Electronic cigarette use among Italian smokers: patterns, settings, and adverse events

Silvano Gallus*, Elisa Borroni, Xiaoqiu Liu, Laura Carrozzi, Gianfranco Dalla Pietra, Shokoofe Eslami Varzaneh, Sergio Hararis, Giovanni Inciso, Paola Martucci, Maria Papale, Francesco Pistelli, Biagio Polla, Maria Francesca Polo, Rosastella, Nolita Pulera, Stefania Raschi, Riccardo Sarzani, Antonella Serafini, Anna Odone, Piet van den BrandtAlessandra Lugo

*Corresponding author for this work

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Information is scanty on the patterns and settings of electronic cigarette use and on its possible adverse events. To fill the knowledge gap on these issues, we conducted a survey among ever-smokers attending smoking cessation services (SCS) in Italy.


In 2016-2018, we enrolled 395 ever-smokers aged > 18 years who were current or former electronic cigarette users in 12 SCS from northern, central, and southern Italy.


In all, 12.4% of ever smokers were regular, 9.4% occasional, and 78.2% past users of electronic cigarettes. Of all users, 93.8% consumed electronic cigarettes with nicotine, 95.9% used refillable devices, and 76.6% purchased electronic cigarette devices or liquids in vape shops. The mean duration of use was 3.7 months and the mean number of puffs per day was 86. Among users, 71.5% used electronic cigarettes in at least 1 smoke-free indoor environment, 53.7% in workplaces, 49.5% in restaurants and bars, 33.5% in train/metro stations or airports, and 18.4% in public transports. The use of electronic cigarettes in smoke-free environments significantly decreased with age and increased with duration of use and nicotine dependence. In our sample, 47.1% reported at least 1 adverse event attributable to electronic cigarette use: 19.5% dry cough, 12.0% dry mouth, 7.6% throat or mouth irritation, and 6.8% sore throat.


In Italy, most conventional cigarette smokers use electronic cigarettes where smoking conventional cigarettes is prohibited. About half of users reported 1 or more symptoms attributable to electronic cigarettes, despite the relatively short duration of use.

Original languageEnglish
Article number0300891620915784
Pages (from-to)229-240
Number of pages12
Issue number3
Publication statusPublished - Jun 2020


  • E-cigarettes
  • adverse events
  • patterns of use
  • survey
  • Italy

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