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Electronic nicotine delivery systems: adult use and awareness of the ‘e-cigarette’ in the USA
  1. Annette K Regan,
  2. Gabbi Promoff,
  3. Shanta R Dube,
  4. Rene Arrazola
  1. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to Gabbi Promoff, Issues Management Team Lead, Office on Smoking and Health, Centers for Disease Control and Prevention, 4770 Buford Highway, MS-K50, Atlanta, GA 30341, USA; gpromoff{at}


Background Electronic nicotine delivery systems (ENDS), also referred to as electronic cigarettes or e-cigarettes, were introduced into the US market in 2007. Despite concerns regarding the long-term health impact of this product, there is little known about awareness and use of ENDS among adults in the USA.

Methods A consumer-based mail-in survey (ConsumerStyles) was completed by 10 587 adults (≥18 years) in 2009 and 10 328 adults in 2010. Data from these surveys were used to monitor awareness, ever use and past month use of ENDS from 2009 to 2010 and to assess demographic characteristics and tobacco use of ENDS users.

Results In this US sample, awareness of ENDS doubled from 16.4% in 2009 to 32.2% in 2010 and ever use more than quadrupled from 2009 (0.6%) to 2010 (2.7%). Ever use of ENDS was most common among women and those with lower education, although these were not the groups who had heard of ENDS most often. Current smokers and tobacco users were most likely to try ENDS. However, current smokers who had tried ENDS did not say they planned to quit smoking more often than smokers who had never tried them.

Conclusions Given the large increase in awareness and ever use of ENDS during this 1-year period and the unknown impact of ENDS use on cigarette smoking behaviours and long-term health, continued monitoring of these products is needed.

  • smoking topography
  • youth tobacco use
  • smokeless tobacco products
  • mental health
  • young adults
  • cessation
  • tobacco use
  • tobacco
  • adolescents
  • tobacco industry
  • qualitative study
  • marginalised populations
  • industry public relations/media
  • industry documents
  • electronic nicotine delivery devices
  • surveillance and monitoring

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  • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

  • Correction notice This article has been corrected since it was pubished Online First. References 4 and 5 have been switched, and this sentence on page 4 has been amended to read: Specifically, diethylene glycol has been found a cartridge of ENDS manufactured in China.13 Diethylene glycol has caused mass poisoning and deaths in the past when substituted for propylene glycol.15

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.