement (vs agreement) on EC regulation, adjusting for age, sex, family income, smoking status, smoking family members and knowledge on secondhand smoke. Data were weighted by the distribution of sex, age, and smoking status according to Hong Kong census data. RESULTS: Disagreement on EC regulation ranged from 6.2% to 28.3%. Each disagreement was significantly associated with lower AOR (0.24-0.53) for annual tobacco tax increase, smokefree area extension and banning tobacco display in retail stores. Commonly lower AORs (0.26-0.61) for banning smoking in all public outdoor areas, showing smoking related diseases, enlarging pictorial warning on cigarette packs, total ban on tobacco sales and use were observed in relation to disagreement. Compared with agreement on all 4 EC regulations, disagreement on any EC regulation was significantly associated with lower AORs of 5 supporting stronger tobacco control policies, i.e. increasing tobacco tax annually (0.36), banning smoking in all public outdoor areas (0.49), banning tobacco display in retail stores (0.44), total ban on tobacco sales (0.56) and use (0.55). Similar pattern of lower AORs were observed for disagreement on all EC regulations compared with agreeing all. CONCLUSIONS: Disagreement on EC regulation was associated with less support for stronger tobacco control policy. Future research should assess whether advocacy for EC regulation could also garner public support for tobacco control.