[INSTITUTE OF BUSINESS MANAGEMENT]

Electronic Cigarettes
The new healthier way to smoke
Rabeya Ropani (7613) Anam Iqbal (9443) Taimoor Ali Khan (10281) Zeeshan Jessani (10843)

Electronic Cigarettes: Exploratory Research

Raaz Muhammad (6848) Abdul Basit Abbassi (8934)

Acknowledgements
April 21st, 2011

Professor Kausar Saeed, Methods in Business Research, Institute of Business Management.

Respected Madam, This report has been prepared on the new phenomenon of electronic cigarettes. This report is exploratory in nature with research on emerging trends of smoking e-cigarettes in Pakistani youth. This report has been a great learning experience for all of us. We sincerely hope that this report meets your expectations. Sincerely, Rabeya Ropani (7613) Anam Iqbal (9443) Taimoor Ali Khan (10281) Zeeshan Jessani (10843) Raaz Muhammad (6848) Abdul Basit Abbassi (8934)
2|Page

Electronic Cigarettes: Exploratory Research

Table of Contents
Acknowledgements.................................................................................................... 2 Table of Contents....................................................................................................... 3 Executive Summary:...................................................................................................4 Literature Review:......................................................................................................5 Stages of Smoking...................................................................................................6 Smoking Trend in Pakistan.........................................................................................7 ............................................................................................................................... 8 Electronic Cigarettes...............................................................................................8 Research Design:........................................................................................................9 Statistical Analysis:...................................................................................................11 Results and Discussion:............................................................................................15 Conclusion:............................................................................................................... 16 References:.............................................................................................................. 17 Appendix: Graphs..................................................................................................... 17

3|Page

Electronic Cigarettes: Exploratory Research

Executive Summary:
Aim of Study: This research examines consumer psychology regarding increasing trend in youth of smoking and comparing it with electronic cigarettes and consumer perception of electronic cigarettes with traditional cigarettes and if it is considered a viable alternative to cigarettes.

Hypothesis: Electronic cigarettes are indeed a healthier way of smoking

Research Method: To conduct our research we used the survey method to reach out to university students from different universities to get a quick picture of smoking habits and perceptions of ecigarettes.

Data Collection A questionnaire consisting of a set of 12 questions consisting of dichotomous questions, Likert rating scale and MCQs was used. Our focus group was mostly smokers since the research is about alternative e-cigarette.

Results Statistical analysis showed that 67% respondents would consider e-cigarette as an alternative and also pay for it if it means smoking in a healthier way. However, this does not mean that they will quit smoking. This can only be achieved through the will and gradual cessation of nicotine addiction.

Conclusion

4|Page

Electronic Cigarettes: Exploratory Research

Pakistani and youngster market here because many people are simply unaware of the alternatives available to them. Also, if proper information on these cigarettes is given to them the usage of these has great potential as shown by our survey and people would be more convinced about its healthiness compared to a regular cigarette if more research and medical evidence is presented to the consumers.

Literature Review:
Breathing the fumes of burning plant material, especially tobacco, from a cigarette, cigar, or pipe, despite social and medical arguments against tobacco use, smoking is widely practiced around the world. Nicotine is an alkaloid in tobacco that is addictive and can have both stimulating and tranquilizing psychoactive effects. The tar (residue) and gases produced by burning tobacco have many negative health effects. They include lung cancer, pancreatic cancer, and laryngeal cancer; heart disease and stroke; and emphysema and chronic bronchitis. Smoking also increases other health-related risk factors (see asbestosis). A nonsmoker who breathes secondhand smoke (such as the smoke from a lit cigarette) is at an increased risk of the same diseases that affect smokers. Second hand smoke also increases the risk of sudden infant death syndrome. Doctor-run programs, along with nicotine patches and gums that provide diminishing doses of nicotine, are among the aids available to help those who wish to quit smoking. Hypnosis, acupuncture, herbal remedies, and other approaches are also widely advertised as ways to quit smoking. Smoking has been greatly reduced in the health-conscious West even as it rises in many less-developed countries. Over the years increasing statistical evidence related smoking to cardiovascular and lung disease, especially bronchitis, emphysema, and cancer. It is undoubtedly true that the pleasures of smoking are derived from the actions of nicotine on the central nervous system. Nicotine is rapidly absorbed from the mucosal membrane of the mouth and from the lungs, and readily penetrates the nervous system. It also has peripheral actions, tending to increase blood pressure and heart rate. The Surgeon-General's Report in the US in 1964 was the real start of the campaign to prevent or abolish smoking. Vested interests in the tobacco companies promoted ideas to reduce the harmful effects by the introduction of filters and creation of low tar cigarettes. It is the carcinogenic compounds in the tar which are the serious hazard to health, and some, but not all, of these compounds are removed by the filters. People changing to cigarettes with low nicotine content tend to smoke more and draw more deeply. Artificial smoking materials have been developed, consisting of pure cellulose-based material impregnated with nicotine.

5|Page

Electronic Cigarettes: Exploratory Research

Tobacco smoking is the practice where tobacco is burned and the vapors either tasted or inhaled. The practice began as early as 50003000 BC. Many civilizations burnt incense during religious rituals, which was later adopted for pleasure or as a social tool. Tobacco was introduced to Eurasia in the late 16th century where it followed common trade routes. The substance was met with frequent criticism, but became popular nonetheless. German scientists formally identified the link between smoking and lung cancer in the late 1920s leading the first anti-smoking campaign in modern history. The movement failed to reach across enemy lines during the Second World War, and quickly became unpopular thereafter. In 1950, health authorities again began to suggest a relationship between smoking and cancer. Scientific evidence mounted in the 1980s, which prompted political action against the practice. Rates of consumption from 1965 onward in the developed world have either peaked or declined. However, they continue to climb in the developing world. Smoking is the most common method of consuming tobacco, and tobacco is the most common substance smoked. The agricultural product is often mixed with other additives and then pyrolyzed. The resulting vapors are then inhaled and the active substances absorbed through the alveoli in the lungs. The active substances trigger chemical reactions in nerve endings which heighten heart rate, memory, alertness, and reaction time. Dopamine and later endorphins are released, which are often associated with pleasure. As of 2000, smoking is practiced by some 1.22 billion people. Men are more likely to smoke than women, though the gender gap declines with younger age.

Stages of Smoking
Stage 1-Experimentation This is how every smoker starts. Either through curiosity or peer pressure, and typically at a young age new smokers start through experimentation. They may want to fit in with a group of new friends, look cool, be rebellious or just see what the big deal is about smoking. Many new smokers never make is past this phase. Either smoking makes them feel ill or they come to their senses and realize that it is not for them. A lot of people do make it through this stage and smoking becomes a bigger part of their life. Stage 2 -Commitment Once a person passes into this stage of smoking they are past a casual urge to smoke and they have made a commitment to their habit. They now actually buy packs of cigarettes. They do not just smoke here and there or just at parties or get-togethers, they smoke all the time.
6|Page

Electronic Cigarettes: Exploratory Research

Some people may to be able to quit at this point. But it gets harder the closer they get to the next stage. Stage 3 -Addiction Once a smoker hits this stage smoking is no longer a choice. They are now having a smoke as soon as they wake up, throughout the course of the day, and before they go to bed at night. Smoking has weaved its way into the fabric of their lives. Stage 4 -Regret Most smokers who have become addicted eventually regret the fact that they have become powerless over cigarettes. They try to quit smoking, only to find that it is difficult. They desperately want to kick the habit but end up lighting up again

Smoking Trend in Pakistan

As many as forty per cent men and eight per cent women in Pakistan smoke regularly, Professor Javaid Khan, Consultant Pulmonologist and Head Section of Pulmonary Medicine, Aga Khan University (AKU) shared the findings of a survey at a Continued Medical Education seminar at the University in Karachi. While tobacco use is declining in most other countries of the world, sadly it is on the rise in Pakistan. If we dont take any action, the current global death toll of five million per year from tobacco use will increase to 10 million per year by 2025. In Pakistan, estimated 100,000 people die every year from Tobacco related diseases, he warned. Educating the public on tobacco and its hazards is the first step for tobacco control in any country but unfortunately marketing and advertising budget of tobacco companies in Pakistan is far greater than the total budget on health promotion by the Government of Pakistan. Dr Muhammad Irfan, Consultant Pulmonologist, AKU said that tobacco advertising has been shown to have strong influence on children and teenagers. Most countries have completely banned tobacco advertising in order to discourage the youth from taking up smoking. He said that tobacco dependence is generally under treated. People trying to quit should use medications in conjunction with as much counseling as possible. During adolescence, tobacco use by peers may create a positive image of smoking and create easy access to cigarettes, especially in developing countries where there are no restrictive laws on the sale of cigarette to minors. The findings presented in this study are consistent with other studies conducted on adolescent smoking behaviour, which showed that parents, siblings, and peers are powerful influences for adolescent smoking. Smoking is usually initiated during adolescence and being amenable to behaviour modification it should become a public health priority to educate adolescents and parents regarding hazards of smoking in Pakistan and other developing countries

7|Page

Electronic Cigarettes: Exploratory Research

Electronic Cigarettes
Ever before considering that the public became aware about the hazards of smoking cigarettes a couple of decades in the past, many men and women have discovered quitting the tobacco habit tough. Businesses have been innovating and manufacturing cigarette smoking cessation goods for numerous years now. From nicotine patches to gum, nicotine addicts have been utilizing them to quit their behavior. Electronic cigarettes (also acknowledged as ecigarettes and electrical cigarettes) are the latest products on the industry. They are designed to search and really feel like true cigarettes, even down to emitting synthetic smoke however they do not truly have any tobacco. Consumers inhale nicotine vapor which looks like smoke without having any of the carcinogens located in tobacco smoke which are unsafe to the smoker and other folks around him. The Digital cigarette is made up of a nicotine cartridge that contains liquid nicotine. When a person inhales, a very small battery driven atomizer turns a small quantity of liquid nicotine into vapor. Inhaling nicotine vapor offers the consumer a nicotine hit in seconds rather than minutes with patches or gum. When the person inhales, a tiny LED light at the tip of the digital cigarette glows orange to simulate a actual cigarette. The nicotine cartridges themselves arrive in different strengths. As they get used to using the electronic cigarette, they can little by little reduce the strength they use till they quit. The primary positive aspects electronic cigarettes have more than nicotine patches or gum is firstly, end users have the nicotine hit much faster and secondly, since a large reason why smokers fail to stop suing patches and gum is since they nonetheless skip the act of inhaling smoke from a cylindrical object. The digital cigarette emulates that even down to the smoke. Through the years, many people have tried to quit smoking over and over again without any success. Today, there is a new and effective way to help people quit smoking forever -- the E cigarette. An E cigarette feels like a regular tobacco cigarette, but it doesn't actually burn tobacco. When you inhale from an E cigarette, you activate an air flow sensor. This sensor releases a nicotine water vapor that either smells like tobacco or some other type of special flavor. You can still receive the nicotine your body craves with an E cigarette without ingesting any of the harmful chemicals of regular tobacco cigarettes. E cigarettes have refillable cartridges that come in a number of flavors. These include regular cigarette flavor, menthol flavor, fruit flavors like pineapple, orange, and strawberry, and even designer flavors like vanilla and energy drink. The different strengths of nicotine include high, medium, low, and even no nicotine. Since e cigarettes don't contain any tobacco, you can usually smoke them in places where traditional tobacco cigarettes are banned, like restaurants, bars, and even at work. You can smoke an E cigarette without worrying about exhaling second hand smoke and affecting the people around you. Compared to nicotine patches, an E cigarette
8|Page

Electronic Cigarettes: Exploratory Research

will give you the same sensation that you feel when smoking regular tobacco cigarettes. When inhaling, your lungs fill with nicotine vapor and when you exhale, you blow out this vapor that looks and feels exactly like smoke, but is healthy and evaporates quickly. Although people are cracking down on regular tobacco cigarette smokers, E cigarettes can allow you a healthy alternative so you can smoke whenever you want without worry.

Research Design:
Exploratory research:
9|Page

Electronic Cigarettes: Exploratory Research

We are exploring the electronic cigarette phenomenon amongst university students especially because these days, youngsters have started smoking a lot due to peer pressure, social acceptability and academic burden Descriptive research The research is also descriptive in nature that is it uses statistics to highlight current smoking patterns and characteristics and future outlook towards electronic cigarettes.

Sources of data:
Primary data Data collected for current research is called primary data Ways for collecting Survey through questionnaire administered to 200 students of different universities including IBA, CBM and Szabist.

Sampling:
We used non probability sampling and relied on convenience sampling for getting questionnaire filled from respondents who were available and willing to fill the information.

Methodology:
We chose 200 students from various universities to conduct our primary research. We included a questionnaire of about 15 questions for them to answer making use of dichotomous and Likert scale to gauge their responses about smoking and usage of electronic cigarettes. We explained the respondents the implications and meaning of electronic cigarettes to get unbiased responses. We also showed them some videos from Youtube and made them aware of refills and cartridges for cost benefit analysis. For secondary research we had to make use of mostly reports from FDA, AKU (in case of Pakistan), Euromonitor and several online reports published on smoking trends and other medical websites which compare e-cigarettes with traditional smoking and judge it to be a healthier alternative.

10 | P a g e

Electronic Cigarettes: Exploratory Research

Statistical Analysis:
The responses of participants were recorded in the form of a table to differentiate between various responses. The responses are presented in a tabular form below.

TABLE 1.1 Age group of respondents 16-20 21-24 24 and above 84 100 16 42% 50% 8%

TABLE 1.2 Do you smoke? Yes No Sometimes 64 36 100 32% 18% 50%

TABLE 1.3 How old were you when you first started smoking? 16-20 21-24 Before 16 40 20 140 20% 10% 70%

TABLE 1.4 No of cigarettes smoked? 2-5 10-15 A pack or more 160 30 10 80% 15% 5%
11 | P a g e

Electronic Cigarettes: Exploratory Research

TABLE 1.5 Did you try quitting in the past 12 months? Yes No 120 80 60% 40%

TABLE 1.6 Have you considered an alternative to smoking? Yes No Sometimes 32 112 56 16% 56% 28%

TABLE 1.7- Have you ever heard of electronic cigarettes? Yes No 40 160 20% 80%

TABLE 1.8 If an electronic cigarette was given to you, would you try?

12 | P a g e

Electronic Cigarettes: Exploratory Research

Yes No Maybe

134 50 16

67% 25% 8%

TABLE 1.9 How much will you be willing to pay for it? Rs.800-1000 Rs.1000-1500 Rs.1500 and above 16 9 25 32% 18% 50%

TABLE 1.10 Electronic cigarettes can help me quit smoking? Agree Dont Know Disagree 50 100 50 25% 50% 25%

13 | P a g e

Electronic Cigarettes: Exploratory Research

TABLE 1.11 E-cigarettes can reduce danger of cancer and other diseases? Agree Somewhat Agree Dont Know SomewhatDisagree Disagree 36 40 80 10 34 18% 20% 40% 5% 17%

TABLE 1.12 To what extent do you believe E-cigarettes can help curb smoking amongst youngsters w/o compromising social acceptability? No effect Attract Non smokers Significant change 66 50 84 33% 25% 42%

14 | P a g e

Electronic Cigarettes: Exploratory Research

Results and Discussion:

Most of our respondents belonged to the age group of 21-24 which consisted of mainly the university students who were in the universities for their Bachelors program or were continuing their studies in the Masters program. The next most concentrated group of respondents was early university students who were in their early years of a Bachelors degree at their respective universities. This research was aimed at smokers mainly therefore we also included occasional smokers in our study due to the fact that many smokers were what is described as social smokers, people who smoked only during social gathering or started due to peer pressure before the habit became a regular part of their lives. A high percentage of our respondents smoked occasionally i.e 50% classifying them as occasional smokers which also included females. It is important to mention here that many females also get their first taste of smoking out of curious habit and even though few take up smoking perpetually due to the social stigma associated with female smoking in Pakistan, they frequent it during meetings with friends and in social circles. A committed 32% respondents smoked perpetually in our survey results. As is evident from survey results and complying with our result of occasional smoking, many respondents tried their first cigarette even before age 16 at 72%. This result is consistent with previous research and findings on smoking habits by experts that many young adults and teenagers start smoking due to peer pressure, curiosity, parents already smoking in the house and social acceptability pressures. Although a good 32% of our respondents smoked however, only 5% smoked a pack or more. One reason for this could be that as smokers continue smoking and it becomes a habit, they start smoking more, however, for those who have just started smoking or are early smokers, their smoking intake is limited to 2-5 cigarettes per day. This could also be due to unacceptability of smoking in families as many young adults hide that they are smokers from families limiting their smoking habits, recent pictorial warnings by the government on cigarette packs and the need to smoke during high pressure circumstances. As highlighted in our literature review, smokers by the end of stage 3 and 4 suffer from addiction and regret therefore even if they try to quit smoking as 60% of our respondents did they are unable to do so because they try to find a quick fix for their addiction and dependence. This is why our next finding is consistent with results that most of them, 56% never think of alternatives because they are either too addicted, have little information or availability of alternatives or have given in to smoking as a perpetual habit. In Pakistan, not many people have heard of a new alternative, touted as a healthier way to smoke which has gained prominence in US and European countries since 2008, i.e electronic cigarettes. 80% of respondents had no idea about an electronic cigarette which as we had anticipated was true. For this reason we had included a short description in our survey about E-cigarettes and also showed
15 | P a g e

Electronic Cigarettes: Exploratory Research

videos on it to some interested participants. Interest in e-cigarette amongst our young respondents is shown by the percentage of responses to the question in Table 1.8. It may be due to fascination with a new device or concept, however, even though 56% of our respondents had not considered an alternative, 67% of them were ready to try electronic cigarettes. It is important to note here that e-cigarettes have as of yet are NOT proved to be smoking cessation devices at a significant level, however, due to its capabilities to adjust to various nicotine levels, flavors and imitation of smoking a cigarette they are popular alternatives and may influence smokers to gradually quit smoking or switch to this healthier way due to vaporized nicotine, no smoke and absence of many toxic substances which are present in a regular cigarette. 50% of our respondents were willing to pay Rs.1500 for electronic cigarettes. This could be due to another cool way of smoking, status image associated with expensive items and also the Cost-Benefit analysis. According to research, the cartridges in an electronic cigarette can be recharged and last more than 40 packs of cigarettes, therefore many consumers save a lot of money on buying regular cigarettes. One limitation of the study was that we could not get the respondents to try an actual electronic cigarette therefore for questions 10-12 the responses were mainly in the domain of speculation and uncertainty and mixed responses towards the actual effect of electronic cigarettes on the health and social implications for individuals. However, one interesting find is that 25% of our respondents believed that e-cigarettes can cause non smokers to adopt smoking too, especially females. This is reinforced by our finding on the internet that many sellers of ecigarettes have pictures of females trying it and on the side they have mentioned its benefits. Overall, 33% believed it wouldnt change much because youngsters would still continue smoking irrespective of the method used.

Conclusion:
Our research is not exhaustive however, it does open more areas of research into e-cigarettes for the Pakistani and youngster market here because many people are simply unaware of the alternatives available to them. Also, if proper information on these cigarettes is given to them the usage of these has great potential as shown by our survey and people would be more convinced about its healthiness compared to a regular cigarette if more research and medical evidence is presented to the consumers. Because this kind of cigarette may attract non smokers and even children, government should make regulations for prohibiting it sale to underage consumers and also the society has a moral obligation to educate its citizens over fair and proper usage of these cigarettes. Overall, this new phenomenon has promising potential in Pakistan and may be used in order to curb smoking habits and lessen its harmful impacts in teenagers and young adults.

16 | P a g e

Electronic Cigarettes: Exploratory Research

References:
http://www.smokelessdelite.com/the-advantages-of-the-e-cigarette.php http://ije.oxfordjournals.org/content/33/3/613.full http://www.electronicigarette.net/12-advantages-to-switching-to-electroniccigarettes/ http://www.wtae.com/r/27521448/detail.html

Appendix: Graphs
17 | P a g e

Electronic Cigarettes: Exploratory Research

18 | P a g e