Article Text

Download PDFPDF
Electronic cigarette use and cigarette smoking in vehicles among adults who use electronic cigarettes and cigarettes in the USA
  1. Eric K Soule1,2,
  2. Sinan Sousan3,4,
  3. Jack Pender5,
  4. Alisha Thomas1,
  5. Neal Patel1
  1. 1Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
  2. 2Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
  3. 3Department of Public Health, East Carolina University, Greenville, North Carolina, USA
  4. 4North Carolina Agromedicine Institute, Greenville, North Carolina, USA
  5. 5Department of Chemistry, East Carolina University, Greenville, North Carolina, USA
  1. Correspondence to Dr Eric K Soule, Department of Health Education and Promotion, East Carolina University, Greenville, NC 27858, USA; soulee18{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Some people who use e-cigarettesf report using e-cigarettes indoors, including in vehicles, as a benefit of e-cigarettes because the aerosol does leave an unpleasant smell and they perceive that e-cigarette use will not harm bystanders, including children.


  • E-cigarette use in vehicles is common, almost all people who use e-cigarettes report some e-cigarette use in their vehicles, and e-cigarette use in vehicles is more common among those who exclusively use e-cigarettes compared to cigarette smoking in vehicles among those who use both e-cigarettes and cigarettes.

  • E-cigarette use in vehicles when others are present may be viewed as more permissible than cigarette smoking, and while e-cigarette use was less common when children or adults were present in vehicles, the current study suggests that many who do not use tobacco may be exposed to e-cigarette aerosol when riding in vehicles with people who use e-cigarettes.


  • Research is needed to examine the health impacts of secondhand e-cigarette aerosol exposure in vehicles on those who do not use e-cigarettes or other tobacco products.

  • Policy makers may consider extending policies that prohibit smoking in vehicles to also prohibit e-cigarette use in vehicles when children are present.


More than 1600 municipalities in the USA have implemented clean indoor air policies that limit tobacco use in public indoor settings.1 Some policies also prohibit cigarette smoking in private vehicles when children are present.2 However, most policies do not extend to electronic cigarette (e-cigarette) use in vehicles. While e-cigarette aerosol contains lower amounts of some chemicals found in cigarette smoke,3 e-cigarette aerosol contains harmful chemicals and particulate matter4–8 that are also present in secondhand e-cigarette aerosol.9 Secondhand e-cigarette aerosol exposure causes increases in e-cigarette-generated chemicals among those who do not use e-cigarettes.10 Therefore, exposure to secondhand e-cigarette aerosol may lead to adverse health effects …

View Full Text


  • Contributors ES, AT and NP developed the survey and conducted the cognitive interviews to test the survey. ES conducted the data analysis and wrote the first draft of the manuscript. SS, JP, AT and NP provided critical review of the manuscript and all authors approved the final version.

  • Funding This research was supported by the National Institute of Environmental Health Sciences (grant number R15ES032138) of the National Institutes of Health (NIH). ES’s effort is also supported by the National Institute on Minority Health and Health Disparities (grant number P50MD017319) and by the National Institute on Drug Abuse of the National Institutes of Health and the Center for Tobacco Products (grant number U54DA036105) of the US Food and Drug Administration (FDA).

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the views of the NIH or the FDA.

  • Competing interests ES is named on a patent application for a smartphone app that determines electronic cigarette device and liquid characteristics.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.