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Use of electronic cigarettes in smoke-free environments
  1. Yuyan Shi1,
  2. Sharon E Cummins1,2,
  3. Shu-Hong Zhu1,2
  1. 1Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California, USA
  2. 2Moores UCSD Cancer Center, University of California, San Diego, La Jolla, California, USA
  1. Correspondence to Dr Shu-Hong Zhu, Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive, MC 0905, La Jolla, CA 92093–0905, USA; szhu{at}


Background Although most US states prohibit cigarette smoking in public places and worksites, fewer jurisdictions regulate indoor use of electronic cigarettes (e-cigarettes). Given the dramatic increase in e-cigarette use and concern about its impact on non-users, there is a need to examine the use of e-cigarettes in smoke-free environments and related attitudes and perceptions.

Methods Recruited from a nationally representative adult panel (GfK's KnowledgePanel), 952 current users of e-cigarettes completed a cross-sectional online survey in 2014. Multivariate logistic regressions were conducted to examine the factors associated with ever using e-cigarettes in smoke-free environments.

Results Overall, 59.5% of e-cigarette users had vaped where cigarette smoking was not allowed. Young adults (18–29 years) were most likely to do so, 74.2%. The places of first-time use most often mentioned were service venues (bar, restaurant, lounge and club), 30.7%, followed by worksites, 23.5%. Daily e-cigarette users were more likely to have vaped in smoke-free environments than non-daily users (OR=2.08, p=0.012). Only 2.5% of those who used e-cigarettes in smoke-free environments reported negative reactions from other people. Most e-cigarette users did not think e-cigarettes are harmful to themselves or to by-standers, and thus should not be banned where smoking is; those who had used e-cigarettes where smoking is banned were even more likely to hold these views.

Conclusions E-cigarette use in smoke-free environments was common, suggesting that most e-cigarette users do not consider smoke-free laws to apply to e-cigarettes. Explicit laws should be considered if jurisdictions want to prohibit e-cigarette use in public places.

  • Electronic nicotine delivery devices
  • Public policy
  • Surveillance and monitoring

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  • Contributors YS, SC and SZ conceptualised the study. YS conducted the statistical analyses and wrote the first draft. All authors participated in writing and finalising the paper.

  • Funding This project was supported by a grant from National Cancer Institute under the State and Community Tobacco Initiative U01 CA154280 to UC San Diego (PI: Shu-Hong Zhu). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

  • Competing interests None declared.

  • Ethics approval University of California, San Diego’s Institutional Review Board.

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