Gender differences in preferences, gateway effects, and potential motivations among e-cigarette users in China

WEI JI ¹ Liyong Shi ¹ Xinjun Lin ¹ Zhiqiang Ji ² Zhihuang Zhao ¹ Yanping Chen ¹ Pengxiang Huang ¹ Xiali Wang ³ Xiaofang Dai ¹ Jing Cheng ³ Lujun Guo ⁴ Diwei Wu ⁵ Yibiao Chen ¹ Zhangcai Wu ¹ Xiaoyang Chen ^1*

• ¹ Fujian Medical University, Fuzhou, China
• ² Zunyi Medical University, Zunyi, Guizhou Province, China
• ³ Quanzhou Medical College, Quanzhou, Fujian Province, China
• ⁴ Suzhou University, Suzhou, Anhui, China
• ⁵ Hainan Medical University, Haikou, Hainan Province, China

Scale, and the General Information Scale to conduct the survey and assessment, and surveyed 360 individuals of those who only used traditional cigarettes for comparison.Results ①The total number of participants in this research study was 1792, the mean age was 26.9±9.0 years and the number of e-cigarette users was 640, of which 535 (83.6%) were males and 105 (16.4%) were females. ②There was a statistically significant association between e-cigarette flavor preferences (flavor/nicotine) and gender (P<0.05). Compared to males, females preferred ecigarettes with scented/tobacco/fruit/beverage/nicotine (0mg/12mg) flavors. ③Compared with males, females were more likely to "Transition to using traditional cigarettes after smoking ecigarettes (Gateway effect)" (p<0.05). ④Whereas males were more likely to experience "Craving for traditional cigarettes after using e-cigarettes (Induction effect)" (p<0.05). ⑤There were significant gender differences in motivations for e-cigarette use. Males were more likely to use ecigarettes to "quit traditional cigarettes", wheras e-cigarette use was more closely related to selfperceptions of "feeling cool". ⑥Multi-factorial logistic regression analysis showed that there was a significant correlation between "e-cigarette liquid flavor (tobacco/fruit/beverage), e-cigarette liquid nicotine concentration (0mg/12mg)" and "Gender" (P<0.05); Gateway effect was significantly correlated with "Gender and Age"(P<0.05); E-cigarette addiction dependence was not significantly correlated with gender; Mild addiction to e-cigarettes was significantly correlated with "hope e-cigarettes carry nicotine, and the motivations for choosing e-cigarettes (to quit traditional cigarettes)" (P<0.05). Severe addiction to e-cigarettes was significantly correlated with "hope ecigarettes carry nicotine, and the motivations for choosing e-cigarettes (unable to use traditional cigarettes in public)" (P<0.05).Among Chinese e-cigarette users, females preferred e-cigarettes with special flavors, and either without or with middling concentrations of nicotine. The gateway effect was more prominent in females and adolescents, and the induction effect was more notable in males. There was no significant correlation between addiction dependence on e-cigarettes and gender. E-cigarette use was more likely to be motivated by a desire to quit using traditional cigarettes in males, wheras women were more likely to be motivated by "self-perception".