Electronic Cigarettes

Quitting smoking is the most important step smokers can take to improve their health. Nonetheless, there is little information on long-term improvements in lung function and/or respiratory symptoms after smoking cessation. Here we illustrate long-term changes in spirometric indices as well as in respiratory symptoms in smokers invited to quit or reduce their cigarette consumption by switching to electronic cigarettes (ECs). Prospective evaluation of cigarette consumption, spirometry and symptoms was performed in a 1-year randomized controlled trial of smokers receiving EC containing 2.4%, 1.8% or 0% nicotine. Spirometric data are presented on the basis of participants’ pooled continuous smoking phenotype classification (Quitters, Reducers, Failures), whereas respiratory symptoms on the basis of their point prevalence-smoking phenotype. Smoking phenotype classification (Quitters, Reducers, Failures) had no significant effect on spirometric indices (FEV1, FVC and FEV1/FVC) with the ex...

E-cigarettes have become an integral part of the average teenager's high school life. With the concealability coming from its tiny USB-like shape, with its endless spectrum of available flavors added to the smoke, with its advertisement as a healthier alternative to smoking; there is no wonder e-cigarettes have taken over the lives of many teenagers.

How did e-cigarettes, originally a way to help ease the withdrawal symptoms of long-time smokers, a way to provide a healthier alternative to smoking conventional cigarettes, become a much greater problem that society is currently facing?

The past few weeks witnessed the death of a few people who were smoking electronic cigarettes (ECs) in the United States. Deaths included different age groups, including middle-aged individuals. One of them was a 50‑year‑old woman who had a history of health problems. She became seriously ill shortly after she started using EC and her symptoms progressed rapidly. The US Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and state health departments are investigating this outbreak; however, no definitive cause could be found.

“Hookah,” which is also known as “Narghileh,” “Maassel,”
or “Shisha,” is a form of waterpipe smoking. Hookah is
composed of a tobacco bowl known as the head where tobacco
(that is processed and flavored) is placed, a body, a water bowl,
a hose, and a mouthpiece. Charcoal is positioned on the top
of the head that contains tobacco. When the smoker inhales
through the hose, the air is drawn into and around the charcoal.
The generated heated air passes through heated tobacco to
produce the mainstream smoke aerosol. This smoke aerosol
passes through the water bowl producing bubbles and goes
through the hose to the smoker. The average hookah smoking
session consists of 171 inhalations (each approximately 0.5 L)
of 2.6 s duration at a frequency of 2.8 inhalations/min.

The unconscious mind tends to disregard negations in its processing of semantic meaning. Therefore, messages containing negated concepts can ironically prime mental representations and evaluations that are opposite to those intended. We hypothesized that the subtle presentation of a negated concept (e.g., “no smoking”) would activate ironic motivational orientations as well. We tested this hypothesis in a public health context. Smokers viewed photographs in which no-smoking signs were either inconspicuously embedded (prime) or edited out (control). Primed smokers showed amplified automatic approach tendencies toward smoking-related stimuli, but not toward smoking-unrelated stimuli. Since passive priming effects generally serve to facilitate forms of action, not inhibit them, anti-smoking and other public health campaigns may ironically increase the very behaviors they seek to reduce.

The development of e-cigarettes was initially hailed as a resource in facilitating a reduction in or cessation of cigarette smoking. Many users of e-cigarettes are ‘dual users’, smoking traditional cigarettes and e-cigarettes. The present qualitative study examines the factors that a group of 20 dual users considered to have been influential in their decisions to use e-cigarettes and their comparative evaluations of e-cigarettes and traditional cigarettes. Health concerns were not found to be sole motivators. Participants pointed to financial and contextual considerations, particularly peer influence on uptake and continued usage of e-cigarettes. E-cigarettes were evaluated as comparable to cigarettes in some ways but not in other important respects such as sensation and satisfaction. Different social evaluations of cigarette and e-cigarette usage were discerned which influenced how participants identified as smokers, ‘vapers’ or neither. Findings are discussed in relation to social...

The tobacco industry worldwide has annual revenues of hundreds of billions of dollars, and annual smoking-associated death rates in the millions. Electronic cigarettes appear to be a less harmful alternative to traditional tobacco products, allowing users to inhale nicotine, without consuming the products of burning tobacco (thus significantly lowering health risks). These and similar innovative solutions (like heat-not-burn) have a potentially disruptive impact on existing markets. Both newcomers and established cigarette firms have been active around these alternatives. However, there is debate around the health implications of such products, and in 2019 much alarm around a lung disease associated with vaping. As a result, most countries and international institutions, including the World Health Organization, have adopted negative attitudes towards electronic cigarettes. Do e-cigarettes represent a Trojan Horse that will undermine tobacco control efforts-or are they an effective way to wean users away from cigarettes thus opening the way towards a better future? This paper outlines estimates of the future health impacts of cigarette and e-cigarette use, and considers the broader issues surrounding this potentially disruptive innovation. It points to areas requiring further research and suggests how Foresight studies might address the topic.

How do professions respond to fast-moving technological changes? Disruptive innovations overturn expectations about how markets function and develop, and they often raise moral, legal and scientific concerns among professionals. Sudden technological changes can result in a state of professional disruption, in which technological change challenges the institutional arrangements of a profession. This article distinguishes between fast and slow processes of professional change, focusing on the role of technology as one cause of fast changes to a profession. Professionals and non-professionals engage in framing contests that draw on cognitive, normative and relational keys to signal their expectations. It is in these framing contests that professionals run the risk of disruption. Drawing on interview data with key policy actors, I investigate electronic cigarettes regulation in the European Union and its recent revision to the Tobacco Products Directive. Medical and public health professionals that control tobacco issues were challenged by a coalition of e-cigarette industry representatives, e-cigarette users, and liberal politicians. The challengers drew on the contending norm of harm reduction in tobacco control, which successfully challenged the centrality of the abstinence norm in the institutional arrangements of the medical and public health professions and their organizational field. By discussing the parallels to other related cases in health regulation, I draw out the implications of the study for researchers and policymakers.

ABSTRACT
In recent years, electronic cigarettes have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, little is known about what is their perception and knowledge towards using electronic cigarettes on replacing conventional cigarettes. There is an urgent need for research into these products. First, there is a need to know why and how these products are used based on their perception. The survey took place about two weeks in august 2015 in which this study conducted with a questionnaire form distributed among participants claimed whether they had used e-cigarettes or were currently using them. Data was analyzed by using descriptive statistics from SPSS. Respondents were (41.9% of e-cigarette user and 58.1% using both e-cig and conventional cigarette) lived in section 13 Shah Alam, Selangor. Most respondents (87%) were male; (18%) female. Although, for legal reasons, e-cigarettes are mainly marketed to current smokers either for enjoyment or for use in smoke-free places, these results suggest that most people who buy these products are current and former smokers who use e-cigarettes to help quit smoking which is 74% of the respondent strongly agree that e-cig is a step to quit smoking 83 % of the respondent was also a regular e-cigarette user which in 88 % use it every day (multiple times). The difference between past and present smoker also can be seen among the e-cig user which they are more likely to reduce the intake of conventional cigarette (smoking more than 30 cigarettes a day) 31.4% while after using e-cig (41.9%) stop taking conventional cigarette. Most of the respondent stated that they also experienced some side effects after using e cigarette such as dry eyes (58.1%), dry mouth (56%), decreased appetite (54.3%), headache (41%) and coughing (55.2%). In this study of dedicated e-cig users, it seems that e-cig is used as long-term substitutes to smoking and motivation for using e-cig comes from their perceptions of less harmful potential compared to conventional smoking.

Background: The Philippines has one of the highest cigarette smoking rates in Southeast Asia. Tobacco prevention and control efforts should not be a one-size-fits-all approach. One of the most recent and highly marketed way of cutting down smoking is the use of E-cigarettes. But its use may also have potential harmful effects which would be similar to cigarette smoking. Purpose: This study aimed to determine the factors predicting electronic cigarette use among adults in a large metropolitan area in the Philippines. Methods:The study used a descriptive-correlational multivariate research design. Adults who are at least 18 years of age, who are electronic cigarettes users, dual users (electronic cigarette and cigarette users), and non-smokers were chosen for this study. The researchers utilized a researcher- made questionnaire based on the Theory of Planned Behavior (TPB) in gathering the data. Results: Multiple regression analysis suggests that positive attitude and high perceived b...

To speak of nicotine replacement today is to speak of nicotine replacement therapies (NRTs) used throughout the world in the treatment of smoking conceived as a manifestation of nicotine addiction. However, I wish to discuss how the logic of nicotine replacement has never been purely a question of therapeutic innovation. By returning to the Swedish birth of NRTs at the end of the 1960s and the original entrepreneurial vision of Nicorette as the delivery of nicotine (nico-) in the right (rette) way I wish to show how things could so easily have been different in the development of nicotine chewing gum as the first NRT. Drawing on a range of sources, including material from the historical archives of the Helsingborg-based pharmaceutical company that brought Nicorette® chewing gum into the world, I wish to discuss how the political and technological tensions inherent in the governmental logic of nicotine replacement have continually pulled new replacement technologies in different directions.

Background and aims
The rapid increase in use of electronic cigarettes (e-cigarettes) has created an international policy dilemma concerning how to use these products. This study assesses the types of beliefs that e-cigarette users in the UK may hold concerning regulation.
Design
Qualitative thematic analysis of written answers to open-ended questions.
Setting
UK, questionnaire conducted by post, 44% recruited from online forums/56% non-online.
Participants
Fifty-five UK vapers, 55% male, mean age 46, 84% sole users of e-cigarettes, 95% vaping daily.
Measurements
Open-ended questions on regulatory and policy options.
Findings
‘Protecting youth’ was seen as a fundamental regulatory requirement which should be achieved through childproofing, age limits, no advertising aimed at children and health warnings about addictiveness of nicotine, but not the restriction of flavours. There was little support for regulating e-cigarettes as medicines or limiting the strength of nicotine liquids. In terms of public use, participants argued against a blanket ban on public vaping given perceptions of a lack of scientific evidence of harm. However, they supported the principle of autonomy, that individuals and organizations have the right to restrict vaping. Some participants suggested banning vaping in places such as schools, hospitals or around food, in line with current smoking norms. Vapers’ regulatory positions were accompanied by political concerns about the use (and misuse) of scientific evidence.
Conclusions
With regard to regulation of e-cigarettes, issues that are salient to UK vapers may include the need for youth protection, regulation as medicines, strength of e-liquids, bans on public vaping and concerns about the misuse of scientific evidence.

Abstract
Background: The aim of this study was to identify and differentiate socially shared accounts of e-cigarette use (vaping) using Q-methodology, combining factor analysis with qualitative comments.
Methods: Seventy statements on e-cigarettes, drawn from media, academic and online discussions, were sorted by participants along a continuum of agreement/disagreement, commenting on strongly ranked items. Each participant thus created their own ‘account’ of their vaping. A by-person correlation matrix of the sorts was conducted, then factor analysed, to identify similar accounts (p<0.01). Fifty-five UK vapers participated by post, 55% male, mean age of 46, 84% only vaping/16% vaping and smoking, 95% vaping daily.
Results: Three accounts of e-cigarettes were identified. The first two were associated with having quit smoking; the third with ongoing tobacco smoking and vaping. In Factor One, ‘Vaping as Pleasure’, vaping was characterized as enjoyable, with long-term use envisaged and a medical model of vaping rejected. Factor One participants also held a strong vaping identity and were politically motivated to maintain the rights of adults to vape. In Factor Two, ‘Vaping as Medical Treatment’, vaping was understood as a pragmatic choice about how to medicate one’s smoking addiction, with the aim being to treat and ultimately reduce nicotine dependence. In Factor Three, ‘Ambivalent E-Cigarette Use’, participants reported fewer benefits and harboured more negative beliefs about e-cigarettes; they also strongly rejected a vaper identity, having no interest in online forums or being labelled a ‘vaper’ themselves.
Conclusion: The UK e-cigarette users in this sample were not a homogeneous group; differing in their beliefs, motivations for use, identity and political interest. In particular they diverged on whether they accepted a medicalized account of vaping and identified as a vaper. Public health messages targeted to one group of e-cigarette users may not resonate with others.

The popularity of e-cigarettes has soared over the last decade. At the last count, over three million adults use e-cigarettes in the UK. Such spurt in popularity has to do with these cigarettes being a less harmful and viable alternative to conventional tobacco based cigarettes.

Introduction: The use of electronic cigarettes has increased rapidly around the world, but the situation was unknown in Bangladesh. For that, the aim of this study was to measures the prevalence of Electronic Cigarettes. Methods: A cross-sectional study was made among university students. An online survey with questions on smoking habits, the experience of e-cigarettes, availability, and attitudes toward 408 respondents Results: The results of the study showed that 31.27 % of respondents were familiar with e-cigarettes and had taken it at least once in their lives, 29.31% said it was readily available in their area and a significant portion of respondents (63.05%) said they did not know of any harmful or beneficial effects. Although 35.48% of the respondents said that smoking e-cigarettes have caused them to become addicted to themselves or the people around them. Conclusion: It undoubtedly gives us a terrible message that E-cigarettes have penetrated in our young generation Whether it is moving in the right direction or not is a matter of research. It can be explored through in-depth studies. Keyword: Electronic cigarettes, Prevalence, University student, Bangladesh Implications: The Department of Narcotics Control is the regulatory body of the Government of Bangladesh. The influx of new drugs and its level of impact on the people is useful information for them. Also, for researchers who want to work in this field, this study may be generate an idea and future direction. I. INTRODUCTION Electronic cigarette (e-cigarette) is one type of electronic nicotine delivery systems (ENDS) that emits a vaporized solution to inhale. It is a battery-powered gadget that operates by heating a liquid into an aerosol that the user inhales and exhales. 1-3. The liquid typically comprises nicotine, propylene glycol, glycerin, flavorings, and other chemicals. It is a new class of electronic nicotine delivery system, introduced in 2004. 2,4,5 The global market for e-cigarettes was worth $15.7 billion in 2018, according to data from Euromonitor International, and is projected to more than double to $40 billion in 2023. 6 Many researchers and public health experts have acknowledged that ENDS are less dangerous than conventional cigarettes because they do not contain more than 60 well-established carcinogens like polycyclic aromatic hydrocarbons, N-nitrosamines, aromatic amines, aldehydes, and metals, but research into the harms that e-cigarette ingredients can do to the human body is still underway. 7-9 In a recent World Health Organization report, Global Tobacco Epidemic-2019, it has identified the e-cigarette as harmful for health. 10 Commercially available e-cigarettes are marketed with different levels of nicotine, and the distribution of inhaled levels have remained unclear. 11,12 E-cigarettes require higher levels of suction to smoke than conventional cigarettes, and the amount and density of aerosol produced by e-cigarettes diminish progressively as puffs are taken. The total level of nicotine in 15 puffs of vapor generated e-cigarettes by an automatic smoking machine varied from 0.5 to 15.4 mg whereas the typical level of nicotine from one smoked conventional cigarette ranges from 1.54 to 2.60 mg. A review of various research articles shows that young people in developed countries like Europe and America are more inclined towards these. 13,14 Research by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) in the USA has found that the use of electronic tobacco products among school-going teens increased by 78% in the last one year. 15,16 The results of their research give us an indication of an alarming situation. Since Bangladesh's culture is influenced by the western countries and it is much more especially observed among the young society. The country currently has no proper statistics on how many people are consuming e-cigarettes and heated tobacco products. DHAKA

NM, Jamalludin AR, et al. Prevalence and characteristics of e-cigarette users among Malaysian current and ex-smokers. Abstract Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of this study was to determine the prevalence of EC use and the socio-demographic and smoking characteristics associated with current EC use among Malaysian current and ex-smokers. Methods: This was a sub-analysis of data from a cross-sectional, national-population-based EC study conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396 individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers. Results: Current EC use was found predominantly among current smokers (8.0%) as compared with ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking (10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001), urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11, 95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among ex-smokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030). Conclusion: This study showed that currently using and ever having used ECs were more prevalent among current smokers. The reasons given for initiating EC use among current smokers were mainly wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence groups.

OBJECTIVE:  Vaping has been marketed as a “safe” or “safer” alternative to smoking.  It has become a very lucrative market and has experienced a surge of interest, especially among the younger generations.  There are many who theorize that there is a health benefit in switching from smoking to vaping, and numerous studies seem to corroborated this.  However, few studies have gone into any depth on the possible harmful effects that vaping can have on individuals.  This paper reviews three studies that were designed to analyze the possible harmful effects of vaping.

DESIGN: Case based, multi-study review of three randomized control trials.

METHODS:  Keyword searches performed in Scopus, TRIP Database, and PubMed to find up-to-date information and clinical trials.

RESULTS: Review of three randomized control trials reveals that at present there is still not sufficient information to determine the unique harms and health risks posed by vaping.  Present evidence, at best, is inconclusive.

Background: Public health leadership in England has taken a distinctive international stance by identifying the potential public health benefit of e-cigarettes for smoking cessation. This includes the development of a groundbreaking set of national guidelines for developing e-cigarette friendly stop smoking services. However, little is known about the views of staff engaged within these services and whether or how such services are becoming e-cigarette friendly. This study aimed to investigate the uptake and usage of e-cigarette guidance, from the perspective of those enacting tobacco cessation interventions 'on the ground'. Methods: Qualitative semi-structured interviews were conducted with 25 cessation service staff, including advisors (n = 15), managers (n = 5) and commissioners (n = 5) from eight different services in the SouthWest of England, UK. A thematic analysis of the transcripts was conducted using NVivo software.

Background: As the use of electronic cigarettes (e-cigarettes) rises, social media likely influences public awareness and perception of this emerging tobacco product.
Objective: This study examined the public conversation on Twitter to determine overarching themes and insights for trending topics from commercial and consumer users.
Methods: Text mining uncovered key patterns and important topics for e-cigarettes on Twitter. SAS Text Miner 12.1 software (SAS Institute Inc) was used for descriptive text mining to reveal the primary topics from tweets collected from March 24, 2015, to July 3, 2015, using a Python script in conjunction with Twitter’s streaming application programming interface. A total of 18 keywords related to e-cigarettes were used and resulted in a total of 872,544 tweets that were sorted into overarching themes through a text topic node for tweets (126,127) and retweets (114,451) that represented more than 1% of the conversation.
Results: While some of the final themes were marketing-focused, many topics represented diverse proponent and user conversations that included discussion of policies, personal experiences, and the differentiation of e-cigarettes from traditional tobacco, often by pointing to the lack of evidence for the harm or risks of e-cigarettes or taking the position that e-cigarettes should be promoted as smoking cessation devices.
Conclusions: These findings reveal that unique, large-scale public conversations are occurring on Twitter alongside e-cigarette advertising and promotion. Proponents and users are turning to social media to share knowledge, experience, and questions about e-cigarette use. Future research should focus on these unique conversations to understand how they influence attitudes towards and use of e-cigarettes.

The health risks associated with electronic cigarettes (ECs) are largely unknown. The purpose of this systematic review was to evaluate published case reports that deal with health effects attributed to EC use. An Internet search was conducted to identify case reports dealing with the effects of EC use on health. Twenty-six case reports representing 27 individuals (one study contained reports for two individuals) were published between April 2012 and January 2016, and these were grouped into categories of effect according to their health outcomes.

Of the 27 individuals, 25 had negative effects subsequent to use or exposure to ECs and their refill fluids, while two reported improvement in chronic immune and gastrointestinal conditions. Three categories of negative health effects were identified: systemic effects, nicotine poisoning, and mechanical injury. Thirteen cases reported EC effects on different systems including: respiratory (6), gastrointestinal or developing intestine of an infant (3), cardiovascular (2), neurological (1), and immune (1). Twelve cases involved nicotine poisoning resulting from accidental (N = 3), misuse/abuse (N = 1), or suicidal/intentional ingestion (N = 8); four of these involved children and three resulted in adult fatalities. Two cases reported mechanical injury caused by an EC battery explosion. Most case reports show that the health of children and adults can be negatively affected by EC products and that if death does not occur, negative effects can be reversed. Data further indicate that EC use can cause negative health effects in previously healthy individuals and exacerbate pre-existing conditions.

Background: E-cigarettes are currently hotly debated as threatening to re-normalize cigarette smokingand make nicotine addiction publicly acceptable once more. In this paper I contextualize the e-cigarette controversy in light of longstanding disagreements about the meaning and significance of nicotine replacement technologies. A concerted effort to develop such technologies first emerged in Sweden at theend of the 1960s, embodying a vital tension. Two competing ‘scripts’ vied to influence and shape inno-vative designs. On the one hand, Nicorette chewing gum was conceived as a therapeutic device aidingsmoking cessation. On the other hand, it was cast as a cigarette substitute designed to deliver nicotine ‘inthe right way’, thereby advancing the creative destruction of the combustible cigarette as a drug delivery platform. Method: Drawing on historical and archival research I outline how these two alternative innovation scripts started out entangled with each other before becoming disentangled, leading to the eventual stabilization of Nicorette gum as a therapeutic product to be deployed in the treatment of smoking as adependence disorder. Results and Conclusion: While a post-therapeutic future for nicotine replacement was charted by Michael Russell at the beginning of the 1990s, it is only with the rise of e-cigarettes after 2003 that such a futurehas started to verge on reality. E-cigarettes can be seen as resurrecting the historically marginalized script of nicotine replacement as dedicated to righting nicotine consumption and freeing it from the wrongful drug delivery of the modern cigarette.

In Norway, low-nitrosamine smokeless tobacco (snus) is allowed to compete with cigarettes for market share. We aimed to study how the availability of snus influenced overall tobacco consumption, smoking initiation and smoking cessation. We discuss whether the Norwegian experience with snus can have any transfer value for e-cigarettes. We analysed consumption data from registered and unregistered supply sources of tobacco. We calculated quit-smoking ratios across snus use status in nine datasets comprising a total of 19,269 ever-smokers. Trends in snus use and smoking were derived from time-series of annual; cross-sectional; nationally representative surveys for the period 1985-2013. The market share for snus increased from 4% in 1985 to 28% in 2012, but overall tobacco consumption decreased by 20.3% over this same period. Snus was the most common method for smoking cessation. Compared with smokers with no experience of using snus, the quit ratio for smoking was significantly higher ...

Electronic cigarettes (e-cigarettes) are battery-powered devices that deliver a heated aerosol, which typically contains nicotine, flavorings, and other additives, to the user. The e-cigarette marketplace is rapidly evolving, but the long-term health effects of these products are not known. Carcinogens and toxins such as diacetyl, acetaldehyde, and other harmful chemicals have been documented in the aerosol from some e-cigarettes (1-3). On May 5, 2016, the Food and Drug Administration (FDA) finalized a rule extending its authority to all tobacco products, including e-cigarettes.* The prevalence of e-cigarette use among U.S. adults has increased in recent years, particularly among current and former conventional cigarette smokers (4); in 2014, 3.7% of all U.S. adults, including 15.9% of current cigarette smokers, and 22.0% of former cigarette smokers, used e-cigarettes every day or some days (5). The extent of current e-cigarette use among U.S. working adults has not been assessed. T...

Objective: The aim of this study was to evaluate the electronic cigarette use characteristics of the society and attitude towards e-cigarette. Method: This is a cross-sectional field study conducted face to face in Izmir. The sample size was calculated as 369. 7 districts were determined by lot method. 353 volunteers were reached. The questionnaire form prepared by the researchers was filled out. Results: 19% of the participants declared that they used e-cigarette at least once in their lifetime. In the attitude towards e-cigarettes, smoking characteristics, information source, social environment and perspective are seen as determinants. Gender specific features did not differ in attitude towards e-cigarette. Just, women think that e-cigarettes cause passive smoking compared to men. People who use e-cigarettes think e-cigarette is less harmful than traditional cigarette. E-cigarette is preferred more frequently by people who use traditional cigarette, especially dual use comes to the fore. Another situation is that, those who quit smoking prefer e-cigarettes. Because e-cigarettes are seen as an alternative to get rid of cigarette addiction. Conclusion: The results of research are expected to guide the shaping of the community's attitude towards e-cigarettes, preventive activities and treatment services to be planned for the society. I ÖZ Amaç: Bu çalışmada İzmir'de elektronik sigara (e-sigara) kullanım özelliklerinin ve tutumunun değerlendirilmesi amaçlanmıştır. Yöntem: İzmir'de yüz yüze yapılan kesitsel bir alan araştırmasıdır. Örneklem büyüklüğü 369 olarak hesaplanmıştır. Kura yöntemi ile 7 ilçe belirlenmiştir. Alanda gönüllü olan 353 kişiye ulaşılmıştır. Araştırmacılar tarafından hazırlanan anket formu doldurtulmuştur. Bulgular: Katılımcıların %19'u yaşamı boyunca en az bir kere e-sigara kullandığını beyan etmiştir. E-sigaraya yönelik tutumda sigara kullanım özellikleri, bilgi kaynağı, sosyal çevre ve bakış açısının belirleyici olduğu görülmektedir. E-sigaraya yönelik tutumda cinsiyete özgü özellikler farklılık yaratmamıştır. Sadece, kadınlar, erkeklere göre e-sigaranın pasif içiciliğe yol açtığını daha fazla düşündüğünü ifade etmiştir. E-sigara kullanan kişiler, e-sigaranın geleneksel sigaraya göre daha az zararlı olduğunu düşünmektedir. E-sigara, geleneksel sigarayı kullanan kişilerce daha sık tercih edilmekte, özellikle ikili kullanım ön plana çıkmaktadır. Bir diğer durum ise, sigarayı bırakanların e-sigarayı tercih etmesidir. Çünkü e-sigara, sigara bağımlılığından kurtulmada bir alternatif olarak görülmektedir. Sonuç: Araştırma sonuçlarının, e-sigara konusunda topluma yönelik planlanacak koruyucu faaliyetlere ve tedavi hizmetlerine rehberlik etmesi beklenmektedir.

Celebrities endorsing e-cigarette brands on social media may exert a strong influence on e-cigarette uptake. Using a between-subject experiment, this study examines the effects of endorser type (celebrities, non- celebrities and products only) in e-cigarette brand Instagram advertisements on e-cigarette attitudes and smoking intentions. Results showed that celebrity endorsers significantly increased positive attitudes towards e-cigarettes and smoking intentions, compared to non-celebrities or products only. Celebrity endorsers also rated significantly higher on trustworthiness, expertise, goodwill and attractiveness, compared to non- celebrities. Additionally, identification, social comparison, health consciousness and social networking site use moderated between endorser type and key dependent measures. Implications for e-cigarette marketing regulation are discussed.

Electronic cigarettes (e-cigarettes) are growing in popularity among young smokers in France seeking to reduce tobacco-induced harms without abandoning the small everyday pleasures and social relationships that unfold around smoking. But e-cigarettes raise ideological challenges: The World Health Organization and the French Agency for Safety of Medicine and Health Products (Agence Nationale de Sécurité du Médicament) have denied e-cigarettes the status of pharmaceutical substitution products in the cessation of smoking, while their possibilities for pleasure are seen as a threat by France’s public health council, the Haut Conseil de Santé Public. This paper discusses how different actors (policy makers, tobacco companies, and users themselves) have embraced this new technology. I argue that e-cigarettes have become a valued form of substitution precisely because they provide occasions for social bonding, gustatory pleasure, and the non-medicalized management of health with endless possibilities for individualized tailoring.

Background

Electronic cigarettes (e-cigarettes) are battery-powered devices that vaporize a liquid solution to deliver a dose of inhaled nicotine to the user. There is ongoing debate regarding their regulation.
Objectives

This comprehensive narrative review aimed to discuss key issues including usage patterns, health effects, efficacy in smoking cessation and regulatory concerns with a view to informing future regulation and research agendas.
Methods

PubMed, Scopus and Web of Science databases were searched using the terms (electronic cigarettes OR e-cigarettes) for articles in English, relevant to humans and published during January 2009-January 2014.
Results

The literature search revealed 37 relevant articles. Findings suggest that e-cigarettes are mostly used by middle-aged current smokers, particularly males, to help them for quitting or for recreation. E-cigarettes contain very low levels of multiple toxic substances such as formaldehyde and acrolein, but these levels are many times lower than those found in cigarettes. They were found to have effectiveness in aiding smoking cessation to a limited degree. Debate continues regarding regulating their use for cessation versus heavy restrictions to control recreational use on the basis that it perpetuates nicotine addiction.
Conclusions

The cytotoxicity and long term health effects of e-cigarettes are unknown. Nevertheless the e-cigarette market continues to expand, largely driven by middle-aged smokers who claim to be using e-cigarettes in an attempt to reduce or quit smoking. E-cigarettes may have some potential as smoking cessation aids and, in the researchers? view, should therefore be subject to further research and regulation similar to other nicotine replacement therapies.
The complete article is available as a provisional PDF. T