Patterns of electronic cigarette use and user beliefs about their safety and benefits: An Internet survey

UK Centre for Tobacco Control Studies, Tobacco Dependence Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
Drug and Alcohol Review (Impact Factor: 1.55). 09/2012; 32(2). DOI: 10.1111/j.1465-3362.2012.00512.x
Source: PubMed


Introduction and aims:
As the popularity of electronic cigarettes (e-cigarettes) increases, it is becoming important to find out more about the characteristics of e-cigarette users, why and how they use the product and whether e-cigarettes are used exclusively or in combination with conventional cigarettes. The objective of this study was to investigate patterns and effects of e-cigarette use and user beliefs about e-cigarette safety and benefits.

Design and methods:
E-cigarette users in Poland were recruited online and asked to participate in a web-based survey. The participants provided information on their smoking history, patterns of e-cigarette use, beliefs and attitudes regarding the product and information on concurrent use of conventional cigarettes.

The survey was completed by 179 e-cigarette users. Almost all participants used e-cigarettes daily. E-cigarettes were primarily used to quit smoking or to reduce the harm associated with smoking (both 41%), and were successful in helping the surveyed users to achieve these goals with 66% not smoking conventional cigarettes at all and 25% smoking under five cigarettes a day. Most participants (82%) did not think that e-cigarettes were completely safe, but thought that they were less dangerous than conventional cigarettes. Sixty percent believed that e-cigarettes were addictive, but less so than conventional cigarettes.

Discussion and conclusions:
The participants primarily used e-cigarettes as a stop-smoking aid or as an alternative to conventional cigarettes, and the majority reported that they successfully stopped smoking. More data on e-cigarette safety and its efficacy in harm-reduction and smoking cessation are needed.

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Available from: Peter Hajek, Apr 09, 2015
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    • "To understand the relative importance of the reasons for e-cigarette use, it is necessary to require respondents to consider a trade-off between their reasons for using e-cigarettes. Here, a few studies have asked respondents to select the primary reason they started using e-cigarettes (Goniewicz et al., 2013; Tackett et al., 2015). We however , are the first to pose the question as a direct trade-off between two fundamental economic motivations and to provide information on the strength of this trade-off. "
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    ABSTRACT: The highly controversial e-cigarette industry has generated considerable policy debate and mixed regulatory responses worldwide. Surprisingly, an issue that has been largely ignored is the categorisation of e-cigarettes as substitutes or (dynamic) complements for conventional smoking. We conduct an online survey of US participants finding that 37% of e-cigarette users view them primarily as complementary. We use this result along-side publicly available data to calibrate a cost-benefit analysis, estimating that complementarity reduces the potential cost-savings of e-cigarettes by as much as 57% (or $3.3-4.9bn p.a.) relative to case with zero complementarity.
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    • "E-cigarettes appear to be much safer than cigarettes, but further studies are required to fully assess their safety for long-term use (Caponnetto et al., 2012). Concerns regarding the possible adverse effects have been raised (Etter, 2010; McQueen et al., 2011; Chen, 2013; Goniewicz et al., 2013). These effects include irritation of the mouth and throat that may diminish over time, indicating a transient effect (Polosa et al., 2011). "
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    ABSTRACT: Development of physiologically relevant test methods to analyse potential irritant effects to the respiratory tract caused by e-cigarette aerosols is required. This paper reports the method development and optimization of an acute in vitro MTT cytotoxicity assay using human 3D reconstructed airway tissues and an aerosol exposure system. The EpiAirway(TM) tissue is a highly differentiated in vitro human airway culture derived from primary human tracheal/bronchial epithelial cells grown at the air-liquid interface, which can be exposed to aerosols generated by the VITROCELL(®) smoking robot. Method development was supported by understanding the compatibility of these tissues within the VITROCELL(®) system, in terms of airflow (L/min), vacuum rate (mL/min) and exposure time. Dosimetry tools (QCM) were used to measure deposited mass, to confirm the provision of e-cigarette aerosol to the tissues. EpiAirway(TM) tissues were exposed to cigarette smoke and aerosol generated from two commercial e-cigarettes for up to 6 hrs. Cigarette smoke reduced cell viability in a time dependent manner to 12% at 6 hrs. E-cigarette aerosol showed no such decrease in cell viability and displayed similar results to that of the untreated air controls. Applicability of the EpiAirway(TM) model and exposure system was demonstrated, showing little cytotoxicity from e-cigarette aerosol and different aerosol formulations when compared directly with reference cigarette smoke, over the same exposure time. Copyright © 2015. Published by Elsevier Ltd.
    Toxicology in Vitro 06/2015; 29(7). DOI:10.1016/j.tiv.2015.05.018 · 2.90 Impact Factor
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    • "Although they usually deliver less nicotine than cigarettes, they have been found to alleviate craving and cigarette withdrawal symptoms [9-11]. Several surveys report that e-cigarette users consider the product a satisfactory replacement for cigarettes and an effective stop-smoking treatment [12-15]. It is therefore not surprising that health professionals who support smokers to stop are being asked to provide information on e-cigarettes [16]. "
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    ABSTRACT: Background Use of e-cigarettes (inhalable vapour producing battery powered devices that aim to simulate tobacco cigarettes), is rising in a number of countries, but as yet none of these products are regulated as medicinal devices or available as smoking cessation treatments. Smokers seeking support from health professionals to stop smoking are interested in e-cigarettes and may be buying them to aid a quit attempt. Determining what smokers are asking, and what health professionals think about these products may have implications for smoking treatment services in a number of countries. Methods Stop smoking service advisors, managers and commissioners in the United Kingdom were asked to take part in two surveys on e-cigarettes. Data was analysed from 587 practitioners who completed a survey in 2011 and 705 practitioners who completed a repeat survey in 2013. Responses to multiple choice questions and free text comments were analysed. Results Responding practitioners reported that interest in, and use of, e-cigarettes is growing among adults seeking help to stop smoking in the UK. In 2013 91% of respondents reported that interest in e-cigarettes had grown in the past year and whilst in 2011, 2% of respondents reported a ‘quarter to a half’ of their clients saying that they were regularly using e-cigarettes, by 2013 this had increased to 23.5% (p < .001). Responding practitioners’ views towards e-cigarettes became more positive between the first and second surveys (15% strongly agreed/agreed in 2011 that ‘e-cigarettes are a good thing’ rising to 26% in 2013). However, they continued to have concerns about the products. In particular, analysis of free text responses suggested practitioners were unsure about safety or efficacy for smoking cessation, and were worried that smokers may become dependent on the products. Practitioners were also aware of the potential of e-cigarettes to undermine smokers’ willingness to use evidence-based methods to stop, and to challenge policies aiming to denormalise tobacco smoking. Conclusions Health professionals are asking for reliable and accurate information on e-cigarettes to convey to smokers who want to quit. Randomized controlled trials and ongoing surveillance of e-cigarette use and its consequences for smoking cessation rates and smoking treatment services are required.
    Tobacco Induced Diseases 08/2014; 12(1):13. DOI:10.1186/1617-9625-12-13 · 1.50 Impact Factor
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