Table 1.
Prevalence of various types of tobacco products.
| Category | City tier | Age group | Sex | ||||||
|---|---|---|---|---|---|---|---|---|---|
| All (%) | First-tier (%) | Second-tier (%) | Third-tier (%) | 18–29 (%) | 30–39 (%) | 40–60 (%) | Male (%) | Female (%) | |
| Cigarette | 91.5 | 95.1 | 89.2 | 90.2 | 93.2 | 90.3 | 90.8 | 91.4 | 91.8 |
| E-cigarette | 18.5 | 21.7 | 19.6 | 14.1 | 21.8 | 18.1 | 11.4 | 16.3 | 25.0 |
| Cigar | 9.8 | 13.1 | 9.7 | 6.6 | 8.7 | 10.9 | 9.7 | 9.8 | 9.9 |
| Heated tobacco product (HTP) | 3.4 | 3.9 | 3.4 | 2.9 | 3.1 | 3.9 | 2.8 | 3.0 | 4.6 |
| Waterpipe | 2.7 | 2.1 | 3.1 | 3.0 | 2.3 | 3.0 | 3.0 | 2.8 | 2.4 |
| Roll-your-own cigarette | 2.6 | 1.9 | 3.0 | 3.0 | 2.7 | 2.7 | 2.6 | 2.6 | 2.8 |
| Tobacco pipe | 2.3 | 0.9 | 2.9 | 3.2 | 1.9 | 2.1 | 4.4 | 2.6 | 1.6 |
| Smokeless tobacco (ST) | 2.1 | 2.8 | 2.5 | 0.9 | 2.1 | 2.0 | 2.1 | 1.9 | 2.6 |
| Number of participants | 3000 | 1000 | 1000 | 1000 | 1156 | 1361 | 483 | 2246 | 754 |
Table 2.
Proportion of mixed use of different tobacco products.
| Category | Dual use (%) | Triple use (%) | ||||
|---|---|---|---|---|---|---|
| Cigarette | 57.60 | / | 63.48 | 60.77 | 39.10 | 53.56 |
| E-cigarette | / | 42.50 | 36.52 | / | 29.10 | 24.62 |
| Smokeless tobacco (ST) | 42.40 | 57.50 | / | / | 31.70 | / |
| Heated tobacco product (HTP) | / | / | / | 39.03 | / | 21.82 |
Table 3.
Composition of smokeless tobacco (ST) users.
| Characteristics of tobacco users | Category | Users (%) | Non-users (%) |
|---|---|---|---|
| Sex | Female | 32.1 | 25.0 |
| Male | 67.9 | 75.0 | |
| Age | 18–29 years | 30.6 | 38.7 |
| 30–39 years | 53.3 | 45.2 | |
| 40–60 years | 16.1 | 16.1 | |
| Household income (per month) | < 10,000 RMB (< 1,533 USD) | 3.2 | 18.2 |
| 10,000–19,999 RMB (1,533–3,065 USD) | 45.1 | 46.6 | |
| 20,000–29,999 RMB (3,065–4,598 USD) | 46.8 | 27.2 | |
| > 30,000 RMB (> 4,598 USD) | 4.8 | 7.9 | |
| Education | College degree below | 8.5 | 0.2 |
| College degree | 18.5 | 5.2 | |
| Bachelor degree | 65.3 | 84.9 | |
| Master degree or above | 7.7 | 9.7 | |
| Total (number) | 62 | 2938 |
Table 4.
Degree of nicotine dependence based on the Fagerström Test for Nicotine Dependence - Smokeless Tobacco (FTND-ST).
| Degree of dependence | All | City tier | Age category (years) | Sex | ||||
|---|---|---|---|---|---|---|---|---|
| First-tier (%) | Second-tier (%) | 18–29 (%) | 30–39 (%) | 40–60 (%) | Male (%) | Female (%) | ||
| Very low | 9.4 | 12.7 | 7.4 | 4.0 | 14.1 | 4.0 | 10.8 | 5.0 |
| Low | 21.0 | 19.0 | 22.2 | 16.5 | 20.6 | 25.8 | 23.0 | 14.9 |
| Moderate | 19.9 | 20.3 | 19.6 | 16.5 | 22.5 | 17.2 | 16.8 | 28.9 |
| High | 43.3 | 43.7 | 43.1 | 55.1 | 36.3 | 48.0 | 41.3 | 49.3 |
| Extremely high | 6.5 | 4.3 | 7.8 | 8.0 | 6.6 | 5.1 | 8.1 | 2.0 |
| Average score | 5.29 | 5.14 | 5.38 | 5.90 | 5.03 | 5.30 | 5.20 | 5.56 |
| Overall (number) | 801 | 400 | 401 | 176 | 427 | 198 | 600 | 201 |
Figure 1.
Analysis of the self-reported use occasions of ST in China based on city tiers, age, and sex.
(Total participants, n = 801; First-tier city, n = 400; Second-tier city, n = 401; 18–29 years, n = 176; 30–39 years, n = 427; 40–60 years, n = 198; Male, n = 600; Female, n = 201).
Table 5.
User concerns about smokeless tobacco (ST) products.
| Category | All (%) | City Tier | Age category (years) | Sex | ||||
|---|---|---|---|---|---|---|---|---|
| First-tier (%) | Second-tier (%) | 18–29 (%) | 30–39 (%) | 40–60 (%) | Male (%) | Female (%) | ||
| Taste and feel | 49.2 | 44.7 | 53.6 | 40.3 | 51.0 | 54.3 | 52.1 | 40.2 |
| Convenience of carrying | 38.5 | 42.2 | 35.0 | 46.7 | 37.8 | 32.4 | 38.5 | 41.5 |
| Taste | 38.1 | 34.3 | 42.5 | 35.4 | 38.0 | 40.2 | 39.3 | 35.5 |
| Word-of-mouth | 36.3 | 41.0 | 32.3 | 52.7 | 31.2 | 33.3 | 34.8 | 44.3 |
| Brand | 23.8 | 28.1 | 18.4 | 30.1 | 23.1 | 21.6 | 23.0 | 25.2 |
| Ease of purchase | 23.0 | 18.5 | 27.3 | 18.4 | 25.7 | 23.0 | 26.4 | 14.9 |
| Physiological strength (nicotine content) | 21.8 | 24.3 | 20.6 | 21.1 | 22.8 | 22.2 | 24.2 | 16.0 |
| The smell of the product before use | 20.2 | 18.1 | 23.2 | 18.0 | 18.3 | 27.8 | 20.1 | 21.2 |
| Production place | 19.5 | 24.6 | 14.4 | 30.9 | 20.7 | 10.5 | 17.5 | 26.1 |
| Package | 15.9 | 18.5 | 14.1 | 16.7 | 15.1 | 18.3 | 18.9 | 10.7 |
| Pipe shape | 11.1 | 12.3 | 10.0 | 10.6 | 11.2 | 12.1 | 12.3 | 9.6 |
| Overall (number) | 801 | 400 | 401 | 176 | 427 | 198 | 600 | 201 |
Table 6.
Nicotine content preference for smokeless tobacco (ST) products.
| Nicotine content (mg/g) | All (%) | City tier | Age category (years) | Sex | ||||
|---|---|---|---|---|---|---|---|---|
| First-tier (%) | Second-tier (%) | 18–29 (%) | 30–39 (%) | 40–60 (%) | Male (%) | Female (%) | ||
| 41–50 | 3.5 | 1.0 | 4.8 | 1.3 | 3.6 | 2.3 | 2.2 | 6.2 |
| 31–40 | 0.8 | 0.0 | 1.1 | 0.0 | 1.4 | 1.2 | 0.0 | 2.7 |
| 21–30 | 9.9 | 7.0 | 13.1 | 9.5 | 7.9 | 13.8 | 11.0 | 6.1 |
| 11–20 | 27.5 | 24.7 | 30.8 | 32.2 | 27.2 | 26.0 | 31.0 | 16.8 |
| 1–10 | 58.6 | 67.3 | 50.2 | 57.0 | 60.9 | 55.7 | 55.8 | 69.2 |
| Average (mg/g) | 11.54 | 10.00 | 13.10 | 10.53 | 11.43 | 12.69 | 11.64 | 11.27 |
| Overall (number) | 801 | 400 | 401 | 176 | 427 | 198 | 600 | 201 |
Figure 2.
Factors influencing the preference for ST producing areas.
Figure 3.
Analysis of the first opportunity to try using ST for Chinese smokers based on the city level, age, and sex.
(Total participants, n = 801; First-tier city, n = 400; Second-tier city, n = 401; 18–29 years, n = 176; 30–39 years, n = 427; 40–60 years, n = 198; Male, n = 600; Female, n = 201)
Figure 4.
Analysis of the main reason of ST use for Chinese smokers based on the city level, age, and sex.
(Total participants, n = 801; First-tier city, n = 400; Second-tier city, n = 401; 18–29 years, n = 176; 30–39 years, n = 427; 40–60 years, n = 198; Male, n = 600; Female, n = 201)