ArticleBMC public health2025
Prevalence of cigarette and e-cigarette dual use and associated factors among people who smoke in China aged 20-69 years.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- [Cessation intention and behavior of e-cigarettes and associated factors among 18-44 Chinese adults: Based on protection motivation theory].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Article
- Correction: Prevalence of cigarette and e-cigarette dual use and associated factors among people who smoke in China aged 20-69 years.BMC public health · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
16 authors.
Funding
Abstract
BACKGROUND AND
aimsEvidence on the dual use profile of electronic cigarettes (e-cigarettes) and cigarettes remains limited, especially for the adult population. This study aimed to assess the prevalence and associated factors of lifetime dual use among adults who smoke in China.
methodsThe nationally representative survey of the China Health Literacy Survey (CHLS) was conducted in 2018. Participants were recruited from 31 provinces in the Mainland of China (n=21,582). Dual use was defined as self-reported ever use of both cigarettes and e-cigarettes. Multivariate logistic regression models with weights (accounting for study design, non-response rate and post hoc stratification) were used to identify the associated factors of dual use, shown in adjusted odds ratios (aOR) and 95% confidence intervals (CI).
resultsThe prevalence of lifetime dual use of cigarettes and e-cigarettes was 0.82% in China, 2.95% among those who ever smoked, and 3.01% among those who currently smoked. The dual use was consistently more prevalent in urban areas than rural areas and decreased with age. In the adjusted logistic model, dual use was associated with younger age, living in urban areas, single status, high educational level, high income, poor self-reported health status, nicotine dependence, and other smoking-related factors. Withdrawal symptoms were more prevalent among those who used both cigarettes and e-cigarettes compared with those who exclusively smoked cigarettes, including the urge to smoke, hard to concentrate, quick temper, increased appetite, weight gain, involuntary hand tremor, and sleepiness (P<0.05).
conclusionAlthough the prevalence of lifetime dual use is low, the absolute number of affected individuals in China is substantial. Our study identified key risk factors associated with lifetime dual use, providing critical evidence to inform targeted interventions for at-risk populations and guide the development of tailored tobacco control strategies.
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