Electronic Nicotine Delivery Systems Could Help Reduce Smoking

New Study Among Current and Former Smokers in Four Countries Reveals Awareness, Perceptions, and Usage Patterns, American Journal of Preventive Medicine Reports

San Diego, CA, February 5, 2013 – Electronic nicotine delivery systems (ENDS), or e-cigarettes, debuted in China in 2003 and have since become available globally, particularly through the Internet. While they resemble traditional tobacco cigarettes, they produce fewer toxins in the vapor for the smoker. Still, these novel products have unknown long-term health and addiction consequences, are of varying nicotine content and delivery, and may appeal to nonusers and youth. ENDS have been banned by health authorities in Canada and Australia.

Researchers from the United States, Australia, the United Kingdom, and Canada investigated ENDS awareness, use, and perceptions among current and former cigarette smokers.

“We were not aware of any studies to date that examined cross-national patterns of ENDS use,” says lead investigator Richard J. O’Connor, PhD, Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York. “No studies have examined use in markets where ENDS are nominally banned.”

Data from the International Tobacco Control (ITC) Four-Country Survey, collected from nearly 6,000 respondents through telephone and web surveys from July 2010 to June 2011, formed the basis of the study. Across countries, ENDS awareness reached nearly 47 percent, ranging from 73 percent in the United States where ENDS are legal, to 20 percent in Australia where they are banned. Awareness was higher among younger (aged 18-24), non-minority populations with higher incomes. Of those aware, 16 percent had tried ENDS.

Slightly more than 70 percent of respondents said that ENDS were less harmful than traditional cigarettes. Perceptions of harm were higher in the United States and the United Kingdom.

Current users included non-daily smokers and those who smoked twenty or more cigarettes a day. Nearly 80 percent reported they used ENDS because they were considered less harmful than traditional cigarettes. Seventy-five percent said they used ENDS to reduce the number of cigarettes they smoke. Eighty-five percent reported using ENDS to help them quit smoking. Nearly three-quarters reported use of ENDS to access nicotine in smoke-free spaces, suggesting the use of ENDS to satisfy nicotine addiction during periods of temporary abstinence.

The high level of awareness of ENDS in countries where they are banned may demonstrate the importance of the Internet’s promotion of the product.

Says Dr. O’Connor: “This study represents a snapshot in time of the use of ENDS from mid-2010 to mid-2011. As the market evolves, awareness, trial, and use of ENDS is likely to increase. Should regulatory authorities approve direct claims about reduced harm, one might expect greater adoption of these products, at least among current cigarette smokers. If credible evidence can be provided to regulators, through independently researched, well-controlled studies, that ENDS reduces the number of cigarette smokers and does not attract use among nonsmokers, then the net public health effect is likely to be positive.”

# # #

Notes for Editors
“Electronic Nicotine Delivery Systems: International Tobacco Control Four-Country Survey,” by Sarah E. Adkison, MA; Richard O’Connor, PhD; Maansi Bansal-Travers, PhD; Andrew Hyland, PhD; Ron Borland, PhD; Hua-Hie Yong, PhD; K. Michael Cummings, PhD, MPH; Ann McNeill, PhD; James F. Thrasher, PhD, David Hammond, PhD; Geoffrey T. Fong, PhD (DOI: 10.1016/j.amepre.2012.10.018). It appears in the American Journal of Preventive Medicine, Volume 44, Issue 3 (March 2013), published by Elsevier. Full text of the article is available to credentialed journalists upon request; contact Brianna Lee at +1 858 534 9407 oreAJPM@ucsd.edu. Journalists wishing to interview the authors should contact Ann Deck-Miller at +1 716 845 8593 or Ann.Deck-Miller@RoswellPark.org.

About The American Journal of Preventive Medicine
The American Journal of Preventive Medicine (www.ajpm-online.net) is the official journal of The American College of Preventive Medicine (www.acpm.org) and the Association for Prevention Teaching and Research (www.aptrmweb.org). It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

The American Journal of Preventive Medicine, with an Impact Factor of 4.044, is ranked 12th out of 157 Public, Environmental and Occupational Health titles and 17th out of 153 General & Internal Medicine titles according to the 2011 Journal Citation Reports® published by Thomson Reuters.

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence, and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact
Brianna Lee
+1 858 534 9407
eAJPM@ucsd.edu