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June 16th, 2014:

Determinants and prevalence of e-cigarette use throughout the European Union

http://tobaccocontrol.bmj.com/content/early/2014/04/30/tobaccocontrol-2013-051394

Determinants and prevalence of e-cigarette use throughout the European Union: a secondary analysis of 26 566 youth and adults from 27 Countries

Abstract
Objective This study assessed the prevalence and determinants of e-cigarette use among persons aged ≥15 years in 27 European Union (EU) member countries during 2012.

Methods The 2012 Eurobarometer 385 (77.1) survey was analysed for n=26 566 respondents. Knowledge, perception of harm, and determinants of e-cigarettes use were assessed, while separate regression analyses among current (n=7352) and former cigarette smokers (n=5782) were performed. National estimates of the number of e-cigarette users were also extrapolated.

Results 20.3% of current smokers, 4.7% of ex-smokers, and 1.2% of never cigarette smokers in the EU reported having ever used an e-cigarette (overall approximately 29.3 million adults). Among smokers, ever e-cigarette use was more likely among 15–24-year-olds (aOR 3.13, 95% CI 2.22 to 4.54) and 25–39-year-olds (aOR 2.00, 95% CI 1.47 to 2.78) in comparison to older smokers, and among those who smoked 6–10 cigarettes/day (aOR 1.53, 95% CI 1.10 to 2.13) or 11–20 cigarettes/day (aOR 2.07, 95% CI 1.52 to 2.81) in comparison to very light smokers (≤5 cigarettes/day). Moreover, e-cigarette use was more likely among smokers who had made a past year quit attempt (aOR 2.08, 95% CI 1.67 to 2.58). E-cigarette use among ex-smokers was associated only with the respondents’ age, with younger ex-smokers being more likely to have ever used an e-cigarette.

Conclusions A substantial number of EU adults have ever used e-cigarettes. Ever users were more likely to be younger, current smokers, or past-year quit attempters. These findings underscore the need to evaluate the potential long term impact of e-cigarette use on consumer health, cessation and nicotine addiction and formulate a European framework for e-cigarette regulation within the revised EU Tobacco Product Directive.

E-Cigarettes and the Future of Tobacco Control

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Determinants and prevalence of e-cigarette use throughout the European Union

Determinants and prevalence of e-cigarette use throughout the European Union: a secondary analysis of 26 566 youth and adults from 27 Countries

It is noteworthy to report that, based on the above percentages, an extrapolated 3.9 million former smokers and 2.3 million never smokers in the EU reported in 2012 that they had ever used e-cigarettes.

The perception of harm among smokers also significantly varied throughout the EU, with overall 40.6% (38.8% to 42.3%) of smokers reporting e-cigarettes as not harmful, 28.5% (26.9% to 30.1%) as harmful, while 30.9% (29.3% to 32.6%) reported that they did not know if they were or were not harmful.

Multivariate logistic regression analyses performed among all respondents of the 2012 Eurobarometer 385 survey (smokers, ex-smokers, and never smokers, n=26 566), indicated that current smoking of combustible tobacco products was the strongest predictor of ever e-cigarette use (adjusted OR (aOR) 10.63, 95% CI 8.72 to 12.95) (table 2). Participants’ age was a significant determinant of e-cigarette use: younger respondents aged between 15–24 years were 3.3 (95% CI 2.50 to 4.55) times more likely to have used an e-cigarette, those aged 25–39 years were 1.89 times more likely (95% CI 1.43 to 2.50), = it is important to assess the potential harm versus benefits. In light of the new European TPD—which now includes ecigarettes and will provide the regulatory framework for their use within the EU—further research is needed to assess the long term impact of e-cigarette use on consumer health, smoking cessation, and nicotine addiction.

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Public health response to Electronic Nicotine Delivery Systems (ENDS) Letter

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