New insight into use and awareness of electronic cigarettes

Survey findings released today show new insight into the use and awareness of electronic cigarettes, devices that allow smokers to inhale vaporized nicotine in a cigarette-like fashion. According to a peer-reviewed scientific article in the American Journal of Public Health, 40.2 percent of Americans have heard of e-cigarettes and over 70 percent believe they are less harmful than regular cigarettes. In addition, current smokers are more likely to use e-cigarettes than non-smokers. This is the first nationally representative study to look at awareness and prevalence of these products.

E-cigarettes, formally known as Electronic Nicotine Delivery Systems (ENDS), really are drug-delivery devices and not cigarettes at all. They have recently earned attention in the media, public health and public policy arenas. While proponents claim e-cigarettes are a harm-reducing alternative to smoking, scientists have raised concerns about the need for regulation of any new nicotine-delivery device, as well as how they might affect smokers who are trying to quit, or attract non-smokers – especially youth and young adults – who might be willing to try a "high-tech" approach to nicotine intake or be attracted by the availability of different flavors.

"The data suggest that younger smokers are more likely to have ever tried an e-cigarette," said Jennifer Pearson, PhD, Research Investigator at the Schroeder Institute at Legacy. "We don't know why younger smokers are more likely to try e-cigarettes, but this highlights the need for more information on the health and behavioral consequences of exclusive 'vaping' and dual use with combustible tobacco products."

Researchers from Legacy and its Steven A. Schroeder Institute for Tobacco Research and Policy Studies looked at results on e-cigarette awareness, use, and harm perceptions from more than 6,000 adult participants in two national surveys. "We found that, while overall e-cigarette use is still relatively low, awareness of e-cigarettes is high," Pearson said.

Current smokers are several times more likely to have tried an e-cigarette than non-smokers. The researchers say there could be various reasons for this, including that e-cigarettes are perceived as safer than regular cigarettes, are used as cessation devices, or are used to avoid smoke-free indoor air laws. According to the report, more than 70 percent of Americans believe that e-cigarettes are less harmful than regular cigarettes.

E-cigarettes are constructed to mimic real cigarettes in size and appearance, but contain no tobacco leaf. Though individual brands vary in construction, the products generally produce a propylene glycol mist containing nicotine along with flavorings and other chemicals. A previous study released by the Schroeder Institute showed that some e-cigarette manufacturers have poor quality control over their constituents and generally have much less nicotine than advertised. In response to a 2010 court decision, the U.S. Food and Drug Administration signaled that it will move to regulate e-cigarettes as tobacco products rather than drug delivery devices; however, these products are as yet unregulated, raising serious concerns for public health, since they have poor quality control standards and contain nicotine, a highly addictive substance.

"Given the poor quality control of these products, consumers are taking unknown risks by using e-cigarettes, with little proven new benefits," said David Abrams, PhD, Executive Director of the Schroeder Institute at Legacy. "Until adequate research and regulation is in place, smokers should be wary of using e-cigarettes, and smokers who want to quit should, instead, pursue research-proven effective cessation tools, such as nicotine replacement products, telephone quit lines and Web-based cessation services, as well as non-nicotine pharmacotherapies like bupropion and varenicline," Abrams added.