Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project

Abstract

Background: In recent years, electronic cigarettes (e-cigarettes) have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents self-reported awareness, trial and current use of e-cigarettes in 10 countries surveyed between 2009 and 2013; for six of these countries, we present the first data on e-cigarettes from probability samples of adult smokers. Methods: A cross-sectional analysis of probability samples of adult (≥ 18 years) current and former smokers participating in the International Tobacco Control (ITC) surveys from 10 countries. Surveys were administered either via phone, face-to-face interviews, or the web. Survey questions included sociodemographic and smoking-related variables, and questions about e-cigarette awareness, trial and current use. Results: There was considerable cross-country variation by year of data collection and for awareness of e-cigarettes (Netherlands (2013: 88%), Republic of Korea (2010: 79%), United States (2010: 73%), Australia (2013: 66%), Malaysia (2011: 62%), United Kingdom (2010: 54%), Canada (2010: 40%), Brazil (2013: 35%), Mexico (2012: 34%), and China (2009: 31%)), in self-reports of ever having tried e-cigarettes (Australia, (20%), Malaysia (19%), Netherlands (18%), United States (15%), Republic of Korea (11%), United Kingdom (10%), Mexico (4%), Canada (4%), Brazil (3%), and China (2%)), and in current use (Malaysia (14%), Republic of Korea (7%), Australia (7%), United States (6%), United Kingdom (4%), Netherlands (3%), Canada (1%), and China (0.05%)). Conclusions: The cross-country variability in awareness, trial, and current use of e-cigarettes is likely due to a confluence of country-specific market factors, tobacco control policies and regulations (e.g., the legal status of e-cigarettes and nicotine), and the survey timing along the trajectory of e-cigarette awareness and trial/use in each country. These ITC results constitute an important snapshot of an early stage of what appears to be a rapid progression of global e-cigarette use.

Factors Associated With Electronic Cigarette Users’ Device Preferences and Transition From First Generation to Advanced Generation Devices

“…[3][4][5][6] A 2013 report of the International Tobacco Control Four Country Survey found that 7.6% of current and former smokers had tried an e-cig, and of those, 38.7% continued use. 7 Survey research has reported that the most common reasons for initiating use are to reduce or quit conventional smoking, [7][8][9][10][11][12][13][14][15][16][17] although evidence from randomized controlled trials using e-cigs to aid smoking cessation have shown only modest quit rates.…”

Prevalence and predictors of e-cigarette trial among adolescents in Argentina

“…However, over the last few years, the increasing use of electronic cigarettes, commonly known as "e-cigarettes", has become a new public health problem that threatens to interfere with established tobacco control strategies. Several studies from developed countries show that e-cigarette use is increasing both in adults and adolescents [2][3][4][5] . Moreover, the potential for dual use of conventional cigarettes and e-cigarettes could undermine long term tobacco control efforts 6,7 .…”

Conhecimento e uso de cigarros eletrônicos e percepção de risco no Brasil: resultados de um país com requisitos regulatórios rígidos

“…Brazilian smokers' awareness of e-cigs (37.4%) was lower than in other ITC countries without such requirements (Netherlands, 88%; United States, 73%; Republic of Korea, 79%; and United Kingdom, 54%); but ever-use (9%) was not much lower compared to the same countries (18%, 12%, 10%, and 15%, respectively). In contrast, 2009 data from China, a country with no ban, showed lower awareness (31%) and ever-use (2%), likely attributable to Chinese market factors and earlier survey date (2009) 24 . Between-country comparisons should be interpreted with caution because country-specific factors may have contributed to variability.…”