Electronic Cigarette Use in 12 European Countries: Results From the TackSHS Survey

Abstract

Background Limited data on electronic cigarette prevalence, patterns, and settings of use are available from several European countries. Methods Within the TackSHS project, a face-to-face survey was conducted in 2017–2018 in 12 European countries (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania and Spain). Overall, 11,876 participants, representative of the population aged 15 years in each country, provided information on electronic cigarette. Results 2.4% (95% confidence interval [CI], 2.2–2.7%) of the subjects (2.5% among men and 2.4% among women; 0.4% among never, 4.4% among current- and 6.5% among ex-smokers) reported current use of electronic cigarette, ranging from 0.6% in Spain to 7.2% in England. Of the 272 electronic cigarette users, 52.6% were dual users (ie, users of both electronic and conventional cigarettes) and 58.8% used liquids with nicotine. In all, 65.1% reported using electronic cigarette in at least one indoor setting where smoking is forbidden; in particular, at workplaces (34.9%) and bars and restaurants (41.5%). Multivariable logistic regression analysis showed that electronic cigarette use was lower among older individuals ( P for trend <0.001) and higher among individuals with high level of education ( P for trend = 0.040). Participants from countries with higher tobacco cigarette prices more frequently reported electronic cigarette use (odds ratio 3.62; 95% CI, 1.80–7.30). Conclusion Considering the whole adult population of these 12 European countries, more than 8.3 million people use electronic cigarettes. The majority of users also smoked conventional cigarettes, used electronic cigarettes with nicotine, and consumed electronic cigarettes in smoke-free indoor areas.

E‐cigarette use and conventional cigarette smoking among European students: findings from the 2019 ESPAD survey

“…Although there is consensus that e-cigarette use among adolescents, particularly non-smokers, should be discouraged [18][19][20], of particular concern is the fact that during the past decade vaping has shown a growing prevalence, especially among teenagers, both in the United States [21,22] and among countries in Europe [17,23,24],…”

“…Each TCS variable was dichotomized based on the average of its possible maximum value as conducted by Gallus et al [24] T A B L E 1 Country-specific prevalence (%) of cigarette and e-cigarette current use and corresponding 95% confidence intervals (CI) in 35…”

The Prevalence of Tobacco, Heated Tobacco, and E-Cigarette Use in Poland: A 2022 Web-Based Cross-Sectional Survey

“…The highest smoking prevalence is observed in Eastern Europe (28%) and the lowest in Northern Europe (20%) [13]. Moreover, it is estimated that approximately 2-2.5% of Europeans regularly use electronic cigarettes (e-cigarettes) [11,14]. Moreover, heated tobacco products (such as IQOS or glo) are gaining popularity [15].…”

Reaping what you sow: England's drastic reduction in childhood secondhand smoke exposure in two decades

“…E-cigarette users emit toxicants, including nicotine and ultrafine particles and other potentially harmful substances. 8 , 9 Thus, beyond SHS, exposure to SHA needs consideration and should be a focus for future research particularly in England - by far the country in Europe with the highest prevalence of e-cigarette users 10 and of exposure to SHA. 7 Despite the generally low prevalence of e-cigarette use in Europe (2.4% of the adult population 10 ), daily exposure to SHA is frequently reported by e-cigarette non-users (16.0% 7 ).…”

“… 8 , 9 Thus, beyond SHS, exposure to SHA needs consideration and should be a focus for future research particularly in England - by far the country in Europe with the highest prevalence of e-cigarette users 10 and of exposure to SHA. 7 Despite the generally low prevalence of e-cigarette use in Europe (2.4% of the adult population 10 ), daily exposure to SHA is frequently reported by e-cigarette non-users (16.0% 7 ). This is likely due to the misperception of European e-cigarette users and non-users that SHA is not harmful for human's health.…”