Electronic cigarette use in 12 European countries. Results from the TackSHS survey

Silvano Gallus*, Alessandra Lugo, Chiara Stival, Sonia Cerrai, Luke Clancy, Filippos T Filippidis, Giuseppe Gorini, Maria José Lopez, Ángel López-Nicolás, Sabrina Molinaro, Anna Odone, Joan B Soriano, Olena Tigova, Piet A VAN DEN Brandt, Constantine I Vardavas, Esteve Fernandez, TackSHS Project Investigators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Limited data on electronic cigarette prevalence, patterns and settings of use are available from several European countries.

METHODS: Within the TackSHS project, a face-to-face survey was conducted in 2017-2018 in 12 European countries (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania and Spain). Overall, 11,876 participants, representative of the population aged ≥15 years in each country, provided information on electronic cigarette.

RESULTS: 2.4% (95% confidence interval, CI: 2.2-2.7) of the subjects (2.5% among men and 2.4% among women; 0.4% among never, 4.4% among current- and 6.5% among ex-smokers) reported current use of electronic cigarette, ranging from 0.6% in Spain to 7.2% in England. Of the 272 electronic cigarette users, 52.6% were dual users (i.e., users of both electronic and conventional cigarettes) and 58.8% used liquids with nicotine. In all, 65.1% reported using electronic cigarette in at least one indoor setting where smoking is forbidden, in particular in workplaces (34.9%), and bars and restaurants (41.5%). Multivariable logistic regression analysis showed that electronic cigarette use was lower among older individuals (p for trend <0.001) and higher among individuals with high level of education (p for trend 0.040). Participants from countries with higher tobacco cigarette prices more frequently reported electronic cigarette use (odds ratio 3.62; 95% CI: 1.80-7.30).

CONCLUSIONS: Considering the whole adult population of these 12 European countries, more than 8.3 million people use electronic cigarettes. The majority of users also smoked conventional cigarettes, used electronic cigarettes with nicotine and consumed electronic cigarettes in smoke-free indoor areas.

Original languageEnglish
Pages (from-to)276-284
Number of pages9
JournalJournal of Epidemiology
Issue number6
Early online date13 Nov 2021
Publication statusPublished - Jun 2023


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