title: Electronic nicotine delivery systems: international tobacco control four-country survey.
abstract: BACKGROUND
  Electronic nicotine delivery systems (ENDS) initially emerged in 2003 and have since become widely available globally, particularly over the Internet.
  
  
  OBJECTIVE
  Data on ENDS usage patterns are limited. The current paper examines patterns of ENDS awareness, use, and product-associated beliefs among current and former smokers in four countries.
  
  
  METHODS
  Data come from Wave 8 of the International Tobacco Control Four-Country Survey, collected July 2010 to June 2011 and analyzed through June 2012. Respondents included 5939 current and former smokers in Canada (n=1581); the U.S. (n=1520); the United Kingdom (UK; n=1325); and Australia (n=1513).
  
  
  RESULTS
  Overall, 46.6% were aware of ENDS (U.S.: 73%, UK: 54%, Canada: 40%, Australia: 20%); 7.6% had tried ENDS (16% of those aware of ENDS); and 2.9% were current users (39% of triers). Awareness of ENDS was higher among younger, non-minority smokers with higher incomes who were heavier smokers. Prevalence of trying ENDS was higher among younger, nondaily smokers with a high income and among those who perceived ENDS as less harmful than traditional cigarettes. Current use was higher among both nondaily and heavy (≥20 cigarettes per day) smokers. In all, 79.8% reported using ENDS because they were considered less harmful than traditional cigarettes; 75.4% stated that they used ENDS to help them reduce their smoking; and 85.1% reported using ENDS to help them quit smoking.
  
  
  CONCLUSIONS
  Awareness of ENDS is high, especially in countries where they are legal (i.e., the U.S. and UK). Because trial was associated with nondaily smoking and a desire to quit smoking, ENDS may have the potential to serve as a cessation aid.
authors: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
authors: Sarah E
authors: SE
authors: Adkison
authors: Richard J
authors: RJ
authors: O'Connor
authors: Maansi
authors: M
authors: Bansal-Travers
authors: Andrew
authors: A
authors: Hyland
authors: Ron
authors: R
authors: Borland
authors: Hua-Hie
authors: HH
authors: Yong
authors: K Michael
authors: KM
authors: Cummings
authors: Ann
authors: A
authors: McNeill
authors: James F
authors: JF
authors: Thrasher
authors: David
authors: D
authors: Hammond
authors: Geoffrey T
authors: GT
authors: Fong
mesh_terms: D000293:Adolescent; D000328:Adult; D019049:Developed Countries; D016503:Drug Delivery Systems / Q000295:instrumentation*; D004581:Electronics / Q000331:legislation & jurisprudence*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007880:Legislation, Drug; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage*; D012907:Smoking / Q000331:legislation & jurisprudence*; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D009538:Nicotine