Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project

S. Gravely, G.T. Fong, K.M. Cummings, M. Yan, A.C.K. Quah, R. Borland, H.H. Yong, S.C. Hitchman, A. McNeill, D. Hammond, J.F. Thrasher, M.C. Willemsen, H.G. Seo, Y. Jiang, T. Cavalcante, C. Perez, M. Omar, K. Hummel

Research output: Contribution to journalArticleAcademicpeer-review

31 Citations (Scopus)


Background: In recent years, electronic cigarettes (e-cigarettes) have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents self-reported awareness, trial and current use of e-cigarettes in 10 countries surveyed between 2009 and 2013; for six of these countries, we present the first data on e-cigarettes from probability samples of adult smokers. Methods: A cross-sectional analysis of probability samples of adult (>= 18 years) current and former smokers participating in the International Tobacco Control (ITC) surveys from 10 countries. Surveys were administered either via phone, face-to-face interviews, or the web. Survey questions included sociodemographic and smoking-related variables, and questions about e-cigarette awareness, trial and current use. Results: There was considerable cross-country variation by year of data collection and for awareness of e-cigarettes (Netherlands (2013: 88%), Republic of Korea (2010: 79%), United States (2010: 73%), Australia (2013: 66%), Malaysia (2011: 62%), United Kingdom (2010: 54%), Canada (2010: 40%), Brazil (2013: 35%), Mexico (2012: 34%), and China (2009: 31%)), in self-reports of ever having tried e-cigarettes (Australia, (20%), Malaysia (19%), Netherlands (18%), United States (15%), Republic of Korea (11%), United Kingdom (10%), Mexico (4%), Canada (4%), Brazil (3%), and China (2%)), and in current use (Malaysia (14%), Republic of Korea (7%), Australia (7%), United States (6%), United Kingdom (4%), Netherlands (3%), Canada (1%), and China (0.05%)). Conclusions: The cross-country variability in awareness, trial, and current use of e-cigarettes is likely due to a confluence of country-specific market factors, tobacco control policies and regulations (e.g., the legal status of e-cigarettes and nicotine), and the survey timing along the trajectory of e-cigarette awareness and trial/use in each country. These ITC results constitute an important snapshot of an early stage of what appears to be a rapid progression of global e-cigarette use.
Original languageEnglish
Pages (from-to)11691-11704
JournalInternational Journal of Environmental Research and Public Health
Issue number11
Publication statusPublished - 1 Jan 2014

Cite this

Gravely, S., Fong, G. T., Cummings, K. M., Yan, M., Quah, A. C. K., Borland, R., Yong, H. H., Hitchman, S. C., McNeill, A., Hammond, D., Thrasher, J. F., Willemsen, M. C., Seo, H. G., Jiang, Y., Cavalcante, T., Perez, C., Omar, M., & Hummel, K. (2014). Awareness, Trial, and Current Use of Electronic Cigarettes in 10 Countries: Findings from the ITC Project. International Journal of Environmental Research and Public Health, 11(11), 11691-11704.