الفهرس 
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Abstract
Summary
Electronic cigarettes (E-cigs) are devices designed to deliver nicotine and other constituents by burning an electronic cigarette liquid (E-liquid) via vaping rather than smoke and without combustion of tobacco. They are considered as a safer alternative to conventional cigarettes and now they are marketed as lifestyle-choice consumables (Abelia et al., 2023).
Electronic cigarettes (E-Cigs) have become more popular among current cigarette smokers due to their perceived safety and targeted marketing as a potential cessation aid to regular smoking. The long-term health effects of E-Cigs use are not known, and the evidence for E-Cigs as a smoking cessation aid has also been inconclusive (Vindhyal et al., 2020).
E-cigarette use was associated with myocardial infarction (MI), with an odds ratio of 1.7 for e-cigarette users relative to nonusers of e-cigarettes. Additionally, e-cigarette use has been associated with hemodynamic changes, affecting cardiac physiology. It causes an increase in heart rate and systolic blood pressure, albeit these changes were noted in the short-term, as vitals were taken only 20 minutes post vaping. It also, causes an overall increase in sympathetic predominance (Walley & Wilson, 2021).
Aim of the study
This study aimed to investigate heart disease patients’ awareness toward electronic cigarette smoking through:
Identifying patients’ knowledge toward electronic cigarette smoking.
Assessing patients’ attitude toward electronic cigarette smoking.
Assessing the patients’ health status.
Research Questions:
What is the heart disease patients’ knowledge about electronic cigarette smoking?
What is the heart disease patients’ attitude about electronic cigarette smoking?
Is there a relation between the patients’ knowledge and their sociodemographic characteristics?
Is there a relation between the patients ’attitude and their sociodemographic characteristics?
Subjects and Methods
A descriptive analytical research design was used in this study. The study was conducted at Cardiac outpatient clinic at Menofia University Hospital. The total attending patients at cardiac outpatient clinic were 8506 patients. Sample size was 368 patients. A purposive sample was used in this study.
Inclusion criteria:
The age from 18 to 55 years.
Smokers
Tools of data collection:
The data for this study were collected by using three tools:
Tool I: interviewing questionnaire:
Data was collected by using the interviewing questionnaire. It was written in an Arabic language and divided into three parts:
Part 1: It was concerned with socio-demographic characteristics of the patients. It consists of 7 questions.
Part 2: It was concerned with patients’ knowledge regarding electronic cigarette smoking. It consists of 11questions.
Part 3: It was concerned with the health status of the studied patients such as medical history, family history, smoking history.
Tool II:
A four points Likert-type scale was used to assess patients’ attitude toward ECS. It contains 13 statements. It was modified from (Feng et al., 2019 and Wang et al., 2020) by the investigator related to the aim of the study.
Tool III:
It was concerned with a medical record for the studied patients such as vital signs, investigations, weight, height and Body Mass Index (BMI).
Results:
The most important findings that obtained from the present study can be summarized as the following:
Patient’s age range was 45-≤55 with Mean SD=52.93 ± 7.27.
Regarding to educational level 44% of the studied patients had secondary school.
There were 98.9% of the studied patients were males.
There were 83.2% of the studied patients were married.
There were 36.7% of the studied patients had information about electronic cigarette from internet and social networking sites.
There were 69.0% of the studied patients had unsatisfactory level of total knowledge about electronic cigarette smoking.
There were 76.6% of the studied patients had negative attitude toward electronic cigarette smoking.
There were a highly statistically significant difference between age, gender and educational level with total level of knowledge (P= <0.01).
There was a statistically significant difference between total patient’s attitude level and their age, occupation and educational level (P= < 0.05).
There was a highly significant positive correlation between total patients’ knowledge and their total attitude level regarding electronic cigarette smoking (P= < 0.01).
Conclusion
On the light of the findings of the present study and research questions, it can be concluded that:
More than two thirds of the studied patients had unsatisfactory level of total knowledge about electronic cigarette smoking. More than three quarters of the studied patients had negative attitude toward electronic cigarette smoking. Also, there was a highly statistically significant difference between age, gender and educational level with total level of knowledge (P= <0.01). Moreover, there was a statistically significant difference between total patient’s attitude level and their age, occupation and educational level (P= <0.05). Finally, there was a highly significant positive correlation between total patients’ knowledge and their total attitude level regarding electronic cigarette smoking (P= <0. 01).
Recommendations
Development of educational health programes to raise awareness of smokers, heart disease patients and public about e-cigarette smoking through mass media, social media, clear language booklets and simplified brochures.
Further research is necessary to investigate contributing factors associated with using of e-cigarettes among heart disease patients.
Further studies including larger numbers of cardiac outpatient clinics from different geographical areas in Egypt to generalize the results.