title: Country-level correlates of e-cigarette use in the European Union.
abstract: OBJECTIVE
  The aim of this study was to assess the relationship between the prevalence of e-cigarette use and country-level factors across 28 European countries.
  
  
  METHODS
  The study objectives were addressed in an ecological design in which both exposures and outcomes were measured at the country level. Data from the Eurobarometer Report, the Eurostat database and the WHO observatory were analyzed. Bivariate and multivariate analyses were performed considering the rates of current and ever smokers of e-cigarettes as dependent variables, and socio-economic factors, health status and policies against tobacco as independent variables.
  
  
  RESULTS
  Both the rate of current smokers and ever smokers of e-cigarette were positively associated to the offer of help to quit tobacco use (P < 0.01; P = 0.04) and to the raise of taxes on tobacco (P = 0.01; P = 0.01). The warn on dangers of tobacco negatively correlated with the rate of e-cigarette current smokers. The rate of current e-cigarette smokers correlated with the rate of current smokers and with national Gross Domestic Product, while the rate of ever e-cigarette smokers did not correlate with any socio-economic factor.
  
  
  CONCLUSIONS
  Our analysis suggests that both policy and non-policy factors are associated with the geographical variability seen in the prevalence of e-cigarette use. Policies against the consumption of conventional tobacco products may lead to an increase of e-cigarette smokers.
authors.affiliation: Department of Public Health and Infectious diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Torre
authors.affiliation: Department of Public Health and Infectious diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy. daniele.mipatrini@uniroma1.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Mipatrini
mesh_terms: D000328:Adult; D016208:Databases, Factual; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods; D012923:Social Class
keywords: Europe; Smoking cessation; Tobacco policy; e-Cigarette