Americans' Perceptions of Electronic Cigarette, Use Experience and Use Intention

This study aimed to understand Americans’ perceptions of E-cigarette in relation to the past use experience and future use intention. A national sample of 470 Americans was collected through an online survey. Participants responded to a battery of questions about E-cigarette consequences/benefits and typed up additional qualitative comments. The results indicated that over a third of the participants were ambivalent about health consequences/benefits of E-cigarettes. Mexican-Americans faced the highest risk of having tried E-cigarette and intending to use it in the future, followed by Asian Americans, European Americans and lastly, African Americans. Logistic regression indicated that individuals who had used traditional cigarette were 1.5 times more likely to have used E-cigarette compared to never smokers of traditional cigarette. Individuals were more likely to have tried E-cigarette if they were young, perceived E-cigarette as containing no toxin, not risky, tasting good, and smelling better than traditional cigarette. Past use of E-cigarette was the strongest predictor of future E-cigarette use intention. Among these who had experience with E-cigarette, they were more likely to intend to use it when they had high income, perceived E-cigarette as containing no toxin, healthier than traditional cigarette, and helpful for quitting traditional cigarette smoking. Qualitative data indicated that although some current traditional cigarette smokers used E-cigarette to help quit, many used E-cigarette as a substitute for traditional cigarette or ended up using both at the same time, implying the potential adverse effect of E-cigarette despite its advertised benefits for quitting traditional cigarette. The negative views of traditional cigarette seemed to carry over to E-cigarette among nonsmoker and former smokers of traditional cigarette that most responded that “smoking is smoking” and suggested banning E-cigarette. However, many occasional smokers perceived E-cigarette to be “safe”, “cool” and “enjoyable” and indicated frequent current use and high future use intention. It is possible that the advertisement on and social acceptance of E-cigarette are contributing to the formation a new smoker group of E-cigarette. Overall, it is concluded that there is sizable public ambiguity about E-cigarette and the implication for prevention programs to educate American public about E-cigarette is great.