Use of electronic cigarettes and hookah in brazil: a new and emerging landscape.

The objective of the study was to estimate the prevalence and correlates of e-cigarette and hookah experimentation and use among adults (18+ years) in Brazil. Methods: COVITEL is a countrywide cross-sectional telephone-based study conducted in 2022. The sample was designed to be representative of the country and its five regions and included 1,800 individuals in each of Brazilian’s five regions. Telephone numbers were selected using a random digit dialling procedure proportionally for each direct distance dialling code in each region and then electronically validated (900 cell phones and 900 fixed number in each region). Current manufactured smoking was assessed (no/yes, regardless of the frequency). For both e-cigarettes and hookah, information was collected on lifetime experimentation and current use (no/yes, regardless of the amount). Results: The prevalence of lifetime use of e-cigarettes and hookah was identical (7.3%; 95%CI:6.0-8.9), whereas the prevalence of manufactured cigarette smoking was 12.2% (95%CI:10.4-14.1). Young adults (18-24 years) displayed the highest experimental prevalence: 19.7% (95%CI: 15.1-17.0) for e-cigarettes and 17% (95%CI:12.2-23.2) for hookah. E-cigarettes and hookah were more reported in the Mid-West region and among those with higher education, while manufactured cigarette use was more prevalent among those with lower schooling. Individuals who used all three forms of tobacco corresponded to 1.5% of sample (nearly 2 million individuals based on the size of the Brazilian adult population). Conclusions: Surveillance is essential for the monitoring and prevention of these new forms of nicotine consumption.