| Summary: | Dual usage of e-cigarettes (ECs) and conventional cigarettes (CCs) may prolong the usage of both products, reducing the urge to quit smoking and increasing nicotine dependence. This study used a mixed method explanatory sequential design, consisting of both quantitative (Phase I) and qualitative (Phase II) methods. In phase 1, secondary data was obtained from the Malaysian Contraband Trade Study comprising 40,000 smokers, which used validated questions originating from the International Tobacco Control (ITC). Phase II recruited 27 dual users based on saturation point and explored their perceptions about EC use and attempts to quit smoking using the integrated components of the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB). According to Phase I findings, there was a total of 5116 (12.8%) dual users of ECs and CCs. Living in an urban area (aOR 1.29, 95%CI:1.21- 1.38), being Muslim (aOR 5.46, 95% CI: 2.88-10.32), being between the ages of 18 and 25 (aOR 10.0, 95% CI 5.59-18.0), had previous attempt to quit smoking CCs (aOR 2.33, 95% CI: 2.16-2.52) and find it somewhat challenging to go without smoking for an entire day (aOR 1.95, 95% CI: 1.56-2.46) were all factors associated with dual use. Regarding the factors associated with the frequency of EC use (daily, weekly and monthly), dual users who used other tobacco products (aOR 1.449, 95% CI 1.144-1.837), planning to quit within a month (aOR 2.188, 95% CI 1.471-3.254), opting for ECs because of their less harmful effects towards health.
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