How are self-reported physical and mental health conditions related to vaping activities among smokers and quitters: Findings from the ITC four country smoking and vaping wave 1 survey

Francisco Manuel Gasca Sanchez, Jesús Santos-Guzmán, Ricardo Elizondo-Dueñaz, Gerardo Manuel Mejia Velazquez, cecilia ruiz, Deborah Reyes, Elsie Vazquez, Jose Ascencion Hernandez, Rosa del Carmen Lopez, Rocio Ortiz-Lopez, Daniel Olvera, Augusto Rojas-Martinez

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


This study examines whether having health conditions or concerns related to smoking is associated with use of vaping products. Data came from the 2016 wave of the International Tobacco Control Four Country Smoking and Vaping Survey. Smokers and recent quitters (n = 11,344) were asked whether they had a medical diagnosis for nine health conditions (i.e., depression, anxiety, alcohol problems, severe obesity, chronic pain, diabetes, heart disease, cancer, and chronic lung disease) and concerns about past and future health effects of smoking, and their vaping activities. Respondents with depression and alcohol problems were more likely to be current vapers both daily (Adjusted odds ratio, AOR = 1.42, 95% confidence interval, CI 1.09–1.85, p < 0.05 for depression; and AOR = 1.52, 95% CI 1.02–2.27, p < 0.05 for alcohol) and monthly (AOR = 1.32, 95% CI 1.11–1.57 for depression, p < 0.01; and AOR = 1.43, 95% CI 1.06–1.90, p < 0.05 for alcohol). Vaping was more likely at monthly level for those with severe obesity (AOR = 1.77, 95% CI 1.29–2.43, p < 0.001), cancer (AOR = 5.19, 95% CI 2.20–12.24, p < 0.001), and concerns about future effects of smoking (AOR = 1.83, 95% CI 1.47–2.28, p < 0.001). Positive associations were also found between chronic pain and concerns about past health effects of smoking and daily vaping. Only having heart disease was, in this case negatively, associated with use of vaping products on their last quit attempt (AOR = 0.72, 95% CI 0.43–0.91, p < 0.05). Self-reported health condition or reduced health associated with smoking is not systematically leading to increased vaping or increased likelihood of using vaping as a quitting strategy.

Original languageEnglish
Article number1412
Pages (from-to)1-13
Number of pages13
JournalInternational Journal of Environmental Research and Public Health
Issue number8
Publication statusPublished - 2 Apr 2019
Externally publishedYes

Bibliographical note

Funding Information:
Conflicts of Interest: G.T.F. has served as an expert witness on behalf of governments in litigation involving the tobacco industry. K.M.C. has received grant funding from the Pfizer, Inc., to study the impact of a hospital-based tobacco cessation intervention. K.M.C. also receives funding as an expert witness in litigation filed against the tobacco industry. The other authors declare that they have no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Funding Information:
Funding: The ITC Four Country Smoking and Vaping Survey in the US, Canada, and England was supported by grant P01 CA200512 from the US National Cancer Institute, and a Foundation Grant (FDN-148477) from the Canadian Institutes of Health Research. The ITC Australia Project was supported by the National Health and Medical Research Council of Australia (APP1106451). Additional support was provided to GTF from a Senior Investigator Award from the Ontario Institute for Cancer Research.

Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Copyright 2019 Elsevier B.V., All rights reserved.

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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