Rise of popularity of electronic cigarettes and correlates with marketing and regulations trajectory

Introduction Electronic nicotine delivery systems (ENDS) were introduced and advertised since five years in Tunisia (The developing African Country), but Public interest in this product is undocumented. Purpose By monitoring search queries, e-cigarettes popularity and correlates were assessed in Tunisia. Methods French-language and Arabic-language Google searches were conducted from Mai 2013 through Mai 2018. Google engine was used to search data related to electronic cigarettes marketing and regulations using terms: electronic cigarettes, e-liquid, vape. The corresponding Arabic terms were also used. We analyzed trends in Google search queries related to ENDS. Searches for each week were scaled to the highest weekly search proportion (100), with lower values indicating the relative search proportion compared to the highest-proportion week (e.g., 5050% of the highest observed proportion). Analyses were performed in Mai 2018. Methods—Google trend were correlates of e-cigarettes marketing and regulations trajectory. Results Searches increased from Mai 2013 through to March 2018. After that, the ENDS search fell and remained stable until the beginning of August 2017. After this date the search for ENDS increased rapidly with a maximum in March 2018. This fall and rising is contemporary to the establishment and easing of the monopoly of the ENDS import and distribution by the national tobacco board and to occurrence of aggressive marketing activities. Conclusions It is necessary to put an end of uncertainty on ENDS regulations and policies in Tunisia. The ratification of the new proposed law classifying ENDS as a tobacco product is a crucial