E-Cigarettes Use Intensity, Behavior and Nicotine Addiction among Young Users in Bali, Indonesia

By on May 15, 2023. Posted in .

Ni Made Dian Kurniasari1,2,3, Ni Nyoman Putri Wantini3, Desak Nym. Widyanthini1,3,Putu Ayu Swandewi Astuti1,2,3, Made Kerta Duana1,2,3

1Public Health and Preventive Medicine Department, Faculty of Medicine Universitas Udayana,

2Udayana CENTRAL (Center for NCDs, Tobacco Control and Lung Health, Universitas Udayana)

3School of Public Health, Faculty of Medicine Universitas Udayana

Correspondence email: dian_kurniasari@unud.ac.id


The prevalence of e-cigarette use in Indonesia have increase 10 folds from 0.3% (2011) to 3% (2021), and this continue to rise especially among youth users. The use of e-cigarette is not harm-free, thus this study aimed to gain detail information regarding intensity of use, behavior patterns to understand practices that can affect the potential toxicity/ nicotine addiction of e-cigarettes among young users.


This was a quantitative study with a cross-sectional approach conducted in April – May 2023 in Bali, Indonesia. A total of 190 young e-cigarette users aged 18-25 years were gained from snowballing and consecutive sampling. Invitation was sent and published through social media and WhatsApp group. Data were collected via phone interviews to those who consented to participate. Data were analyzed descriptively.


There were 76.3% male e-cigarette users, mean of age 21.5 year, 94.7% have high education and 59.5% were student. A 34.7% was dual-smokers, mean of age at initiation of use was 18.5 years and 55.8% was using POD/JUUL. Most of users (94.2%) bought e-cigarettes in vape store, most favorably (42.6%) bought with sweet/desserts flavor and mostly (94.2%) never mixing their own liquid. A 28.4% used e-cigarette as replacement to quit smoking, 30.5% reasoned to reduce stress, 43.2% said e-cigarettes have various enticing flavors. Most of them knew e-cigarettes from and smoking with their friends. Majority consumed 30 ml (44.2%) to 60 ml (41.6%) of e-cigarette liquid from the last used, time of finishing e-liquid mostly in 3-4 weeks (45.8%), mean of nicotine concentration in e-liquid was 13.5 mg. Half of them used e-cigarettes for 3-10 (35.8%) and 11-20 times (22.6%) per day with duration less than 15 minutes (48.9%) and 15 -30 minutes (34.7%). A 82.6% was addicted to nicotine based on the measurement on signs of addiction using Hooked On Nicotine Checklist (HONC).  


The high intensity of e-cigarettes use among youth have put adolescents at risk for nicotine addiction, thus highlights the need to address addiction and prevent initiation to e-cigarette smoke. Creating a strong, comprehensive regulation to ban the sale of flavored tobacco products, should be implemented.

Key words: e-cigarette, intensity use, addiction, behavior, youth.

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