Trends in use of electronic cigarettes in England 2011-2013 Robert West Emma Beard Jamie Brown

Questions How has prevalence of electronic cigarette use for smoking cessation and harm reduction changed since 2011? What effect does this appear to be having on incidence of quit attempts? use of licensed nicotine products for harm reduction and cessation? cigarette consumption?

Methods Smoking Toolkit Study (www.smokinginengland.info) Monthly household surveys 1800 per month aged 16+ Representative sample in England

Prevalence of electronic cigarette use Significant increase p<0.001

Use by smokers vs recent ex-smokers

Mean daily electronic cigarette use Some e-cigarette models are designed to correspond to more than one tobacco cigarette

Prevalence of electronic cigarette use in most recent quit attempt Significant increase p<0.001

Quitting behaviour Significant increase p<0.05

Attempts to quit by smokers Significant increase p<0.05

Prevalence of current use of all nicotine products (NRP) Significant increase p<0.001 NRP=NRT plus electronic-cigarettes

Prevalence of current use of NRT Significant decrease p<0.001

Prevalence of nicotine product use in most recent quit attempt Significant increase p=0.05

Cigarette consumption

Conclusions Prevalence of e-cigarette use has increased 5-fold It is partly substituting for use of NRT 80-90% of users are smokers The incidence of quit attempts has increased It is not taking market share from cigarettes The situation is changing rapidly and needs close monitoring