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Electronic Cigarettes

Electronic cigarettes section last updated: April 2014  

Suggested citation style: Electronic cigarettes (ENDS) section, Key findings on electronic cigarettes (ENDS), accessed 18.04.14.


The purpose of this section is to provide information on electronic nicotine delivery systems (ENDS), among which the most widely known and used are electronic cigarettes (popularly referred to as ‘e-cigarettes’ or ‘e-cigs’). In this section we use the term “e-cigarettes”, because it is the most widely used term in the scientific literature, by the media and the public.

The product category is very diverse and includes products marketed as 'electronic cigarettes', 'electronic cigars', 'electronic waterpipes' and others. Within each of these product types there is great variability in product content, emissions, and operational features. Some resemble cigarettes ('cigalikes') and others ('new-generation') have refillable atomizers and high-capacity batteries. In common are the following components: an aerosol generator, a flow sensor, a battery and a nicotine-containing solution storage area (Brown & Cheng, 2014).

Unlike tobacco cigarettes, e-cigarettes do not burn tobacco. Instead, they vaporize a liquid comprising a humectant, commonly propylene glycol and glycerin in a 70/30% mixture, plus (usually) nicotine, flavors and other additives. The liquid is contained in disposable cartridges, ‘cartomizers’ (cartridges combined with vaporizers into a single unit) or in some models, refillable reservoirs ('tanks'). When users draw on the mouthpiece (or press a button on tank e-cigarette models), the heating element is activated, vaporizing the humectant into a mist that can be inhaled.

E-cigarettes first appeared on the market in China in 2003 and have since become widely available throughout the world (Adkison et al., 2013). Most are sold by distributors via the internet, or through a range of retail outlets.

Awareness and use of e-cigarettes is growing rapidly: Google search queries for e-cigarettes from 2008-2010 increased substantially over this period (Ayers et al., 2012) among US adults taking part in mail-in surveys in 2009 and 2010, awareness doubled from 16% in 2009 to 32% in 2010 (Regan et al., 2013).

Among people responding to web surveys in the US in 2010 and 2011, ever-use almost doubled from 3% to 6% in 2011 (King et al., 2013) and in Great Britain current use more than doubled from 2.7% of smokers in 2010 to 6.7% in 2012 (Dockrell et al, 2013).

The reasons for use vary from survey to survey but a high proportion of smokers say they use them to try to quit (Etter, 2010; Vickerman et al., 2013), to reduce consumption (Kralikova et al., 2013), because they are cheaper than cigarettes, or to obtain nicotine when in smoke-free areas (Etter, 2010).

Adkison SE, O'Connor RJ, Bansal-Travers M, Hyland A, Borland R, Yong HH, Cummings KM, McNeill A, Thrasher JF, Hammond D, Fong GT. Electronic nicotine delivery systems: international tobacco control four-country survey. Am J Prev Med. 2013 Mar;44(3):207-15.

Ayers JW, Ribisl KM, Brownstein JS. Tracking the rise in popularity of electronic nicotine delivery systems (electronic cigarettes) using search query surveillance. Am J Prev Med. 2011 Apr;40(4):448-53.

Brown CJ, Cheng JM. Electronic cigarettes: product characterisation and design considerations. Tob Control. 2014 May;23(suppl 2):ii4-ii10.

Dockrell M, Morrison R, Bauld L, McNeill A. E-cigarettes: prevalence and attitudes in Great Britain. Nicotine Tob Res. 2013 Oct;15(10):1737-44.

Etter JF. Electronic cigarettes: a survey of users. BMC Public Health. 2010 May 4;10:231.

King BA, Alam S, Promoff G, Arrazola R, Dube SR. Awareness and ever-use of electronic cigarettes among U.S. adults, 2010-2011. Nicotine Tob Res. 2013 Sep;15(9):1623-7.

Kralikova E, Novak J, West O, Kmetova A, Hajek P. Do e-cigarettes have the potential to compete with conventional cigarettes?: a survey of conventional cigarette smokers' experiences with e-cigarettes. Chest. 2013 Nov;144(5):1609-14.

Regan AK, Promoff G, Dube SR, Arrazola R. Electronic nicotine delivery systems: adult use and awareness of the 'e-cigarette' in the USA. Tob Control. 2013 Jan;22(1):19-23.

Vickerman KA, Carpenter KM, Altman T, Nash CM, Zbikowski SM. Use of electronic cigarettes among state tobacco cessation quitline callers. Nicotine Tob Res. 2013 Oct;15(10):1787-91. logo