E-cigarette usage and reasons for use among a representative sample of the general population in France

Introduction The use of Electronic Cigarettes (ECs) is the subject of scientific controversies, in particular, because of the lack of data on its smoking cessation effectiveness, health impact and users’ trajectory. In France, the High Council of Public Health 1 has called for caution in its use although it has been steadily increasing since 2016 2 . What is the situation in 2021 in France regarding its prevalence and the reasons for using it? Material and Methods The Cancer Barometer (INCa and SpFrance) is a cross-sectional phone-administered survey conducted in a representative sample of the general population in France in 2021 (n=4938). ECs usage was measured on the basis of awareness, the experience of use, and current use. Participants were asked to specify their usage motivations (to reduce tobacco consumption; to stop smoking; to replace tobacco but without the intention of stopping; or other). Descriptive analyses and multinomial logistic regressions were conducted to identify socio-demographic determinants of trying EC. Results In this sample, 99.6% of respondents were aware of ECs, 36.9% had ever used them, 7.5% considered themselves current users, and 29.5% were former users. Women were less likely to have tried ECs (OR = 0.82 [0.68-0.98]). Participants under age 55 (notably, 15-24, OR= 21.19 [14.25-31.51]; 25-34, OR=8.51 [6.36-11.40]), unemployed persons (OR= 0.73 [0.58-0.90]), urban-based residents (OR=1.24 [1.02-1.51]), current smokers (OR=75.80 [56.35-101.95]), and daily smokers (OR=27.72 [19.80-38.82]) were more likely to have previously tried ECs. Being a current user of EC (n=308) was associated with age, being employed, the level of diploma and tobacco use status (p<0,001). Among them, the most commonly cited reasons for use were to stop combustible cigarettes (CCs, 48%), to replace CCs but without the intention of stopping (21.5%), and to reduce CCs (16.7%). In addition, 13,5% mentioned other reasons, notably for recreational purposes or to avoid certain disadvantages of smoking. Conclusions This study confirms the current increase in the prevalence of vaping observed in France, which is greater compared to other European countries; and some sociodemographic characteristics associated whit an EC attempt. Finally, our results show that the main reason to currently use EC is quitting smoking.