Background: There are various approaches to e-cigarette regulation globally. In Taiwan, the term “e-cigarette” is not found in existing regulations, but health authorities apply explanatory notes derived from standing laws to e-cigarette. Taiwan health authority is in the process of regulative reform to include “e-cigarette” in standing tobacco law. Our objective was to investigate the public’s attitudes towards potential policy options for e-cigarette regulations in Taiwan.
Design and Methods: We conduct an anonymous online survey in the general public. A questionnaire in Mandarin was posted on the website Stop-tabac.ch between July and November 2017.
Results: Participants (n=236) were mostly male, young, highly educated, employed, and smoked or had smoked cigarettes in the past. Half were e-cigarette users. Four measures banning e-cigarettes, labelling content and nicotine level and establishing a maximum-allowable nicotine level were supported by more than 70% of participants. Vaping status was strongly associated with support for most measures after controlling for other factors in multivariate models.
Conclusion: We documented attitudes of a self-selected sample of the general public in Taiwan regarding e-cigarette regulations and policies. These results may be useful to design studies in more representative samples and to inform e-cigarette regulations, policies and education campaigns.
Kennedy RD, Awopegba A, León ED, Cohen JE. Global approaches to regulating electronic cigarettes. Tob Control 2017;26:440–5. DOI: https://doi.org/10.1136/tobaccocontrol-2016-053179
Ministry of Health and Welfare HPA. Tobacco hazards prevention act. Jan 23, 2009. Version in English. Available from: http://www.hpa.gov.tw/Bhpnet/web/rule/LawShow.aspx?No=201406110001
Ministry of Finance. Tobacco and alcohol tax act – Article Content – Laws & Regulations Database of The Republic of China, 2017. Accessed on: 2019 May 1. Available from: https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=G0330010
Health Promotion Administration, Ministry of Health and Welfare. Meeting Report of the Consultation on e-cigarette regulation. 2009.
Taiwan Ministry of Health and Welfare. Pharmaceutical Affairs Act. Dec 2015. Available from: https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=L0030001
Health Promotion Administration, Ministry of Health and Welfare. E-cigarettes in the form of tobacco smoking pipe. 2014. Available from: https://health99.hpa.gov.tw/flipbook/21814/index.html#p=31
Health Promotion Administration, Ministry of Health and Welfare. Multi-sectoral Joint Efforts on E-cigarettes. Available from: https://health99.hpa.gov.tw/flipbook/21814/index.html#p=24
Kaohsiung High Administrative Court. No.19 Chien-Shan 106. 2017. Available from: http://jirs.judicial.gov.tw/FJUD/index_1_S.aspx?p=tRrzEQzh7pSBsukxB%2fFCi5a05biJ758LINVTLPymY0k%3d
Kaohsiung High Administrative Court. No. 31 Chien-Shan 106. 2017. Available from: http://jirs.judicial.gov.tw/FJUD/index_1_S.aspx?p=tRrzEQzh7pTmyQfmBE3J%2fjC%2bKyzFBkeWuj8iKUQyqWc%3d
Institute for Global Tobacco Control. Country Laws Regulating E-cigarettes: A Policy Scan. 2018. Available from: http://globaltobaccocontrol.org/e-cigarette/country-laws-regulating-e-cigarettes
Health Promotion Administration, Ministry of Health and Welfare. E-cigarettes Page. 2013. Available from: https://www.hpa.gov.tw/Pages/List.aspx?nodeid=444
Chen P-C, Chang L-C, Hsu C, Lee Y-C. Dual use of e-cigarettes and traditional cigarettes among adolescents in Taiwan, 2014-2016. Nicotine Tob Res 2019;21:48-54. DOI: https://doi.org/10.1093/ntr/nty003
Chen P-C, Chang L-C, Hsu C, Lee Y-C. Electronic cigarette use and attempts to quit smoking cigarettes among adolescents in Taiwan. J Adolesc Health 2019;64:99-106. DOI: https://doi.org/10.1016/j.jadohealth.2018.07.008
Chang H-C, Tsai Y-W, Shiu M-N, et al. Elucidating challenges that electronic cigarettes pose to tobacco control in Asia: a population-based national survey in Taiwan. BMJ Open 2017;7:e014263. DOI: https://doi.org/10.1136/bmjopen-2016-014263
Shih C-S, Etter J-F. The profile of e-cigarette users: Results of an online survey in Taiwan. Asia Pac J Health Sci 2019;2019:219-27.
Jiang TH, Cheng LM, Hawkins MA. A study of regulatory policies and relevant issues concerning electronic cigarette use in Taiwan. Int J Health Plann Manage 2017;33:e119-30. DOI: https://doi.org/10.1002/hpm.2440
Gao W, Sanna M, Huang L-L, et al. Juggling two balls – Smoking (re)normalization and harm reduction: E-cigarettes – Facts and misconceptions in Taiwan. Asia Pac J Public Health 2018;30:328-31. DOI: https://doi.org/10.1177/1010539518773479
Health Promotion Administration, Ministry of Health and Welfare. E-cigarettes pose threat to teen health: HPA. 2016. Available from: https://www.hpa.gov.tw/EngPages/Detail.aspx?nodeid=1038&pid=10547
Wackowski OA, Delnevo CD. Smokers’ attitudes and support for e-cigarette policies and regulation in the USA. Tob Control 2015;24:543–6. DOI: https://doi.org/10.1136/tobaccocontrol-2014-051953
Brose LS, Partos TR, Hitchman SC, McNeill A. Support for e-cigarette policies: a survey of smokers and ex-smokers in Great Britain. Tob Control 2017;26:e7-15. DOI: https://doi.org/10.1136/tobaccocontrol-2016-052987
Wright KB. Researching internet-based populations: Advantages and disadvantages of online survey research, online questionnaire authoring software packages, and web survey services. J Comput-Mediat Commun 2005. doi: 10.1111/j.1083-6101.2005.tb00259.x DOI: https://doi.org/10.1111/j.1083-6101.2005.tb00259.x
Taiwan Network Information Center. A survey on broadband internet usage in Taiwan – A summary report. 2017. Available from: https://www.twnic.net.tw/download/200307/20170721d.pdf
Health Promotion Administration, Ministry of Health and Welfare. Taiwan Tobacco Control Annual Report 2018. Available from: https://health99.hpa.gov.tw/media/public/pdf/22077.pdf
Health Promotion Administration, Ministry of Health and Welfare. Preview: Tobacco Hazards Prevention Act. 2017. Available from: https://join.gov.tw/policies/detail/4c5cbfeb-a093-46fc-8f9b-f7aad0a19af2
Executive Yuan. The Executive Yuan approved the amended draft of Tobacco Hazards Prevention Act. 2.16.886.101.20003. 2017. Available from: https://www.ey.gov.tw/News_Content2.aspx?n=F8BAEBE9491FC830&s=ABF2096B17CC2940
WHO. Taxation. Available from: http://www.who.int/tobacco/economics/taxation/en/
Gov.uk [Internet]. Evidence review of e-cigarettes and heated tobacco products 2018: executive summary. 2018. Available from: https://www.gov.uk/government/publications/e-cigarettes-and-heated-tobacco-products-evidence-review/evidence-review-of-e-cigarettes-and-heated-tobacco-products-2018-executive-summary
Dockrell M, Morrison R, Bauld L, McNeill A. E-cigarettes: prevalence and attitudes in Great Britain. Nicotine Tob Res 2013;15:1737-44. DOI: https://doi.org/10.1093/ntr/ntt057
Tan ASL, Bigman CA. E-cigarette awareness and perceived harmfulness: prevalence and associations with smoking-cessation outcomes. Am J Prev Med 2014;47:141-9. DOI: https://doi.org/10.1016/j.amepre.2014.02.011