Patterns of e-cigarette use, biochemically verified smoking status and self-reported changes in health status of a random sample of vapeshops customers in Greece.

Introduction:
This article reports the findings of a study on the characteristics and smoking status of a random sample of e-cigarette users in Greece. The study aimed to determine the characteristics and smoking status, objectively verified by measuring exhaled carbon monoxide (eCO), of a random sample of e-cigarette users, customers of a random sample of vape-shops in Athens.

Key Points:

* The study selected 14 vapeshops in the region of Athens and recruited every third customer buying products for personal use.
* Current smoking status was assessed by measuring exhaled carbon monoxide (eCO), with a value ≥ 7 ppm being used to classify subjects as current smokers.
* A questionnaire was used to examine past smoking status, patterns of e-cigarette use, changes in health status and experienced side effects.
* A total of 309 participants were analyzed, with 82.5% being daily e-cigarette users.
* The vast majority (98%) were smokers before e-cigarette use initiation, with 69.6% of them having eCO < 7 ppm (former smokers).
* Most participants were using third-generation devices (61.8%) and non-tobacco flavors (58.9%).
* The average liquid consumption was 5 mL/day.
* Most participants experienced health benefits, mainly improvement in physical status, exercise capacity, olfactory and gustatory senses, while the most common side effects were throat irritation and cough.

Main Message:
The study found that vapeshops customers in Greece are mainly current and former smokers with the majority of them having quit smoking. E-cigarette use by never smokers is rare and none of them subsequently initiate smoking. These findings suggest that e-cigarettes may be an effective tool for smoking cessation and reduction, and that their use by never smokers is not a significant concern. However, further research is needed to confirm these findings and to better understand the long-term health effects of e-cigarette use.

Diamantopoulou E, Barbouni A, Merakou K, Lagiou A, Farsalinos K. Patterns of e-cigarette use, biochemically verified smoking status and self-reported changes in health status of a random sample of vapeshops customers in Greece. Internal and emergency medicine. 2019;14(6):843-851. doi:10.1007/s11739-018-02011-1