Relieving or Aggravating the Burden: Non-Communicable Diseases (NCDs) of Electronic and Conventional Cigarette Users (Dual Users) in Indonesia

Abstract

Introduction Conventional (tobacco) and e-cigarette smoking prevalence is a growing concern in Indonesia. It has worsened as e-cigarettes complement conventional cigarettes, causing dual users. Dual users of e-cigarettes and conventional cigarettes potentially cause an additional burden in terms of the health of their users. Methods Our study is a secondary data analysis of the 2018 National Basic Health (Riskesdas) Survey. The sample is limited to respondents aged 15 – 64 years old who either only used e-cigarettes (e-cigarette single users), only used conventional cigarettes (conventional cigarette single users) or used both e-cigarettes and conventional cigarettes (dual users) in the last month. The sample size of the data was 174,917 individuals. Our analysis utilized the logit and negative binomial regression to test whether the type of smoking behavior was associated with reporting to have a Non Communicable Diseases (NCDs) and complications, respectively. Results Our study finds: (1) dual users are positively associated to report having NCDs, such as liver failure (AOR=2.38; 95% CI: 2.32–2.44), diabetes (AOR=1.53; 95% CI: 1.50–1.57), hypertension (AOR=1.49; 95% CI: 1.48–1.51), and gum diseases (AOR=1.74; 95% CI: 1.73–1.74) compared to single users and(2) e-cigarette single users are positively associated with reporting to have NCDs and dental problems, such as asthma (AOR=3.11; 95% CI: 3.01–3.22), diabetes (AOR=16.01; 95% CI: 14.57–17.59), broken tooth (AOR=1.04; 95% CI: 1.03–1.06) and they have disease complication compared to conventional cigarette single users. Conclusions Therefore, simultaneous control of the consumption of e-cigarettes and conventional cigarettes is essential. In addition, it is important to promote policies to increase the price of e-cigarettes and conventional cigarettes to reduce smoking prevalence and prevent dual users. Moreover, as there are negative consequences of conventional and e-cigarette single users or dual users, the most effective alternative is to stop smoking, not switch smoking.

Keywords

• disease
• dual user
• e-cigarette
• indonesia
• smoking