Duke and DKU professors complete research project on use of e-cigarettes in China with help of DKU students

August 12, 2019

Duke professor Yantao Zuo and Duke Kunshan professor Abu Abdullah recently completed a research project which assessed use and perception of e-cigarettes in mainland China, with the help of DKU student research assistants. The research was supported by an ERIC (Education and Research in China) award, a funding program previously administered by the Office of DKU Programs at Duke to facilitate research collaboration between Duke and Duke Kunshan University.

An assistant professor in the psychiatry department at Duke, Zuo’s research involves using neuroimaging techniques to investigate brain mechanisms associated with the addictive effects of nicotine and nicotine withdrawal, and also focuses on examining individual differences in affective and craving processes. In October 2018, Zuo traveled to Duke Kunshan at the invitation of the DKU Global Health Research Center and presented a talk, titled “Can E-cigarette’s Help Curb the Smoking Epidemic in China?”. During the talk, Zuo discussed the challenges China faces in curbing the country’s tobacco use, and also reviewed the epidemiology of e-cigarettes which was promoted as a potential smoking cessation aid in Chinese social media. The talk generated a number of questions and discussion among attendees as well as research interest among DKU students.

After the talk, 12 DKU students, including two graduate students and 10 undergraduate students, joined the project as research assistants. They received training from Zuo and Abdullah, which they translated into hands-on experience in human subject research and field data collection. The students’ participation was purely voluntary: the project was not part of any program or course requirement, and the students did not receive credit.

The teams of professors and students conducted three studies. They collected internet survey responses from 1,037 adult e-cigarette users, conducted field surveys with 265 local smokers/e-cigarette users in Kunshan, and completed in-depth interviews with 30 long-term e-cigarette users.

For the internet survey, about two-thirds of the responders agreed that e-cigarette use might help people quit smoking cigarettes. Over 77% of the responders said they believed that tobacco cigarettes are more harmful to public health than e-cigarettes, and 88% of responders said they would recommend e-cigarettes to smokers who have not used them before. The field survey of local smokers was conducted in public locations in Kunshan, and found that though 94% of respondents had heard of e-cigarettes, only 13.6% had used them in the past 30 days. The field survey responses highlighted participants’ concerns about health risks and lack of e-cigarette regulation, highlighting the need for more information and regulatory measures in China. The teams are currently still processing and analyzing data from the in-depth interviews, which they hope will provide deeper insights in to the patterns and reasons of e-cigarette use.

The overall preliminary findings from the studies suggest that electronic cigarettes are increasingly accepted by Chinese users as alternatives to tobacco cigarettes, and as aids for smoking cessation. However, increased regulations of the e-cigarette industry would be necessary in addressing the public’s concerns over use. The data suggest that continued research into e-cigarettes as a promising intervention into the tobacco epidemic is warranted. Zuo and Abdullah plan to complete data analysis for the rest of the project, and will submit their findings in two to three manuscripts for publication. The students who have and will continue to engage significantly in the data analyses and preparation of the manuscript will be included as co-authors, and others will be acknowledged for their support in the study.