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.

Keywords: ENDS; Europe; cross-sectional study; electronic cigarettes; nicotine.

Figure 1.. Country-specific prevalence (%)^a of electronic cigarette use among subjects aged ≥15 years in 12 selected European countries: TackSHS, 2017–2018. ^aCountry weights were applied, which combined individual weights with an additional weighting factor, each country contributing in proportion to its population aged 15 years or over (from Eurostat).

Figure 2.. Use of electronic cigarettes in selected indoor and outdoor areas, among 272 users who visited the corresponding setting in the last 6 months in 12 European countries. Proportions (%) and corresponding 95% confidence intervals: TackSHS survey 2017–2018. For each setting, numbers in round brackets are number of the participants who visited the corresponding setting in the last 6 months and the percentages of participants who visited the setting in the last 6 months. CI, confidence interval.