Feature Briefing

E-cigarettes latest: users on the up but rules tighten

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6444 (Published 27 October 2014) Cite this as: BMJ 2014;349:g6444
  1. Zosia Kmietowicz, news editor, The BMJ

Zosia Kmietowicz summarises the latest information on e-cigarette use, regulation, advertising, and safety

What’s the latest market intelligence on e-cigarettes?

Only one company was making e-cigarettes in 2005, but today there are 466 brands in a market estimated to be worth £1.8bn (€2.3bn; $3bn).1 Many early, small scale companies making e-cigarettes have been swallowed up by tobacco manufacturers. In January 2014 there were 7764 unique flavours on the market, including menthol, fruits, candies, alcoholic drinks, and snacks.2

Around 2.1 million people in the United Kingdom reported regularly using e-cigarettes in 2014, up from 700 000 in 2012.3 In 2010 just 8% of current or former smokers had tried e-cigarettes, but now more than half (52%) have.

It has been estimated that in the European Union 23 million smokers, 3.9 million former smokers, and 2.3 million non-smokers had used e-cigarettes in 2012.4

What’s the latest evidence on whether e-cigarettes help people quit smoking?

Proponents of e-cigarettes argue that they are a safe alternative to cigarettes and are often used by smokers who are trying to wean themselves from tobacco smoking. A recent, widely quoted study showed that smoking e-cigarettes could help some people quit but that they were no more effective than other forms of nicotine replacement.5 Most people who quit smoking do so without any help.

Is there any evidence that e-cigarettes are a gateway to tobacco products?

Many public health officials are concerned that e-cigarettes encourage tobacco use by addicting users to nicotine and by making smoking more socially acceptable. Some commentators have said that children are especially vulnerable, as they are at risk of getting hooked on nicotine and then turn to conventional cigarettes, thus increasing the prevalence of smoking. E-cigarettes may also sustain smoking among smokers who might otherwise have quit or may cause former smokers to begin smoking again.

Most of the evidence indicating that children are increasingly turning to e-cigarettes comes from the United States. One report found that in 2012 …

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