The Use and Perception of Electronic Cigarettes and Snus among the U.S. Population

Introduction:
This study aimed to provide measures on how much of a foot-hold e-cigarettes had already taken among the U.S. population before Lorillard Inc. purchased a well-known e-cigarette brand and started a significant television advertising campaign. The study uses a survey of a probability sample of the U.S. population to examine knowledge about e-cigarettes among smokers and nonsmokers, provide population prevalence measures on ever and current use of e-cigarettes and the rate of transition from ever use to current use, assess perceived utility of e-cigarettes as a quitting aid or as a potential harm reduction product and compare it with that of snus, and estimate the proportion of the U.S. population that is susceptible to future e-cigarette use.

Key Points:

* The study is based on a survey commissioned by the University of California, San Diego and administered by Knowledge Networks.
* Knowledge Networks recruits a probability sample representative of the U.S. population using an address-based sampling methodology.
* The survey was designed to gather information on smoking history and cigarette use, perceptions about different tobacco products and quitting aids, attitudes toward tobacco control efforts, and beliefs and ideation about the process of quitting smoking.
* The study oversampled the smokers in the KnowledgePanel so that all the available smokers were included, with a random sub-sample of former smokers and never smokers from the panel.
* Cigarette smoking behavior was assessed using multiple questions, with current smokers defined as those who had smoked at least 100 cigarettes in their lifetime and answered the question, “Do you currently smoke cigarettes every day, some days, or not at all?” with “every day” or “some days”.
* Use of e-cigarettes was assessed by asking respondents if they have ever heard of e-cigarettes, where they had heard about e-cigarettes, whether they had used e-cigarettes or snus, how often they used them, and why they used them.
* The survey was conducted between February 24th and March 8th, 2012.

Main Message:
The study found that e-cigarettes have surpassed snus in adoption rate among the U.S. population, with approximately 8% reporting ever use and 1.44% reporting current use. Women were more likely than men to have tried e-cigarettes, and both current and recent former smokers were more likely to have tried and to be currently using e-cigarettes than snus. The study also found that over 80% of current e-cigarette users were non-daily users, and that those who had tried e-cigarettes were more likely than those who tried snus to report their products being safer than regular cigarettes. The study concludes that e-cigarette use is likely to increase in the next few years and that the design and packaging of e-cigarettes may have contributed to their appeal to women. The study also notes that the rationale for banning e-cigarettes is chiefly based on predicted potential harm, and that insufficient scientific research on the safety and efficacy of e-cigarettes is one reason for the controversy surrounding their regulation.

Zhu, Shu-Hong, Anthony Gamst, Madeleine Lee, Sharon Cummins, Lu Yin, and Leslie Zoref. “The Use and Perception of Electronic Cigarettes and Snus among the U.S. Population.” Edited by Alan Blum. PLoS ONE 8, no. 10 (October 24, 2013): e79332. https://doi.org/10.1371/journal.pone.0079332.