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Cited by 45Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesLGBTQ Health, Identity, and Policy

Gender Differences in Reasons for Using Electronic Cigarettes and Product Characteristics: Findings From the 2018 ITC Four Country Smoking and Vaping Survey

Open access
Yimsaard, Pongkwan, McNeill, Ann, Yong, Hua-Hie, Cummings, K Michael, Chung-Hall, Janet, Hawkins, Summer Sherburne, Quah, Ann C K, Fong, Geoffrey T +2 more·2021·Nicotine & Tobacco Research
DOI 10.1093/ntr/ntaa196PMC PMC7976932
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Abstract

Introduction: Little is known about why males are more likely to use electronic cigarettes (ECs) compared with females. This study examined gender differences in reasons for vaping and characteristics of EC used (device type, device capacity, e-liquid nicotine strength, and flavor). Methods: Data were obtained from 3938 current (≥18 years) at-least-weekly EC users who participated in Wave 2 (2018) ITC Four Country Smoking and Vaping Survey in Canada, the United States, England, and Australia. Results: Of the sample, 54% were male. The most commonly cited reasons for vaping in females were “less harmful to others” (85.8%) and in males were “less harmful than cigarettes” (85.5%), with females being more likely to cite “less harmful to others” (adjusted odds ratio [aOR] = 1.64, p = .001) and “help cut down on cigarettes” (aOR = 1.60, p = .001) than males. Significant gender differences were found in EC device type used (χ 2 = 35.05, p = .043). Females were less likely to report using e-liquids containing >20 mg/mL of nicotine, and tank devices with >2 mL capacity (aOR = 0.41, p < .001 and aOR = 0.65, p = .026, respectively) than males. There was no significant gender difference in use of flavored e-liquids, with fruit being the most common flavor for both males (54.5%) and females (50.2%). Conclusion: There were some gender differences in reasons for vaping and characteristics of the product used. Monitoring of gender differences in patterns of EC use would be useful to inform outreach activities and interventions for EC use. Implications: Our findings provide some evidence of gender differences in reasons for vaping and characteristics of EC used. The most common reason for vaping reported by females was “less harmful to others,” which may reflect greater concern by female vapers about the adverse effects of secondhand smoke compared with male vapers. Gender differences might be considered when designing gender-sensitive smoking cessation policies. Regarding characteristics of EC products used, we found gender differences in preferences for e-liquid nicotine strength and device capacity. Further studies should examine whether the observed gender differences in EC use reasons and product characteristics are predictive of smoking cessation. Furthermore, studies monitoring gender-based marketing of ECs may be considered.

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  • Sex and gender differences in nicotine use have been reported in human populations, notably among adolescent users, as well as in rodent studies.

    “Sex and gender differences in nicotine use have been reported in human populations [154–156], notably among adolescent users, as well as in rodent studies [157].”

    From Adolescent nicotine exposure and persistent neurocircuitry changes: unveiling lifelong psychiatric risks (2025) · cites this paper as [155]

    The Discussion (page not available in our copy) reports gender differences in vaping reasons and nicotine strengths among human users. The paper does not report sex or gender differences in nicotine use among adolescents; its references to adolescent studies do not establish that point. The rodent-studies clause has a separate citation and is not attributed to this source. (LLM, conf=0.84)

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  1. [19]19. Wang B. FDA's Partial E-Cig Flavor Ban Draws Ire From Health Orgs, Lawmakers . Vol. 12; Arlington: InsideHealthPolicy.com's Daily Brief, 2020.

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Authors
Yimsaard, P., McNeill, A., Yong, H.-H., Cummings, K. M., Chung-Hall, J., Hawkins, S. S., Quah, A. C. K., Fong, G. T., O’Connor, R. J., & Hitchman, S. C.
Affiliations
  • King Chulalongkorn Memorial Hospital (TH)
  • King's College London (GB)
  • Deakin University (AU)
  • Medical University of South Carolina (US)
  • Department of Psychology, University of Waterloo, Waterloo, ON, Canada
  • Boston College (US)
  • Ontario Institute for Cancer Research (CA)
  • Roswell Park Comprehensive Cancer Center (US)
Corresponding author
Yimsaard, Pongkwan
ORCID
Venue
Nicotine & Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2020-09-30
Volume
23
Issue
4
Pages
678-686
ISSN
  • 1462-2203 (ISSN-L)
  • 1469-994X
DOI
10.1093/ntr/ntaa196
PMC
PMC7976932
OpenAlex
W3089608401
Cited by
45
References
34
Citations by year
2026: 7 · 2025: 13 · 2024: 6 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 1
FWCI
2.41
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • Nicotine & Tobacco Research (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
  • US National Cancer Institute (P01 CA200512)
  • Canadian Institutes of Health Research (FDN-148477)
  • National Health and Medical Research Council of Australia (APP1106451)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Keywords
electronic cigarettes, vaping, gender differences, e-liquid flavors, smoking cessation, tobacco control, Canada, United States, England, Australia, tobacco harm perception, gender-sensitive interventions
MeSH terms
Vaping, Smokers, Adolescent, Adult, Australia, Canada, England, Female, Flavoring Agents, Humans, Male, Middle Aged, Surveys and Questionnaires, Sex Factors, United States, Young Adult, Electronic Nicotine Delivery Systems

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