Electronic cigarette use among Italian smokers: patterns, settings, and adverse events

Abstract

Objective: Information is scanty on the patterns and settings of electronic cigarette use and on its possible adverse events. To fill the knowledge gap on these issues, we conducted a survey among ever-smokers attending smoking cessation services (SCS) in Italy. Methods: In 2016–2018, we enrolled 395 ever-smokers aged ⩾18 years who were current or former electronic cigarette users in 12 SCS from northern, central, and southern Italy. Results: In all, 12.4% of ever smokers were regular, 9.4% occasional, and 78.2% past users of electronic cigarettes. Of all users, 93.8% consumed electronic cigarettes with nicotine, 95.9% used refillable devices, and 76.6% purchased electronic cigarette devices or liquids in vape shops. The mean duration of use was 3.7 months and the mean number of puffs per day was 86. Among users, 71.5% used electronic cigarettes in at least 1 smoke-free indoor environment, 53.7% in workplaces, 49.5% in restaurants and bars, 33.5% in train/metro stations or airports, and 18.4% in public transports. The use of electronic cigarettes in smoke-free environments significantly decreased with age and increased with duration of use and nicotine dependence. In our sample, 47.1% reported at least 1 adverse event attributable to electronic cigarette use: 19.5% dry cough, 12.0% dry mouth, 7.6% throat or mouth irritation, and 6.8% sore throat. Conclusion: In Italy, most conventional cigarette smokers use electronic cigarettes where smoking conventional cigarettes is prohibited. About half of users reported 1 or more symptoms attributable to electronic cigarettes, despite the relatively short duration of use.

The Role of Novel (Tobacco) Products on Tobacco Control in Italy

“…Whereas the safety consequences of these products are still largely unknown [1], more and more concerns have been raised by independent research on public health consequences [1, [19][20][21]. In particular: (i) electronic cigarette use has been found to increase-rather than decrease-tobacco smoking in the general adult population [19] and has been associated with tobacco smoking initiation among adolescents [1, [22][23][24][25]; (ii) also never smokers or ex-smokers having quit since several years are attracted to these new products [21]; (iii) novel product users are more frequently dual users consuming the novel product where smoking is forbidden [26]; (iv) the role of electronic cigarette on smoking cessation is unclear and uncertain [1] and, as HTPs are tobacco products, the conversion from conventional cigarettes to HTPs should not be considered cessation [1]; and (v) electronic cigarettes increase the risk of renormalization of smoking in society [1, [27][28][29]. Moreover, a survey conducted in 12 European countries recently showed how a large proportion of ex-smokers using HTPs did not quit smoking switching to HTPs but they firstly quit and then relapsed to the use of tobacco [30].…”

Pharmacological Approach to Smoking Cessation: An Updated Review for Daily Clinical Practice

“…A recent study conducted in Italy showed that almost all e-cigarette users among Italian smokers consumed liquids containing nicotine and most of them used these devices in indoor environments where conventional cigarette smoking is usually banned [48]. Consequently, to avoid the dual use (i.e.…”

The prevalence of xerostomia among e-cigarette or combustible tobacco users: A systematic review and meta-analysis

“…A total of 14 studies were included 8,9,[19][20][21][25][26][27][28][29][30][31][32][33] , with a total sample size of 6827 cases. We summarized the prevalence of xerostomia for all smokers.…”