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SAMRC releases a study on e-cigarette and hookah advertisement targeted to university students


A research study aimed to explore university students’ exposure to electronic cigarettes (e-cigarettes) and hookah through deliberate marketing and advertisement in South Africa was recently launched by the SAMRC on Thursday 15 February at the Durban University of Technology.

The study led by Dr Cathrine Egbe, Senior Specialist Scientist at the Mental health, Alcohol, Substance use & Tobacco Research Unit also looks into the knowledge, attitudes and perceptions about e-cigarettes and hookah. The prevalence of e-cigarette and hookah use as well as dual and poly use of tobacco and e-cigarettes products were also investigated as secondary objectives.

The study findings reveal current prevalence of e-cigarette use among university students to be 26.3% (28.7% among males and 24.1% among females) and of that, 12.5% of students (15.4% among males and 9.8% among females) use e-cigarettes on a daily basis.

“This is not a good indication of protecting and preserving the lives of young people,” says Dr Egbe

The use of e-cigarettes in relation to their marketing exposure showed 58.7% of students noticed advertisements or signs promoting e-cigarettes in stores where e-cigarettes were sold (65.7% of those who currently use and 56.3% of those who do not use). Overall, 76.4% of students reported any exposure to advertisements and marketing of e-cigarettes (88.2% of those who currently use and 72.2% of those who do not use).

The prevalence of hookah smoking among the university students was 31.5% (32.1% among males and 30.9% among females). About 10.5% of the students reported smoking hookah on a daily basis. Students also reported noticing promotional activities for hookah including discounted prices (26.7%), free samples (24.8%), free gifts (19.8%), coupons (19.0%) and hookah smoking competitions (18.9%).

Students who reported being exposed to e-cigarette or hookah advertisement and marketing in and around their university campus were two times more likely to currently use e-cigarettes or smoke hookah compared to those who were not exposed. Also, students who reported being exposed to e-cigarette or hookah promotions were four times more likely to currently use e-cigarette or smoke hookah compared to those not exposed.

About 19.9% of the students reported using both e-cigarettes and smoking hookah while 13.9% reported smoking cigarettes, hookah and e-cigarettes.

In seeking to understand the knowledge, attitudes, and perceptions about e-cigarettes and hookah, the study findings indicated that 17.2% of the students believed that using e-cigarettes was less harmful than smoking conventional cigarettes while 44.9% of students believed using e-cigarettes was more harmful than smoking conventional cigarettes.

Some of the recommendations of the study assert that government needs to urgently pass the Tobacco Products and Electronic Delivery Systems Control Bill of 2022 which seeks to strengthen tobacco control in the country including regulating e-cigarettes in order to protect young people from being targeted by the manufacturers and marketers of these products.

“There should be clearer graphic health warnings and plain packaging of hookah, e-cigarettes and cigarette products, these can assist to communicate the health risks associated with its use and may deter students from initiating use. The ban on tobacco advertising, promotion and sponsorship (one of six MPOWER measures) should be enforced for hookah products and urgently extended to cover e-cigarettes,” concludes Dr Egbe

View the Prevalence of Use and Exposure of Young Adults to Electronic Cigarette and Hookah Advertisement and Marketing in South Africa - Study Report

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