Introduction Despite substantial declines in smoking prevalence in the Philippines over the past decade, many adults who smoke continue to face challenges in quitting, and the growing popularity of e-cigarettes has introduced new challenges for public health. As awareness of e-cigarette availability expanded, particularly among young adults and people who smoke seeking alternatives, patterns of use and nicotine dependence became more prominent. In 2020, the government introduced an excise tax on e-cigarettes to curb use and mitigate health risks. We examine patterns of e-cigarette awareness and current use among Filipino adults using nationally representative data. Methods We analysed the 2015 and 2021 Global Adult Tobacco Survey (GATS) waves. Survey-weighted logistic regression assessed associations between sociodemographic factors, tobacco use status and quit intentions, media exposure and (1) awareness and (2) current use among those aware. Since current use was uncommon in some subgroups, we conducted a Firth bias-reduced logistic sensitivity analysis to address small-sample bias and quasi-separation. Results Awareness of e-cigarettes was widespread, but use was concentrated among specific groups. Young adults, males and individuals with higher educational attainment were more likely to be aware of and use e-cigarettes, with prevalence highest among people who smoke and intend to quit. Conclusions E-cigarette awareness and use were disproportionately higher among young adults and people who currently smoke. These findings highlight the importance of continuous monitoring of e-cigarette trends and the need for targeted public health interventions to prevent nicotine dependence and reduce potential gateway effects. Strengthening regulatory oversight and sustaining public education efforts are crucial to protecting vulnerable populations, particularly the youth.
Lacaza et al. (Wed,) studied this question.