Usage of electronic cigarettes

Since the introduction of electronic cigarettes to the market in 2003,[1]  their global usage has risen exponentially.[2]  By 2013, there were several million users globally.[3]  Awareness and use of e-cigarettes greatly increased over the few years leading up to 2014, particularly among young people and women in some parts of the world.[4]  Vaping is increasing in the majority of high-income countries.[5]  E-cigarette use in the US and Europe is higher than in other countries,[6]  except for China which has the greatest number of e-cigarette users.[7] Growth in the UK as of January 2018 had reportedly slowed since 2013.[8]  The growing frequency of e-cigarette use may be due to heavy promotion in youth-driven media channels, their low cost, and the misbelief that e-cigarettes are safer than traditional cigarettes, according to a 2016 review.[9]

The prevalence of vaping among adolescents is increasing worldwide.[10]  There is substantial variability in vaping in youth worldwide across countries.[11]  Over the years leading up to 2017 vaping among adolescents has grown every year since these devices were first introduced to the market.[12]  There appears to be an increase of one-time e-cigarette use among young people worldwide.[13]  Most e-cigarette users among youth have never smoked.[14]  Many youth who use e-cigarettes also smoke traditional cigarettes.[15]  Vaping seems to be a gateway to using traditional cigarettes in adolescents.[16]  Youth who use e-cigarettes are more likely to go on to use traditional cigarettes.<sup id="cite_ref-SGUSFactSheet2016_17-0">[17] <sup id="cite_ref-FOOTNOTEStratton2018Summary,_16_18-0">[18]  The evidence suggests that young people who vape are also at greater risk for subsequent long-term tobacco use.<sup id="cite_ref-ACS2018_19-0">[19]  E-cigarettes are expanding the nicotine market by attracting low-risk youth who would be unlikely to initiate nicotine use with traditional cigarettes.<sup id="cite_ref-GlantzBareham2018_20-0">[20]  Adolescents were more likely to initiate vaping through flavored e-cigarettes.<sup id="cite_ref-Cormet-BoyakaZare2018_21-0">[21]

There are varied reasons for e-cigarette use.<sup id="cite_ref-Rahman2014_6-1">[6]  Most users' motivation is related to trying to quit smoking, but a large proportion of use is recreational.<sup id="cite_ref-Rahman2014_6-2">[6]  Adults cite predominantly three reasons for trying and using e-cigarettes: as an aid to smoking cessation, as a safer alternative to traditional cigarettes, and as a way to conveniently get around smoke-free laws.<sup id="cite_ref-GlantzBareham2018_20-1">[20]  Many users vape because they believe it is healthier than smoking for themselves or bystanders.<sup id="cite_ref-Pepper2013_22-0">[22]  Usually, only a small proportion of users are concerned about the potential adverse health effects.<sup id="cite_ref-Pepper2013_22-1">[22]  Seniors seem to vape to quit smoking or to get around smoke‐free policies.<sup id="cite_ref-QasimKarim2017_23-0">[23]  There appears to be a hereditary component to tobacco use, which probably plays a part in transitioning of e-cigarette use from experimentation to routine use.<sup id="cite_ref-Weaver2014_24-0">[24]  The introduction of e-cigarettes has given cannabis smokers a different way of inhaling cannabinoids.<sup id="cite_ref-Giroudde2015_25-0">[25]  Recreational cannabis users can individually "vape" deodorized or flavored cannabis extracts with minimal annoyance to the people around them and less chance of detection, known as "stealth vaping".