The Health Promotion Administration announced the results of a survey conducted in 2020 on the smoking behaviors of people aged 18 and above. The e-cigarette use rate among this population nearly tripled from 0.6% in 2018 to 1.7% in 2020. E-cigarettes have become a major warning sign of a threat to the health of our nation.

The results of the survey showed that the majority of e-cigarette users are under 40 years of age, with the largest group being men aged 26-30 (6.3%), followed by women aged 21-25 (4.6%). While the cigarette smoking rate of the population aged 18 and above has not changed significantly (13.1% in 2020 vs. 13.0% in 2018), the percentage of flavored cigarettes usage among smokers has increased from 8.2% in 2018 to 15.6%, with significantly more females than males (41.7% vs. 12.5%, respectively). Among the flavored cigarette users, the largest group consists of female smokers aged 21-25 (68.2%), followed by males aged 18-20 (68.1%). In addition, the ratio of combined use of e-cigarettes and cigarettes has also increased from 0.5% in 2018 to 0.9% in 2020. In terms of the second-hand smoke exposure rate, there has been a slight decrease in non-smoking public places (5.4% in 2018 vs. 5.0% in 2020); however, it has increased from 45.6% to 48.8% % in outdoor public areas.

The primary reasons for using e-cigarettes are “curiosity” (38.9%), “to quit smoking” (17.3%), and “my friends use e-cigarettes” (9.7%). The 2020 survey investigated for the first time the use of heated tobacco products (HTPs) among the population aged 18 and above; the rate was 0.5% overall (male, 0.9%; female, 0.2%). Among these users, 36.8% listed “curiosity” as their reason for using HTPs, followed by “to not smell like tobacco” (12.6%), “it has a lower health risk” (11.3%), and “to quit smoking” (2.9%). However, scientific evidence shows that e-cigarettes and HTPs do not help quit smoking, and their health hazards are not any lower than other tobacco products. Using these products because of curiosity or following others’ examples has no benefit whatsoever.

The tobacco product applications submitted to the Health Promotion Administration in 2019 revealed that there are about 1,200 flavor additives used in tobacco products, most of which are chemical substances (essences). Tobacco manufacturers add a variety of flavors to their products to reduce people’s aversion to the smell of cigarette smoke, so that young people and women might be attracted to these products and eventually become addicted. While a limited amount of these substances may not be harmful when used as food additives, their long-term effects when inhaled into the lungs are not so clear. Take e-cigarettes that use chemical solvents for example: Between 2019 and 2020, the United States reported 2,807 cases of e-cigarette or vaping product use-associated lung injury (EVALI), of which 68 ended in death. In December 2020, three hospitals in Taiwan each reported a suspected case. According to experts, one case (a minor) was highly likely an EVALI caused by e-cigarettes, and the other two (adults) were possible cases of asthma aggravated and/or induced by e-cigarettes. 

E-cigarettes, HTPs, and traditional tobacco products are all health hazards. Stay away from smoking, and do not follow any tricks and shortcuts, but seek professional help instead. During the COVID-19 pandemic, call the toll-free Quitline at 0800-636363 for help. There are nearly 4,000 contracted medical institutions in Taiwan for you to consult with professionals, who can custom-fit the best smoke cessation plan to eradicate your addiction and reclaim your health.