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Awareness, trial, and current use of electronic cigarettes in 10 countries: Findings from the ITC project

Gravely S 1 , Fong GT 2 , Cummings KM 3 , Yan M 4 , Quah AC 5 , Borland R 6 Show all authors , Yong HH 7 , Hitchman SC 8 , McNeill A 9 , Hammond D 10 , Thrasher JF 11 , Willemsen MC 12 , Seo HG 13 , Jiang Y 14 , Cavalcante T 15 , Perez C 16 , Omar M 17 , Hummel K 18

Affiliations 

  • 1 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. shannon.gravely@uwaterloo.ca
  • 2 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. gfong@uwaterloo.ca
  • 3 Medical University of South Carolina, 171 Ashley Ave, Charleston, SC 29425, USA. cummingk@musc.edu
  • 4 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. m6yan@uwaterloo.ca
  • 5 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. ackquah@uwaterloo.ca
  • 6 The Cancer Council Victoria, 615 St. Kilda Road, Melbourne, Victoria 3004, Australia. Ron.Borland@cancervic.org.au
  • 7 The Cancer Council Victoria, 615 St. Kilda Road, Melbourne, Victoria 3004, Australia. Hua.Yong@cancervic.org.au
  • 8 King's College London, Strand, London, WC2R 2LS, UK. sara.hitchman@kcl.ac.uk
  • 9 King's College London, Strand, London, WC2R 2LS, UK. ann.mcneill@kcl.ac.uk
  • 10 School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. dhammond@uwaterloo.ca
  • 11 Arnold School of Public Health, University of South Carolina, Colombia, SC 29208, USA. thrasher@mailbox.sc.edu
  • 12 Maastricht University (CAPHRI), P. Debyeplein 1, 6229 HA Maastricht, the Netherlands. marc.willemsen@maastrichtuniversity.nl
  • 13 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. hongwan@ncc.re.kr
  • 14 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. jiangyuan88@vip.sina.com
  • 15 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. taniac@inca.gov.br
  • 16 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. cperez@inca.gov.br
  • 17 Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. cummingk@musc.edu
  • 18 Maastricht University (CAPHRI), P. Debyeplein 1, 6229 HA Maastricht, the Netherlands. Karin.hummel@maastrichtuniversity.nl
Int J Environ Res Public Health, 2014 Nov 13;11(11):11691-704.
PMID: 25421063 DOI: 10.3390/ijerph111111691

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: 37%), 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%), Brazil (8%), Mexico (4%), Canada (4%), 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%)) [corrected].

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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