Patterns of electronic cigarette and heated tobacco product use among adults in Lithuania

Abstract

The use of electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) is increasing globally. The pattern of dual and poly-use raises concerns about compounding hazards. However, in Lithuania, there is a lack of comprehensive evaluation of use patterns. To characterise the use of e-cigarettes and/or HTPs, patterns and characteristics associated with their use among 18–64-year-olds who have used these products at least once in the past 12 months. In 2022, we carried out a cross-sectional study in Lithuania using the CATI (Computer-assisted telephone interviewing) method. A total of 1009 respondents were interviewed. We explored data on e-cigarettes and HTPs use, frequency and intensity, quit attempts, preference towards nicotine and flavours, subjective considerations for initiation and changes in smoking habits. Of the 1009 respondents, 69.5% were dual or poly users, and 63.5% continued to smoke conventional cigarettes alongside e-cigarettes or HTPs. Among 18–24-year-olds, a higher proportion than in older age groups reported e-cigarettes as their first tobacco product ever used (28.1%, p < 0.05). The most frequently reported reasons for use were social influence, product appeal, and flavours, whereas a wish to quit conventional cigarettes was reported by only about one in five users. Around 40% of users reported no reduction in conventional cigarette use after adopting these products. In this sample, adult e-cigarette and HTP users tended to supplement rather than replace conventional cigarette smoking, and these products were used more often for experimentation and social reasons than for cessation. These findings highlight the need for regular monitoring, clearer communication about risks, improved cessation support, and data-informed tobacco control policies.