Next Article in Journal
How Has the Availability of Snus Influenced Cigarette Smoking in Norway?
Previous Article in Journal
Liver δ-Aminolevulinate Dehydratase Activity is Inhibited by Neonicotinoids and Restored by Antioxidant Agents
Article Menu

Export Article

Correction published on 27 April 2015, see Int. J. Environ. Res. Public Health 2015, 12(5), 4631-4637.

Open AccessArticle

Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project

Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
Ontario Institute for Cancer Research, MaRS Center, West Tower, 661 University Avenue, Suite 510, Toronto, Ontario, M5G 0A3, Canada
Medical University of South Carolina, 171 Ashley Ave, Charleston, SC 29425, USA
The Cancer Council Victoria, 615 St. Kilda Road, Melbourne, Victoria 3004, Australia
King's College London, Strand, London, WC2R 2LS, UK
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
Arnold School of Public Health, University of South Carolina, Colombia, SC 29208, USA
Mexican Institute of Public Health, Universidad N. 655 Colonia Stana Maria Ahuacatitlan, Cerrada Los Pinos y Caminera C.P. 62100, Cuernavaca, Mor, Mexico
Maastricht University (CAPHRI), P. Debyeplein 1, 6229 HA Maastricht, the Netherlands
National Cancer Center of Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang-si Gyeonggi-do, 410-769, Korea
China Center for Disease Control and Prevention, 155 Changbai Road Changping District, Beijing 102206, China
National Cancer Institute of Brazil, Praca Cruz Vermelha, 23, Centro, 20230-130, Rio de Janeiro, Brazil
University Sains Malaysia, Jalan Sungai Dua, 11800 Georgetown, Pulau Pinang, Malaysia
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2014, 11(11), 11691-11704;
Received: 5 June 2014 / Revised: 24 October 2014 / Accepted: 28 October 2014 / Published: 13 November 2014
PDF [670 KB, uploaded 24 November 2014]


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: 35%), 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%), Mexico (4%), Canada (4%), Brazil (3%), 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%)). 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. View Full-Text
Keywords: e-cigarette; electronic cigarette; nicotine; smoking; international e-cigarette; electronic cigarette; nicotine; smoking; international
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Share & Cite This Article

MDPI and ACS Style

Gravely, S.; Fong, G.T.; Cummings, K.M.; Yan, M.; Quah, A.C.K.; Borland, R.; Yong, H.-H.; Hitchman, S.C.; McNeill, A.; Hammond, D.; Thrasher, J.F.; Willemsen, M.C.; Seo, H.G.; Jiang, Y.; Cavalcante, T.; Perez, C.; Omar, M.; Hummel, K. Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project. Int. J. Environ. Res. Public Health 2014, 11, 11691-11704.

Show more citation formats Show less citations formats

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top